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Takahashi H, An M, Sasai T, Seki M, Matsumura T, Ogawa Y, Matsushima K, Tabata A, Kato T. The effectiveness of dance movement therapy for individuals with Down syndrome: a pilot randomised controlled trial. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:640-654. [PMID: 37066677 DOI: 10.1111/jir.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/26/2023] [Accepted: 03/25/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Individuals with Down syndrome (DS) exhibit deficits in static and dynamic balance abilities and maladaptive functions. This study aimed to determine the effectiveness of dance movement therapy (DMT) group intervention in individuals with DS. METHODS The 31 participating individuals with DS, aged 5-29 years, were randomly divided into intervention (n = 16) and control (n = 15) groups. Posturography was used for static balance measurement, timed up and go test for dynamic balance measurement and the Achenbach System of Empirically Based Assessment (ASEBA) questionnaire for adaptive function and behavioural problem measurement in participants before and after the DMT interventions. The intervention group underwent 60-min DMT intervention once a week for 10 times, while the control group had usual daily activities. RESULTS The results revealed a statistically significant difference and large effect sizes in dynamic balance [(f(1, 29) = 4.52, P = 0.04, ηp 2 = 0.14)] in the intervention group compared with the control group. There were no statistically significant differences in static balance and ASEBA scores between the groups. CONCLUSIONS This study found that the DMT interventions helped to improve the dynamic balance in individuals with DS.
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Affiliation(s)
- H Takahashi
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - M An
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - T Sasai
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - M Seki
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - T Matsumura
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - Y Ogawa
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - K Matsushima
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - A Tabata
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - T Kato
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
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Wiffen J, Mah E. Determining functional outcomes after resection and reconstruction of primary soft tissue sarcoma in the lower extremity: A review of current subjective and objective measurement systems. J Surg Oncol 2023; 127:862-870. [PMID: 36683344 DOI: 10.1002/jso.27202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/27/2022] [Accepted: 01/02/2023] [Indexed: 01/24/2023]
Abstract
The surgical management of soft-tissue sarcoma has evolved significantly over the last two decades due to the routine use of adjunct therapies, with an increased focus on postoperative functional outcome. The literature suffers from methodological inconsistency and use of low quality outcome measures to assess an already heterogeneous population. This article aims to review the most frequently used subjective and objective methods of functional outcome assessment and highlight the current benefits and limitations of these.
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Affiliation(s)
- James Wiffen
- St Vincent's Hospital, The University of Melbourne, Melbourne, Australia
| | - Eldon Mah
- Department of Plastic & Reconstructive Surgery, St Vincent's Hospital, Melbourne, Australia
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Gu X, Ricketts S, Mah E. Functional outcomes after single quadriceps muscle resection in patients with soft tissue sarcoma of the anterior compartment of the thigh. ANZ J Surg 2023; 93:288-293. [PMID: 36511137 DOI: 10.1111/ans.18205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 11/22/2022] [Accepted: 12/04/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Soft tissue sarcoma (STS) occurs most commonly in the anterior compartment of the thigh. Limb salvage surgery is the mainstay of treatment, however, resections frequently involve muscle sacrifice. This study determines the impact of a single quadriceps muscle sacrifice on daily living functions. This is to assist clinical decision-making relating to when a functional reconstruction should be offered over simple soft tissue coverage for these defects. METHODS Patients who underwent single quadriceps resection as part of the management of STS between 2010 and 2020 were selected. Three functional tests were performed: Time Up and Go (TUG), Timed Up and Down Stairs (TUDS) and Toronto Extremity Salvage Score (TESS). The results were compared with age/sex matched healthy reference values and literature cohorts of lower limb STS patients. Correlations between the tests and age and follow-up duration were determined by the Spearman's test. RESULTS The mean TESS, TUG and TUDS results of the 13 patients were 89.6%, 9.8 and 1.01 s/step, respectively. These scores were either similar or significantly better than the comparator values. The TESS score showed no statistical significance compared with patients with no muscle resection. TUG and TUDS scores showed significant positive correlation with each other (ρ = 0.885, P = <0.01) and with age (ρ = 0.646, P = 0.017 and ρ = 0.567, P = 0.043, respectively). CONCLUSION This is the largest documented case series of single quadriceps resection for STS. The study suggests that this group of patients does not show a functional deficit and therefore does not require functional reconstruction.
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Affiliation(s)
- Xinchen Gu
- Department of Plastic and Reconstructive Surgery, St Vincent's Hospital, Parade Fitzroy, Victoria, Australia.,Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Sophie Ricketts
- Department of Plastic and Reconstructive Surgery, St Vincent's Hospital, Parade Fitzroy, Victoria, Australia
| | - Eldon Mah
- Department of Plastic and Reconstructive Surgery, St Vincent's Hospital, Parade Fitzroy, Victoria, Australia
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Cha HS, Lee HK, Park SH, Nam MJ. Acetylshikonin induces apoptosis of human osteosarcoma U2OS cells by triggering ROS-dependent multiple signal pathways. Toxicol In Vitro 2022; 86:105521. [DOI: 10.1016/j.tiv.2022.105521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/18/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022]
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Effectiveness of Dance/Movement Therapy Intervention for Children with Intellectual Disability at an Early Childhood Special Education Preschool. AMERICAN JOURNAL OF DANCE THERAPY 2022. [DOI: 10.1007/s10465-022-09356-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Söntgerath R, Däggelmann J, Kesting SV, Rueegg CS, Wittke TC, Reich S, Eckert KG, Stoessel S, Chamorro-Viña C, Wiskemann J, Wright P, Senn-Malashonak A, Oschwald V, Till AM, Götte M. Physical and functional performance assessment in pediatric oncology: a systematic review. Pediatr Res 2022; 91:743-756. [PMID: 33859367 PMCID: PMC9064803 DOI: 10.1038/s41390-021-01523-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/26/2021] [Accepted: 03/29/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Research indicates reduced physical performance from diagnosis into survivorship of pediatric cancer patients. However, there is no systematic information or guideline available on the methods to assess physical performance and function in this population. The purpose was to systematically compile and describe assessments of physical performance and function in patients and survivors of pediatric cancer, including cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait and motor performance test batteries. METHODS We searched the databases PubMed, SPORTDiscus, and Cochrane Database and performed abstract and full-text selection of 2619 articles according to the Cochrane Handbook of Systematic Reviews. Information on patients characteristics, assessments, information on validity and reliability, and relevant references was extracted. RESULTS In summary, 63 different assessments were found in 149 studies including 11639 participants. Most studies evaluated cardiorespiratory fitness and muscle strength with the majority conducted off treatment. Some outcomes (e.g. speed) and diagnoses (e.g. neuroblastoma) were severely underrepresented. With the exception of gait, leukemia patients represented the largest group of individuals tested. CONCLUSIONS Insufficient data and patient heterogeneity complicate uniform recommendations for assessments. Our results support researchers and practitioners in selecting appropriate assessment to meet their specific research questions or individual daily practice needs. IMPACT This systematic review includes 149 studies and provides a comprehensive summary of 63 assessments to evaluate cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait or motor performance test batteries in patients and survivors of pediatric cancer. We present the most studied fields within the pediatric cancer population, which are cardiorespiratory fitness and muscle strength, off treatment phase, and leukemia patients. We propose research priorities by identification of subgroups in terms of cancer type, phase of treatment, and outcome of interest that are underrepresented in studies currently available.
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Affiliation(s)
- Regine Söntgerath
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - Julia Däggelmann
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Sabine V Kesting
- Institute of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- Kinderklinik München Schwabing, TUM School of Medicine, Department of Pediatrics and Children's Cancer Research Center, Technical University of Munich, Munich, Germany
| | - Corina S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | | | - Simon Reich
- Working Group Exercise Oncology Division of Medical Oncology, University Clinic Heidelberg and National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Katharina G Eckert
- Department of Health Management & Public Health, IST University of Applied Sciences Düsseldorf, Düsseldorf, Germany
| | - Sandra Stoessel
- Center for Pediatric and Adolescent Medicine, Childhood Cancer Center, University Medical Center Mainz, Mainz, Germany
| | | | - Joachim Wiskemann
- Working Group Exercise Oncology Division of Medical Oncology, University Clinic Heidelberg and National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Peter Wright
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford, UK
| | - Anna Senn-Malashonak
- Department of Pediatric Oncology, Hematology and Hemostaseology, Goethe University Clinic Frankfurt, Frankfurt am Main, Frankfurt, Germany
| | - Vanessa Oschwald
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Anne-Marie Till
- Department of Pediatric Hematology and Oncology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Miriam Götte
- Department of Pediatric Hematology and Oncology, University Hospital Essen, Pediatrics III, Essen, Germany.
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Wayant C, Manquen J, Wendelbo H, Kerr N, Crow M, Goodell J, Tricco AC, Mack JW, Hellman C, Vassar M. Identification of Evidence for Key Positive Psychological Constructs in Pediatric and Adolescent/Young Adult Patients with Cancer: A Scoping Review. J Adolesc Young Adult Oncol 2021; 10:247-259. [PMID: 33464990 PMCID: PMC8220547 DOI: 10.1089/jayao.2020.0184] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction: Children and adolescents/young adults (AYAs) with cancer are a vulnerable population susceptible to numerous late effects, such as fatigue and depression, which may diminish their long-term psychological, physical, spiritual, and emotional health. A well-rounded understanding of how positive psychological constructs affect the quality of care and treatment outcomes is therefore warranted. Methods: We conducted a scoping review of 15 positive psychological constructs in children and AYAs with cancer. The primary research questions were (1) what is known about positive psychological constructs in children and AYAs with cancer; (2) what value is ascribed to these constructs by patients? Results: Two hundred seventy-six articles were included after database search and screening. These studies were mostly observational or qualitative and conducted in North America. Constructs were often poorly defined, and measurement tools used to gather data were wide ranging. Numerous factors were correlated with increased or decreased expression of certain constructs, but overall themes were difficult to identify. Similarly, patients often spoke of what increased or decreased expression of a construct, with less emphasis on what they implicitly value. Discussion: This scoping review found ample evidence for what increases or decreases expression of positive psychological constructs, but this evidence was observational and often conflicting. In the future, we recommend the development of a core set of psychological outcomes, with definitions and corresponding measurement tools. We further recommend an emphasis on randomized trials to more rigorously study how expression of constructs can be improved and what effect this has on the quality of life.
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Affiliation(s)
- Cole Wayant
- Department of Psychiatry and Behavioral Sciences and Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Jack Manquen
- Department of Psychiatry and Behavioral Sciences and Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Hannah Wendelbo
- Department of Psychiatry and Behavioral Sciences and Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Natalie Kerr
- Department of Psychiatry and Behavioral Sciences and Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Matt Crow
- Department of Psychiatry and Behavioral Sciences and Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Jon Goodell
- Department of Library Services, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Andrea C. Tricco
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jennifer W. Mack
- Division of Population Sciences, Department of Pediatric Oncology, Dana Farber Cancer Institute/Boston Children's Hospital, Boston, Massachusetts, USA
| | - Chan Hellman
- School of Social Work, University of Oklahoma, Norman, Oklahoma, USA
| | - Matt Vassar
- Department of Psychiatry and Behavioral Sciences and Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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Takahashi H, Seki M, Matsumura T, An M, Sasai T, Ogawa Y, Matsushima K, Tabata A, Kato T. The Effectiveness of Dance/Movement Therapy in Children with Williams Syndrome: A Pilot Study. AMERICAN JOURNAL OF DANCE THERAPY 2020. [DOI: 10.1007/s10465-020-09324-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Piscione J, Barden W, Barry J, Malkin A, Roy T, Sueyoshi T, Mazil K, Salomon S, Dandachli F, Griffin A, Saint-Yves H, Giuliano P, Gupta A, Ferguson P, Scheinemann K, Ghert M, Turcotte RE, Lafay-Cousin L, Werier J, Strahlendorf C, Isler M, Mottard S, Afzal S, Anderson ME, Hopyan S. The Pediatric Toronto Extremity Salvage Score (pTESS): Validation of a Self-reported Functional Outcomes Tool for Children with Extremity Tumors. Clin Orthop Relat Res 2019; 477:2127-2141. [PMID: 31299028 PMCID: PMC7000085 DOI: 10.1097/corr.0000000000000756] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/12/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND The physical function of children with sarcoma after surgery has not been studied explicitly. This paucity of research is partly because of the lack of a sufficiently sensitive pediatric functional measure. The goal of this study was to establish and validate a standardized measure of physical function in pediatric patients with extremity tumors. QUESTIONS/PURPOSES (1) What is the best format and content for new upper- and lower-extremity measures of physical function in the pediatric population? (2) Do the new measures exhibit floor and/or ceiling effects, internal consistency, and test-retest reliability? (3) Are the new measures valid? METHODS In Phase 1, interviews with 17 consecutive children and adolescents with bone tumors were conducted to modify the format and content of draft versions of the pediatric Toronto Extremity Salvage Score (pTESS). In Phase 2, the pTESS was formally translated into French. In Phase 3, 122 participants between 7 and 17.9 years old with malignant or benign-aggressive bone tumors completed the limb-specific measure on two occasions. Older adolescents also completed the adult TESS. Floor and ceiling effects, internal consistency, test-retest reliability, and validity were evaluated. RESULTS Feedback from interviews resulted in the removal, addition, and modification of draft items, and the pTESS-Leg and pTESS-Arm questionnaires were finalized. Both versions exhibited no floor or ceiling effects and high internal consistency (α > 0.92). The test-retest reliability was excellent for the pTESS-Leg (intraclass correlation coefficient [ICC] = 0.94; 95% CI, 0.90-0.97) and good for the pTESS-Arm (ICC = 0.86; 95% CI, 0.61-0.96). Known-group validity (ability to discriminate between groups) was demonstrated by lower mean pTESS-Leg scores for participants using gait aids or braces (mean = 68; SD = 21) than for those who did not (mean = 87; SD = 11; p < 0.001). There was no significant difference between pTESS arm scores among respondents using a brace (n = 5; mean = 73; SD = 11) and those without (n = 22; mean = 83; SD = 19; p = 0.13). To evaluate construct validity, we tested a priori hypotheses. The duration since chemotherapy correlated moderately with higher pTESS-Leg scores (r = 0.4; p < 0.001) but not with pTESS-Arm scores (r = 0.1; p = 0.80), and the duration since tumor resection correlated moderately with higher pTESS-Leg scores (r = 0.4; p < 0.001) but not pTESS-Arm scores (r = 0.2; p = 0.4). Higher VAS scores (that is, it was harder to do things) antecorrelated with both pTESS versions (pTESS-Leg: r = -0.7; p < 0.001; pTESS-Arm: r = -0.8; p < 0.001). To assess criterion validity, we compared the pTESS with the current "gold standard" (adult TESS). Among adolescents, strong correlations were observed between the TESS and pTESS-Leg (r = 0.97, p < 0.001) and pTESS-Arm (r = 0.9, p = 0.007). CONCLUSIONS Both pTESS versions exhibited no floor or ceiling effects and had high internal consistency. The pTESS-Leg demonstrated excellent reliability and validity, and the pTESS-Arm demonstrated good reliability and reasonable validity. The pTESS is recommended for cross-sectional evaluation of self-reported physical function in pediatric patients with bone tumors. LEVEL OF EVIDENCE Level II, outcome measurement development.
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Affiliation(s)
- Janine Piscione
- J. Piscione, W. Barden, Rehabilitation Department, Hospital for Sick Children, Toronto, Canada J. Barry, H. Saint-Yves, M. Isler, S. Mottard, Service d'orthopédie, Hôpital Maisonneuve-Rosemont et Université de Montréal, Montréal, Canada A. Malkin, T. Roy, S. Hopyan, Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Canada T. Sueyoshi, C. Strahlendorf, Division of Hematology and Oncology, BC Children's Hospital and University of British Columbia, Vancouver, Canada K. Mazil, P. Giuliano, L. Lafay-Cousin, Department of Oncology, Alberta Children's Hospital and University of Calgary, Calgary, Canada S. Salomon, F. Dandachli, R. E. Turcotte, Divisions of Orthopaedic Surgery and Surgical Oncology, McGill University Health Centre and McGill University, Montréal, Canada A. Griffin, P. Ferguson, Division of Orthopaedic Surgery, Mt Sinai Hospital and University of Toronto, Toronto, Canada A. Gupta, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada K. Scheinemann, Division of Hematology/Oncology, McMaster University Health Sciences Centre, Hamilton, Canada M. Ghert, Division of Orthopaedic Surgery, Juravinski Cancer Centre and McMaster University, Hamilton, Canada J. Werier, Division of Paediatric Orthopaedic Surgery, Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada S. Afzal, Division of Hematology/Oncology, IWK Health Centre and Dalhousie University, Halifax, Canada M. E. Anderson, Orthopedic Center, Boston Children's Hospital, Jimmy Fund Clinic/Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA S. Hopyan, Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Departments of Surgery and Molecular Genetics, University of Toronto, Toronto, Canada
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A Critical Review of the Impact of Sarcoma on Psychosocial Wellbeing. Sarcoma 2019; 2019:9730867. [PMID: 30911268 PMCID: PMC6397984 DOI: 10.1155/2019/9730867] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 12/11/2022] Open
Abstract
Background Previous reviews of outcomes in specific sarcoma populations suggest patients have poor quality of life. In most of these reviews, there is a predominant focus on physical function rather than psychosocial outcome. The aim of this review was to describe the psychosocial impact of diagnosis and treatment on patients with all types of sarcoma. Methods Searches were conducted through six electronic databases for publications of any study design using a validated patient-reported outcome measure reporting the psychosocial impact in this population. Results Eighty-two studies fulfilled the inclusion criteria. Most (65%) were assessed of being of reasonable quality. The most common aspect of psychosocial wellbeing measured was quality of life (80%). Due to the heterogeneity of methods, outcomes, and populations, it was not possible to make definitive conclusions. It seems there is an improvement in the physical aspects of quality of life over time but not in psychosocial function or mental health. There was no change in mental health scores, but patients reported an improvement in adjusting to normal life. There are no differences according to the type of surgery patients receive, and psychosocial outcomes tend to be poorer than the general population. There is no consistency in identifying the factors that predict/influence psychosocial wellbeing. Conclusion The published literature does not provide a clear understanding of the impact of sarcoma diagnosis and treatment on psychosocial wellbeing. Instead, the review demonstrates a need for well-designed studies in this area and a more consistent approach to the measurement of patient-reported outcomes, which include psychosocial domains. Recommendations for future research have been proposed.
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Saebye CKP, Keller J, Baad-Hansen T. Validation of the Danish version of the musculoskeletal tumour society score questionnaire. World J Orthop 2019; 10:23-32. [PMID: 30705838 PMCID: PMC6354105 DOI: 10.5312/wjo.v10.i1.23] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/01/2018] [Accepted: 12/13/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The musculoskeletal tumour society score (MSTS) is a well-known questionnaire for measuring functional outcome in patients with neoplasms in the extremities. Standardized guidelines for cross-cultural translation and validation ensure the equivalence of content between the original and translated versions. The translation and validation provide the possibility to compare different sarcoma populations on an international level. This study is based on the hypothesis that the Danish MSTS questionnaire is a valid tool for measuring the end result after surgery for neoplasms in the extremities.
AIM To validate the Danish version of the upper and lower extremity version of the MSTS.
METHODS The translation of the MSTS was conducted in accordance with international guidelines. Patients operated for sarcomas and aggressive benign tumors were invited to participate in the study. The psychometric properties of the Danish version of the MSTS were tested in terms of validity and reliability and for the risk of floor or ceiling effect. Spearman’s rank coefficient was used to test the validity by comparing with the Toronto Extremity Salvage Score (TESS). The Intraclass Correlation Coefficient (ICC) was used to evaluate inter-rater reliability. Cronbach’s alpha was used to test for internal consistency. Spearman’s rank coefficient was used to compare the MSTS lower extremity version with the objective test, Timed Up and Go (TUG).
RESULTS The upper extremity version demonstrated an ICC of 0.95 in the inter-rater reliability test. The lower extremity version had an ICC of 0.88 in the inter-rater reliability test, respectively. Both MSTS versions showed a ceiling effect. The validity of the MSTS was measured by Spearman’s rank correlation coefficient by comparing the MSTS with the TESS and found it to be of 0.80 (P < 0.01) and 0.83 (P < 0.01) for the upper extremity and lower extremity version, respectively. A Spearman’s rank correlation coefficient of - 0.26 (P < 0.01) was found between the TUG and the MSTS questionnaire. A Spearman’s rank correlation coefficient of - 0.38 (P < 0.01) was found between the TUG and the lower extremity version of the TESS questionnaire.
CONCLUSION The Danish version of the MSTS questionnaires were found to have good reliability and validity, however a substantial ceiling effect was identified.
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Affiliation(s)
- Casper Kloster Pingel Saebye
- Sarcoma Centre of Aarhus University Hospital, Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus N 8200, Denmark
| | - Johnny Keller
- Sarcoma Centre of Aarhus University Hospital, Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus N 8200, Denmark
| | - Thomas Baad-Hansen
- Sarcoma Centre of Aarhus University Hospital, Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus N 8200, Denmark
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Grimshaw SL, Taylor NF, Mechinaud F, Shields N. Assessment of physical function in children with cancer: A systematic review. Pediatr Blood Cancer 2018; 65:e27369. [PMID: 30094937 DOI: 10.1002/pbc.27369] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/03/2018] [Accepted: 07/01/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Appropriate selection of robust assessment tools is essential to monitor physical function in children with cancer during and after treatment. This systematic review aims to identify and critically appraise the measurement properties of physical function measures currently used for children with cancer. PROCEDURE Two systematic searches of seven electronic databases [Cumulative Index to Nursing and Allied Health Literature (CINHAL), Medline, PubMed, PsychINFO, Sportsdiscus, EMBASE, and Allied and Complementary Medicine Database (AMED)] were completed to identify physical function measures used in children with cancer and to evaluate their measurement properties. Methodological quality and the adequacy of measurement properties specific to populations of children with cancer were critically appraised using the COSMIN framework to ascertain which measures have evidence to support their use in children with cancer. RESULTS One hundred and one physical function measures were identified across 154 studies. Measurement property data were available for 12 measures. The measurement properties of only two outcome measures were assessed in more than one study. Despite some positive measurement property data, there was no assessment tool that had consistent and adequate evidence overall to recommend its use in childhood cancer populations. Poor methodological quality of the included studies was the main limiting factor. CONCLUSIONS There is very limited population specific evidence to guide the selection of physical function measures in children with cancer. Further research into the reliability, validity and responsiveness of physical function measures in children with cancer is needed to provide a basis for more effective clinical assessment and management.
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Affiliation(s)
- Sarah L Grimshaw
- School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Nicholas F Taylor
- School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Francoise Mechinaud
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Nora Shields
- School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
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Bishop MW, Advani SM, Villarroel M, Billups CA, Navid F, Rivera C, Quintana JA, Gattuso JS, Hinds PS, Daw NC. Health-Related Quality of Life and Survival Outcomes of Pediatric Patients With Nonmetastatic Osteosarcoma Treated in Countries With Different Resources. J Glob Oncol 2018; 4:1-11. [PMID: 30241221 PMCID: PMC6180792 DOI: 10.1200/jgo.2016.005967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose Health-related quality of life (HRQOL) improves throughout treatment of
patients with nonmetastatic osteosarcoma. We compared HRQOL for patients in
the United States and Chile treated on an international trial (OS99) with
polychemotherapy and surgery, and we assessed the relationships among HRQOL
measures, event-free survival (EFS), and overall survival (OS). Materials and Methods Patients with newly diagnosed, localized osteosarcoma and their parents
completed three HRQOL instruments (PedsQL v.4, PedsQL Cancer v.3, and
Symptom Distress Scale [SDS]). Data were collected at four time points
throughout therapy. Repeated measures models were used to investigate the
effect of treatment site on instrument scores. The log-rank test examined
the impact of treatment site on survival outcomes, and Cox proportional
hazards regression models evaluated baseline HRQOL measures as predictors of
EFS and OS. Results Of 71 eligible patients, 66 (93%) participated in the HRQOL studies in the
United States (n = 44) and Chile (n = 22). The median age was 13.4 years
(range, 5 to 23 years). Clinical characteristics were similar between
treatment sites. US patients reported better scores for physical
(P = .030), emotional (P = .027), and
school functioning (P < .001). Chilean patients
reported poorer scores for worry (P < .001) and
nausea (P = .007). Patient and parent nausea scores were
similar between patients treated in the United States and Chile by the end
of therapy. Differences in symptom distress were not observed between the
countries. Neither HRQOL measures nor treatment site were associated with
EFS or OS. Conclusion Although significant differences in HRQOL were observed between countries,
outcomes were similar, and HRQOL measures were not associated with
prognosis.
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Affiliation(s)
- Michael W Bishop
- Michael W. Bishop, Catherine A. Billups, and Jami S. Gattuso, St Jude Children's Research Hospital; Michael W. Bishop, University of Tennessee Health Science Center, Memphis, TN; Shailesh M. Advani and Najat C. Daw, The University of Texas MD Anderson Cancer Center, Houston, TX; Milena Villarroel, Cecilia Rivera, and Juan A. Quintana, Luis Calvo McKenna Hospital, Santiago, Chile; Fariba Navid, Children's Hospital of Los Angeles, Los Angeles, CA; and Pamela S. Hinds, Children's National Health System and George Washington University, Washington, DC
| | - Shailesh M Advani
- Michael W. Bishop, Catherine A. Billups, and Jami S. Gattuso, St Jude Children's Research Hospital; Michael W. Bishop, University of Tennessee Health Science Center, Memphis, TN; Shailesh M. Advani and Najat C. Daw, The University of Texas MD Anderson Cancer Center, Houston, TX; Milena Villarroel, Cecilia Rivera, and Juan A. Quintana, Luis Calvo McKenna Hospital, Santiago, Chile; Fariba Navid, Children's Hospital of Los Angeles, Los Angeles, CA; and Pamela S. Hinds, Children's National Health System and George Washington University, Washington, DC
| | - Milena Villarroel
- Michael W. Bishop, Catherine A. Billups, and Jami S. Gattuso, St Jude Children's Research Hospital; Michael W. Bishop, University of Tennessee Health Science Center, Memphis, TN; Shailesh M. Advani and Najat C. Daw, The University of Texas MD Anderson Cancer Center, Houston, TX; Milena Villarroel, Cecilia Rivera, and Juan A. Quintana, Luis Calvo McKenna Hospital, Santiago, Chile; Fariba Navid, Children's Hospital of Los Angeles, Los Angeles, CA; and Pamela S. Hinds, Children's National Health System and George Washington University, Washington, DC
| | - Catherine A Billups
- Michael W. Bishop, Catherine A. Billups, and Jami S. Gattuso, St Jude Children's Research Hospital; Michael W. Bishop, University of Tennessee Health Science Center, Memphis, TN; Shailesh M. Advani and Najat C. Daw, The University of Texas MD Anderson Cancer Center, Houston, TX; Milena Villarroel, Cecilia Rivera, and Juan A. Quintana, Luis Calvo McKenna Hospital, Santiago, Chile; Fariba Navid, Children's Hospital of Los Angeles, Los Angeles, CA; and Pamela S. Hinds, Children's National Health System and George Washington University, Washington, DC
| | - Fariba Navid
- Michael W. Bishop, Catherine A. Billups, and Jami S. Gattuso, St Jude Children's Research Hospital; Michael W. Bishop, University of Tennessee Health Science Center, Memphis, TN; Shailesh M. Advani and Najat C. Daw, The University of Texas MD Anderson Cancer Center, Houston, TX; Milena Villarroel, Cecilia Rivera, and Juan A. Quintana, Luis Calvo McKenna Hospital, Santiago, Chile; Fariba Navid, Children's Hospital of Los Angeles, Los Angeles, CA; and Pamela S. Hinds, Children's National Health System and George Washington University, Washington, DC
| | - Cecilia Rivera
- Michael W. Bishop, Catherine A. Billups, and Jami S. Gattuso, St Jude Children's Research Hospital; Michael W. Bishop, University of Tennessee Health Science Center, Memphis, TN; Shailesh M. Advani and Najat C. Daw, The University of Texas MD Anderson Cancer Center, Houston, TX; Milena Villarroel, Cecilia Rivera, and Juan A. Quintana, Luis Calvo McKenna Hospital, Santiago, Chile; Fariba Navid, Children's Hospital of Los Angeles, Los Angeles, CA; and Pamela S. Hinds, Children's National Health System and George Washington University, Washington, DC
| | - Juan A Quintana
- Michael W. Bishop, Catherine A. Billups, and Jami S. Gattuso, St Jude Children's Research Hospital; Michael W. Bishop, University of Tennessee Health Science Center, Memphis, TN; Shailesh M. Advani and Najat C. Daw, The University of Texas MD Anderson Cancer Center, Houston, TX; Milena Villarroel, Cecilia Rivera, and Juan A. Quintana, Luis Calvo McKenna Hospital, Santiago, Chile; Fariba Navid, Children's Hospital of Los Angeles, Los Angeles, CA; and Pamela S. Hinds, Children's National Health System and George Washington University, Washington, DC
| | - Jami S Gattuso
- Michael W. Bishop, Catherine A. Billups, and Jami S. Gattuso, St Jude Children's Research Hospital; Michael W. Bishop, University of Tennessee Health Science Center, Memphis, TN; Shailesh M. Advani and Najat C. Daw, The University of Texas MD Anderson Cancer Center, Houston, TX; Milena Villarroel, Cecilia Rivera, and Juan A. Quintana, Luis Calvo McKenna Hospital, Santiago, Chile; Fariba Navid, Children's Hospital of Los Angeles, Los Angeles, CA; and Pamela S. Hinds, Children's National Health System and George Washington University, Washington, DC
| | - Pamela S Hinds
- Michael W. Bishop, Catherine A. Billups, and Jami S. Gattuso, St Jude Children's Research Hospital; Michael W. Bishop, University of Tennessee Health Science Center, Memphis, TN; Shailesh M. Advani and Najat C. Daw, The University of Texas MD Anderson Cancer Center, Houston, TX; Milena Villarroel, Cecilia Rivera, and Juan A. Quintana, Luis Calvo McKenna Hospital, Santiago, Chile; Fariba Navid, Children's Hospital of Los Angeles, Los Angeles, CA; and Pamela S. Hinds, Children's National Health System and George Washington University, Washington, DC
| | - Najat C Daw
- Michael W. Bishop, Catherine A. Billups, and Jami S. Gattuso, St Jude Children's Research Hospital; Michael W. Bishop, University of Tennessee Health Science Center, Memphis, TN; Shailesh M. Advani and Najat C. Daw, The University of Texas MD Anderson Cancer Center, Houston, TX; Milena Villarroel, Cecilia Rivera, and Juan A. Quintana, Luis Calvo McKenna Hospital, Santiago, Chile; Fariba Navid, Children's Hospital of Los Angeles, Los Angeles, CA; and Pamela S. Hinds, Children's National Health System and George Washington University, Washington, DC
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Morales JS, Valenzuela PL, Rincón-Castanedo C, Takken T, Fiuza-Luces C, Santos-Lozano A, Lucia A. Exercise training in childhood cancer: A systematic review and meta-analysis of randomized controlled trials. Cancer Treat Rev 2018; 70:154-167. [PMID: 30218787 DOI: 10.1016/j.ctrv.2018.08.012] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 08/29/2018] [Accepted: 08/31/2018] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Physical capacity and quality of life (QoL) are typically impaired in children/adolescents with cancer. Our primary objective was to examine the effects of exercise training performed after diagnosis of any type of pediatric cancer on physical capacity-related endpoints, survival, disease relapse and adverse effects. METHODS (a) Search and selection criteria: Systematic review in Pubmed and Web of Science (until August 2018) of randomized controlled trials (RCTs) of exercise interventions in children with cancer during treatment or within one year after its end. (b) Data collection: Two authors independently identified studies meeting inclusion criteria, extracted data, and assessed risk of bias using standardized forms. When needed, we contacted authors to request clarifications or additional data. (c) Statistical Analysis: The pooled standardized mean differences (SMD) were calculated for those endpoints for which a minimum of three RCTs used the same assessment method. We also calculated the pooled odds ratio (OR) of dying or having a tumor relapse. RESULTS Eight RCTs (n = 283 patients) were included in the systematic review. Of these, five studies (n = 173) could be meta-analyzed. Exercise training during pediatric cancer treatment significantly improves patients' functional mobility, as assessed with the timed up and down stairs test (SMD: -0.73, p < 0.001) and does not affect mortality (OR: 0.85, p = 0.76) or relapse risk (OR: 0.96, p = 0.94). CONCLUSIONS Exercise training in children with cancer improves functional mobility. More RCTs analyzing the effects of supervised exercise interventions are needed, as well as the development of a core-set of outcomes in pediatric oncology exercise research.
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Affiliation(s)
- Javier S Morales
- Universidad Europea de Madrid, Faculty of Sport Sciences, Madrid, Spain
| | - Pedro L Valenzuela
- Physiology Unit, Systems Biology Department, University of Alcalá, Madrid, Spain; Department of Sport and Health, Spanish Agency for Health Protection in Sport (AEPSAD), Madrid, Spain
| | | | - Tim Takken
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Carmen Fiuza-Luces
- Universidad Europea de Madrid, Faculty of Sport Sciences, Madrid, Spain; Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain.
| | - Alejandro Santos-Lozano
- Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain; i+HeALTH, European University Miguel de Cervantes, Spain
| | - Alejandro Lucia
- Universidad Europea de Madrid, Faculty of Sport Sciences, Madrid, Spain; Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain.
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15
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Freitas RRD, Crivellaro ALS, Mello GJP, Neto MA, Filho GDF, Silva LVD. HEMIPELVECTOMY: ERASTO GAERTNER HOSPITAL'S EXPERIENCES WITH 32 CASES IN 10 YEARS. Rev Bras Ortop 2015; 45:413-9. [PMID: 27022573 PMCID: PMC4799085 DOI: 10.1016/s2255-4971(15)30390-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective: To show the experience of the Erasto Gaertner Hospital with hemipelvectomy surgery over a 10-year period. Methods: This was a retrospective study on 32 patients who underwent hemipelvectomy at Erasto Gaertner Hospital between 1998 and 2008, assessing clinical and surgical characteristics. Results: Among the 32 patients, 15 were female and 17 were male. The mean age was 37.94 years. Eight cases showed involvement of the neurovascular bundle: three were located in the iliac and extended to the thigh, two were in the acetabulum and extended to the thigh and three were in the acetabulum and pubis. Twenty-three cases presented a neurovascular bundle free from neoplasia: 11 were restricted to the iliac, six were in the acetabular region, two were in the pubic ramus and four extended to the whole hemipelvis bone. One case involved the iliac-femoral vessels: one in the pubic ramus. Seven cases of chondrosarcoma and four cases of Ewing's sarcoma represented the majority. Eight cases underwent external hemipelvectomy and 24 underwent internal hemipelvectomy (11 were type I; four were type II; two were type II + III; three were type III and four were type IV). Of these 24 cases, 13 did not have any reconstruction, 10 had a fibular graft and one had an iliacfemoral vein and artery prosthesis. Twenty-six surgeries were curative and six were palliative. There were 14 deaths. Survival of two and five years was seen in 11 and 10 cases, respectively. For six cases, less than two years had passed since the operation. Three cases were lost during follow-up. Conclusion: This study shows the experiences of an oncology reference service specializing in highly complex surgical treatment.
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Affiliation(s)
| | | | | | - Múrio Armani Neto
- Orthopedists in the Oncological Orthopedics Service, Erasto Gaertner Hospital, Curitiba, PR
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16
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Abstract
BACKGROUND Reduced motor performance can negatively affect physical activity and social partake after childhood cancer. Especially in bone tumor patients, who are at risk of physical limitations due to surgical interventions, motor performance has not yet been sufficiently investigated. Therefore, this study aimed at assessing motor performance in pediatric bone tumor patients. PROCEDURE Motor performance was measured within 2 years posttreatment using the MOON (test for MOtor performance in pediatric ONcology) test. This instrument enables quantitative data collection even in physically impaired patients for comparison with age-matched and sex-matched reference values. RESULTS Twenty-one patients (13 male) ages 15.2±2.1 years (median: 15 y, 10 to 19 y) and 9.4±7.4 months posttreatment (median: 6 mo, 2 to 24 mo) were tested. Motor performance was slightly reduced in muscular endurance of the legs; significantly reduced in speed, flexibility, eye-hand coordination, and muscular explosive strength (P<0.001), whereas patients' hand grip strength and static balance were superior to the reference values. Follow-up duration, body mass index, and tumor localization apparently affected motor performance. CONCLUSIONS These findings show serious reductions in motor performance within 2 years after bone tumor treatment and highlight the need for interventions to improve motor performance. The results should be used to advise and support patients to engage in suitable physical and sports activities.
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17
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Stokke J, Sung L, Gupta A, Lindberg A, Rosenberg AR. Systematic review and meta-analysis of objective and subjective quality of life among pediatric, adolescent, and young adult bone tumor survivors. Pediatr Blood Cancer 2015; 62:1616-29. [PMID: 25820683 PMCID: PMC4515170 DOI: 10.1002/pbc.25514] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 02/23/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pediatric, adolescent, and young adult survivors of bone sarcomas are at risk for poor quality of life (QOL). We conducted a systematic review and meta-analysis to summarize the literature describing QOL in this population and differences in QOL based on local control procedures. PROCEDURE Included studies described ≥5 patients <25 years old who had completed local control treatment for bone sarcoma, defined QOL as a main outcome, and measured it with a validated instrument. Data extraction and quality assessments were conducted with standardized tools. Meta-analyses compared QOL based on surgical procedure (limb-sparing vs. amputation) and were stratified by assessment type (objective physical function, clinician-assessed disability, patient-reported disability, and patient-reported QOL). Effect sizes were reported as the standard mean difference when multiple instruments were used within a comparison and weighted mean difference otherwise. All were weighted by inverse variance and modeled with random effects. RESULTS Twenty-two of 452 unique manuscripts were included in qualitative syntheses, eight of which were included in meta-analyses. Manuscripts were heterogeneous with respect to included patient populations (age, tumor type, time since treatment) and QOL instruments. Prospective studies suggested that QOL improves over time, and that female sex and older age at diagnosis are associated with poor QOL. Meta-analyses showed no differences in outcomes between patients who underwent limb-sparing versus amputation for local control. CONCLUSION QOL studies among children and AYAs with bone sarcoma are remarkably diverse, making it difficult to detect trends in patient outcomes. Future research should focus on standardized QOL instruments and interpretations.
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Affiliation(s)
- Jamie Stokke
- Seattle Children’s Hospital; Seattle, WA; USA,University of Washington; Seattle, WA; USA
| | - Lillian Sung
- Hospital for Sick Children; Toronto, Ontario, CANADA
| | - Abha Gupta
- Hospital for Sick Children; Toronto, Ontario, CANADA,University of Toronto; Toronto, Ontario, CANADA
| | - Antoinette Lindberg
- Seattle Children’s Hospital; Seattle, WA; USA,University of Washington; Seattle, WA; USA
| | - Abby R. Rosenberg
- Seattle Children’s Hospital; Seattle, WA; USA,University of Washington; Seattle, WA; USA,Fred Hutchinson Cancer Research Center, Seattle, WA; USA,Treuman Katz Center for Pediatric Bioethics, Seattle, WA; USA
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18
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Nicolini-Panisson RD, Donadio MVF. Timed "Up & Go" test in children and adolescents. REVISTA PAULISTA DE PEDIATRIA 2014; 31:377-83. [PMID: 24142322 PMCID: PMC4182976 DOI: 10.1590/s0103-05822013000300016] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 01/15/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate, by a literature review, the Timed "Up & Go" (TUG) test use
and its main methodological aspects in children and adolescents. DATA SOURCES The searches were performed in the following databases: PubMed, CINAHL, Web
of Science, SciELO and Cochrane Library, from April to July 2012. Studies
published from 1990 to 2012 using the terms in Portuguese and English "Timed
"Up & Go", "test", "balance", "child", and "adolescent" were selected.
The results were divided into categories: general characteristics of the
studies, population, test implementation METHODS, interpretation of results
and associations with other measurements. DATA SYNTHESIS 27 studies were analyzed in this review and most of them used the TUG test
along with other outcome measures to assess functional mobility or balance.
Three studies evaluated the TUG test in significant samples of children and
adolescents with typical development, and the most studied specific
diagnoses were cerebral palsy and traumatic brain injury. The absence of
methodological standardization was noted, but one study proposed adaptations
to the pediatric population. In children and adolescents with specific
clinical diagnoses, the coefficient of within-session reliability was found
to be high in most studies, as well as the intra and inter-examiner
reliability, which characterizes the good reproducibility of the test. CONCLUSIONS The TUG test was shown to be a good tool to assess functional mobility in
the pediatric population, presenting a good reproducibility and correlation
with other assessment tools.
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Lower Limb Core Scale: a new application to evaluate and compare the outcomes of bone and soft-tissue tumours resection and reconstruction. BIOMED RESEARCH INTERNATIONAL 2014; 2014:652141. [PMID: 25162021 PMCID: PMC4137603 DOI: 10.1155/2014/652141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 07/03/2014] [Accepted: 07/07/2014] [Indexed: 11/18/2022]
Abstract
Several methods are used to evaluate the functional outcome of tumour resections and reconstructions in the lower limb. However, one of their most common limitations is that they are specifically developed to evaluate only oncological patients. We introduced the Lower Limb Core Scale (LLCS) to overcome this limitation. The aim of this study was to evaluate the functional and subjective results in the lower limb and to evaluate the use of the LLCS. We conducted a retrospective cohort study using various tools to investigate the outcomes. The results of the LLCS were correlated with the results of other functional tests. A total of 44 patients were included in the study. None of the demographic variables correlated with the functional or health-related quality of life (QoL) scores except for gender, whereby male patients had an increased functional score. The correlation between LLCS and other scores was positive (r (2) = 0.77). The satisfactory QoL scores, and functional outcomes scores indicated the LLCS to be a reliable option for general and specific evaluation of lower limb reconstructions. We suggest using the LLCS for comparisons of oncological reconstructions with lower limb reconstructions in different disciplines.
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20
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Nicolini-Panisson RD, Donadio MVF. Normative values for the Timed 'Up and Go' test in children and adolescents and validation for individuals with Down syndrome. Dev Med Child Neurol 2014; 56:490-7. [PMID: 24206424 DOI: 10.1111/dmcn.12290] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2013] [Indexed: 11/29/2022]
Abstract
AIM To determine normative values for the Timed Up and Go (TUG) test in typically developing children and adolescents and to validate its use in individuals with Down syndrome. METHOD Participants in this cross-sectional study were South Brazilian schoolchildren aged 3 to 18 years. In phase 1, 459 typically developing individuals (227 males, 232 females; mean age 10 y 8 mo (SD 4 y 4 mo) were included; and in phase 2, 40 individuals with Down syndrome (16 males, 24 females; mean age 10 y 6 mo (SD 4 y 4 mo). Anthropometric measurements, real leg length, TUG test scores, and Gross Motor Function Measure (GMFM) scores were evaluated. The association between the TUG test and possible predictive variables was analyzed. RESULTS In phase 1, the mean time to perform the TUG test was 5.61 seconds (SD 1.06). Values were stratified in age groups that served as normative data for both sexes. A multiple linear regression analysis was conducted and the best variables to predict TUG scores were age and weight. The best model obtained presented an R(2) of 0.25 and a standard error of the estimate of 0.92. Excellent intrasession reliability in the three tests performed (intraclass correlation coefficient [ICC] of 0.93, 0.94, and 0.95) and between the sessions (both with an ICC of 0.95) was demonstrated. In phase 2, the test also showed excellent reproducibility (ICC=0.82 between the two tests performed). The performance time was significantly longer (p<0.001) in individuals with Down syndrome compared with sex- age-, and weight-matched typically developing children with a mean difference of -3.53 (95% confidence interval -4.05 to -3.00). Dimension E of the GMFM (Walking, Running and Jumping) showed the highest correlation (r=-0.55, p<0.001) with the test. INTERPRETATION This study provides normative values for the TUG test and shows that TUG scores can be predicted as a function of age and weight in typically developing individuals. The test can also be used for assessment of functional mobility in individuals with Down syndrome.
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Affiliation(s)
- Renata D'Agostini Nicolini-Panisson
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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21
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Bekkering WP, Vliet Vlieland TPM, Koopman HM, Schaap GR, Beishuizen A, Anninga JK, Wolterbeek R, Nelissen RGHH, Taminiau AHM. A prospective study on quality of life and functional outcome in children and adolescents after malignant bone tumor surgery. Pediatr Blood Cancer 2012; 58:978-85. [PMID: 21990185 DOI: 10.1002/pbc.23328] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2011] [Accepted: 08/03/2011] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few longitudinal data are available concerning quality of life (QoL) and functioning of young patients undergoing surgical procedures for malignant bone tumors around the knee joint. Aim of the present study was to evaluate patients' quality of life, functional ability, and physical activity during a 2-year postoperative period. METHODS This prospective study included patients who underwent surgery for a malignant bone tumor around the knee joint between 2004 and 2008. Assessments were done at 3, 6, 9, 12, 18, and 24 months after surgery. QoL was measured with the TNO-AZL Children's or Adult's Quality of Life Questionnaires (TACQOL and TAAQOL), the Short Form-36 (SF-36) and Bone tumor (Bt)-DUX; functional ability with the Toronto Extremity Salvage Scale (TESS), the 6-minute walk test (6 MWT) and four functional performance tests; and physical activity with the Baecke questionnaire and the ActiLog® activity monitor. Statistical analysis included linear mixed model analysis. RESULTS Forty-four patients (27 males, 17 females, mean age 14.9 (SD 4.8) years) were included, 27 (61%) underwent limb-salvage and 17 (39%) ablative surgery. Twenty patients were lost during the 2 years follow-up as a consequence of oncological complications. Over the first year, survivors showed significant improvement of QoL, functional ability and physical activity, except for the mental dimension of the SF-36 and the activity monitor results. Over the second year, these improvements were less pronounced. CONCLUSIONS In the first 2 years after bone tumor surgery, survivors improved significantly with respect to QoL, functional ability, and physical activity levels.
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Affiliation(s)
- W Peter Bekkering
- Department of Physical Therapy, Leiden University Medical Center, The Netherlands.
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22
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Abstract
PURPOSE To obtain reference values for healthy participants performing the Functional Mobility Assessment (FMA). The FMA is a reliable and valid tool used to examine functional abilities subjectively and objectively in patients with lower-extremity sarcoma in all components of the International Classification of Functioning, Disability, and Health model (body function, activity, and participation). METHODS Children, adolescents, and young adults who were healthy, representing a sample of convenience (n = 503; 260 females, age 10-21 years), participated in this study. RESULTS Means and standard deviations for all participants: Timed Up and Down Stairs 6.18 ± 0.8 seconds, Timed Up and Go 3.78 ± 0.6 seconds, 9-minute run/walk 4161 ± 893 feet, and the FMA total 59 ± 3. CONCLUSION The reference values provided in this study will allow health care professionals to compare the functional abilities of children, adolescents, and young adults with lower extremity sarcoma to age- and gender-matched healthy peers when using the FMA.
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23
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Paxton RJ, Jones LW, Rosoff PM, Bonner M, Ater JL, Demark-Wahnefried W. Associations between leisure-time physical activity and health-related quality of life among adolescent and adult survivors of childhood cancers. Psychooncology 2011; 19:997-1003. [PMID: 19918964 DOI: 10.1002/pon.1654] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Survivors of childhood cancer are at an increased risk for reduced quality of life (QOL), yet few studies have explored factors associated with improving health-related QOL (HRQOL) in this population. We thus explored the relationship between physical activity (PA) and HRQOL among survivors of childhood cancer. METHODS A total of 215 survivors of childhood lymphoma, leukemia, and central nervous system cancers completed mailed surveys that elicited information regarding leisure-time PA (LTPA) measured in metabolic equivalents, HRQOL, and diagnostic and demographic factors. Correlations and adjusted regression models were used to explore the relationship between LTPA and HRQOL. RESULTS In the total sample, modest, yet significant linear associations were observed between LTPA and overall HRQOL (beta=0.17, p<0.01), as well as each of the respective subscales (beta=0.11-0.23 and p's<0.05 to <0.001). Among adolescent survivors of childhood cancer, LTPA was significantly associated with overall HRQOL (beta=0.27), cancer worry (beta=0.36), cognitive function (beta=0.32), body appearance (beta=0.29), and social function (beta=0.27) (all p's<0.05). Among adult survivors of childhood cancer, LTPA was only significantly associated with physical function (beta=0.28, p<0.001). CONCLUSIONS Significant associations exist between LTPA and HRQOL; however, the association was stronger and observed in more domains for adolescent survivors of childhood cancer. More research is needed to determine the antecedents and consequences of PA in this population.
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Affiliation(s)
- Raheem J Paxton
- Department of Health Disparities Research, The University of Texas M D Anderson Cancer Center, Houston, TX 77230-1439, USA.
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Bekkering WP, Vliet Vlieland TP, Koopman HM, Schaap GR, Bart Schreuder H, Beishuizen A, Jutte PC, Hoogerbrugge PM, Anninga JK, Nelissen RG, Taminiau AH. Functional ability and physical activity in children and young adults after limb-salvage or ablative surgery for lower extremity bone tumors. J Surg Oncol 2010; 103:276-82. [DOI: 10.1002/jso.21828] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 11/16/2010] [Indexed: 11/07/2022]
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Barr RD, Wunder JS. Bone and soft tissue sarcomas are often curable--but at what cost?: a call to arms (and legs). Cancer 2009; 115:4046-54. [PMID: 19670445 DOI: 10.1002/cncr.24458] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Ronald D Barr
- Service of Hematology-Oncology, McMaster Children's Hospital, and Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
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Hinds PS, Gattuso JS, Billups CA, West NK, Wu J, Rivera C, Quintana J, Villarroel M, Daw NC. Aggressive treatment of non-metastatic osteosarcoma improves health-related quality of life in children and adolescents. Eur J Cancer 2009; 45:2007-14. [PMID: 19450974 PMCID: PMC2820559 DOI: 10.1016/j.ejca.2009.04.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Accepted: 04/20/2009] [Indexed: 12/01/2022]
Abstract
BACKGROUND Health-related quality of life (HRQOL) of paediatric patients with osteosarcoma has not been documented longitudinally during treatment. Aims of this prospective study were to assess treatment effects on patients' HRQOL at diagnosis, during therapy and after completion of therapy, to assess sex- and age-related differences in HRQOL ratings and to assess differences between patients' and parents' reports. PATIENTS AND METHODS Sixty-six patients (median age, 13.4 years) with newly diagnosed, localised disease completed three HRQOL instruments, and their parents completed two of the same instruments at diagnosis, before surgery (Week 12), at Week 23 and a median of 20 weeks after treatment completion. RESULTS Significant improvements in most domains and worsening of nausea were reported by patients and parents from diagnosis to Weeks 12 and 23. Symptom distress decreased from diagnosis to Weeks 12 and 23 in 81% and 64% of patients, respectively. There were no sex- and few age-related differences in scores. Scores from patients and parents achieved good agreement. CONCLUSIONS The HRQOL of patients improves during aggressive treatment for non-metastatic osteosarcoma, except in the domain of nausea. Clinicians can use these findings to prepare their patients for the distressing symptoms that they will likely experience at certain time points and to provide reassurance that these will significantly improve.
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Affiliation(s)
- Pamela S Hinds
- Department of Nursing Research, Children's National Medical Center, Washington, DC 20010, USA.
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Beebe K, Song KJ, Ross E, Tuy B, Patterson F, Benevenia J. Functional Outcomes After Limb-Salvage Surgery and Endoprosthetic Reconstruction With an Expandable Prosthesis: A Report of 4 Cases. Arch Phys Med Rehabil 2009; 90:1039-47. [DOI: 10.1016/j.apmr.2008.12.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2008] [Revised: 10/24/2008] [Accepted: 12/18/2008] [Indexed: 10/20/2022]
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Abstract
Patients with osteosarcoma undergo extensive treatment using aggressive chemotherapy and surgery and this can have substantial acute and long-term effects on patients. In particular, quality of life (QOL) can be affected. It is important that QOL be examined to see how it is influenced. It is also important to determine who is at highest risk for impaired QOL and develop appropriate interventions. QOL is one of several outcomes that are influenced by the diagnosis and treatment of osteosarcoma. Other outcomes include function, disability, and body image. Currently, gaps exist in our knowledge of QOL in osteosarcoma patients and prospective studies are needed.
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Gilchrist LS, Galantino ML, Wampler M, Marchese VG, Morris GS, Ness KK. A framework for assessment in oncology rehabilitation. Phys Ther 2009; 89:286-306. [PMID: 19147708 PMCID: PMC2967778 DOI: 10.2522/ptj.20070309] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2007] [Accepted: 11/26/2008] [Indexed: 12/28/2022]
Abstract
Although the incidence of cancer in the United States is high, improvements in early diagnosis and treatment have significantly increased survival rates in recent years. Many survivors of cancer experience lasting, adverse effects caused by either their disease or its treatment. Physical therapy interventions, both established and new, often can reverse or ameliorate the impairments (body function and structure) found in these patients, improving their ability to carry out daily tasks and actions (activity) and to participate in life situations (participation). Measuring the efficacy of physical therapy interventions in each of these dimensions is challenging but essential for developing and delivering optimal care for these patients. This article describes the acute and long-term effects of cancer and its treatment and the use of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) as a basis for selection of assessment or outcome tools and diagnostic or screening tools in this population.
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Affiliation(s)
- Laura S Gilchrist
- Doctor of Physical Therapy Program, College of St Catherine, 601 25th Ave S, Minneapolis, MN 55454, USA.
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Health-related quality of life in adolescents at the time of diagnosis with osteosarcoma or acute myeloid leukemia. Eur J Oncol Nurs 2008; 13:156-63. [PMID: 18926773 DOI: 10.1016/j.ejon.2008.08.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Revised: 08/08/2008] [Accepted: 08/20/2008] [Indexed: 11/20/2022]
Abstract
Although measuring health-related quality of life (HRQoL) in adolescents with cancer helps clinicians to personalize care for their patients, no previous studies have included HRQoL measurement at the time of diagnosis of osteosarcoma (OS) or acute myeloid leukemia (AML). The purpose of this study was to evaluate the feasibility of measuring adolescents' HRQoL at the time of their diagnosis of OS or AML, and to compare their ratings with those of their parents and of similarly diagnosed but younger patients aged 8-12 years. Participants included 126 patients (79 adolescents) and 130 parents (78 parents of adolescents); most completed the HRQoL instrument/s within 48 h of the first chemotherapy cycle. Ninety-three percent of adolescents diagnosed with OS and 93% of those diagnosed with AML completed the HRQoL instruments. Agreement between the adolescents and their parents ranged from 0.29 to 0.71 (OS) and 0.44 to 0.62 (AML). In all domains, OS adolescents had significantly lower PedsQL v.4.0 scores than adolescents with AML. Our findings demonstrates the feasibility of measuring HRQoL in adolescents with OS or AML (and their parents) at the time of diagnosis, and thus their HRQoL ratings can be used to inform their cancer care from diagnosis forward.
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Saraiva D, de Camargo B, Davis AM. Cultural adaptation, translation and validation of a functional outcome questionnaire (TESS) to Portuguese with application to patients with lower extremity osteosarcoma. Pediatr Blood Cancer 2008; 50:1039-42. [PMID: 17973319 DOI: 10.1002/pbc.21392] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Evaluation of physical functioning is an important tool for planning rehabilitation. Instruments need to be culturally adapted for use in non-English speaking countries. The aim of this study was to culturally adapt, including translation and preliminary validation, the Toronto extremity salvage score (TESS) for Brazil, in a sample of adolescents and young adults treated for lower extremity osteosarcoma. PROCEDURE The process included two independent forward translations of TESS questionnaire, consensus between translators on a forward translation, back-translation by two independent translators, and a review of the back-translations. Internal consistency of the TESS and known groups validity were also evaluated. RESULTS Internal consistency for the 30 item TESS was high (coefficient alpha = 0.87). TESS score ranges from 0 to 100. Forty-eight patients completed the questionnaire and scores ranged from 56 to 100 (mean score: 89.6). Patients receiving no pain medications scored higher on the TESS than those who were receiving pain medication (P = 0.014), and patients using walking aids had slightly higher but not statistically different scores. Those who were treated with amputation had higher scores than those who were treated with limb salvage procedures (P = 0.003). CONCLUSION Preliminary evidence suggests that Brazilian-Portuguese translation is acceptable, understandable, reliable, and valid for evaluating the function in adolescents and young adults with osteosarcoma in lower extremity in Brazil.
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Indelicato DJ, Keole SR, Shahlaee AH, Shi W, Morris CG, Gibbs CP, Scarborough MT, Marcus RB. Long-Term Clinical and Functional Outcomes After Treatment for Localized Ewing's Tumor of the Lower Extremity. Int J Radiat Oncol Biol Phys 2008; 70:501-9. [PMID: 17855013 DOI: 10.1016/j.ijrobp.2007.06.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2007] [Revised: 06/20/2007] [Accepted: 06/21/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE Retrospective review describing the 35-year University of Florida experience with Ewing's tumors of the lower extremity. PATIENTS AND METHODS Fifty-three patients were treated between 1971 and 2006. Thirty patients were treated with radiotherapy (RT) alone and 23 patients were treated with surgery +/- RT. Larger tumors and tumors of the femur were treated more often with definitive RT. Median potential follow-up was 19.2 years. Functional outcome was assessed using the Toronto Extremity Salvage Score (TESS). RESULTS Before 1985, 24% of patients were treated with surgery; since then, the rate has increased to 61%. The 15-year actuarial overall survival (OS), cause-specific survival (CSS), freedom from relapse, and limb preservation rates were 68% vs. 47% (p = 0.21), 73% vs. 47% (p = 0.13), 73% vs. 40% (p = 0.03), and 43% vs. 40% (p = 0.52), respectively, for patients treated with surgery +/- RT vs. RT alone. Excluding 8 patients who underwent amputation or rotationplasty, the 15-year actuarial local control rate was 100% for the surgery +/- RT group and 68% for the definitive RT group (p = 0.03). The ranges of the TESS for surgery +/- RT vs. RT alone were 70-100 (mean, 94) and 97-100 (mean, 99), respectively. Twenty-six percent (6/23) of patients had complications related to surgery requiring amputation or reoperation. CONCLUSIONS Overall survival and CSS were not statistically compromised, but we observed an increased risk of relapse and local failure in patients treated with RT alone, thereby justifying a transition toward primary surgical management in suitable patients. However, despite an adverse risk profile, patients treated with RT alone had similar long-term amputation-free survival and demonstrated comparable functional outcomes. Poor results observed in Ewing's of the femur mandate innovative surgical and RT strategies.
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Affiliation(s)
- Daniel J Indelicato
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA
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Indelicato DJ, Keole SR, Shahlaee AH, Shi W, Morris CG, Gibbs CP, Scarborough MT, Marcus RB. Impact of local management on long-term outcomes in Ewing tumors of the pelvis and sacral bones: the University of Florida experience. Int J Radiat Oncol Biol Phys 2008; 72:41-8. [PMID: 18234436 DOI: 10.1016/j.ijrobp.2007.12.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2007] [Revised: 12/05/2007] [Accepted: 12/06/2007] [Indexed: 11/18/2022]
Abstract
PURPOSE This retrospective analysis describes our 35-year experience with respect to disease control and functional status. PATIENTS AND METHODS Thirty-five patients with localized Ewing tumors of the pelvis and sacral bones were treated from 1970 to 2005. Twenty-six patients were treated with definitive radiotherapy (RT), and 9 patients were treated with combined local therapy in the form of surgery + RT. The median RT dose was 55.2 Gy. The patients who received RT alone were more likely to be older men with larger tumors exhibiting soft-tissue extension. Patients in the definitive RT group were more likely to receive etoposide and ifosfamide or undergo bone marrow transplant. Median potential follow-up was 19.4 years. RESULTS The 15-year actuarial cause-specific survival, freedom from relapse rate, and local control rates were 26% vs. 76% (p = 0.016), 28% vs. 78% (p = 0.015), and 64% vs. 100% (p = 0.087), respectively, for patients treated with definitive RT and combined therapy. Overall, tumors <8 cm had significantly better cause-specific survival, but this was unrelated to local control. The median Toronto Extremity Salvage Score for the definitive RT and combined therapy groups were 99 and 94, respectively (p = 0.19). Seven definitive RT patients (27%) had serious complications. CONCLUSION Combined modality local therapy should be considered if pelvic Ewing tumors are resectable. However, because of the extent of local disease, most patients have unresectable or partially resectable tumors and therefore require RT in some capacity. For this reason, innovative RT strategies are needed to improve long-term disease outcomes and minimize side effects while maintaining an acceptable functional result.
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Affiliation(s)
- Daniel J Indelicato
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL 32610-0385, USA.
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Marchese VG, Rai SN, Carlson CA, Hinds PS, Spearing EM, Zhang L, Callaway L, Neel MD, Rao BN, Ginsberg JP. Assessing functional mobility in survivors of lower-extremity sarcoma: reliability and validity of a new assessment tool. Pediatr Blood Cancer 2007; 49:183-9. [PMID: 16779807 DOI: 10.1002/pbc.20932] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Reliability and validity of a new tool, Functional Mobility Assessment (FMA), were examined in patients with lower-extremity sarcoma. FMA requires the patients to physically perform the functional mobility measures, unlike patient self-report or clinician administered measures. PROCEDURE A sample of 114 subjects participated, 20 healthy volunteers and 94 patients with lower-extremity sarcoma after amputation, limb-sparing, or rotationplasty surgery. Reliability of the FMA was examined by three raters testing 20 healthy volunteers and 23 subjects with lower-extremity sarcoma. Concurrent validity was examined using data from 94 subjects with lower-extremity sarcoma who completed the FMA, Musculoskeletal Tumor Society (MSTS), Short-Form 36 (SF-36v2), and Toronto Extremity Salvage Scale (TESS) scores. Construct validity was measured by the ability of the FMA to discriminate between subjects with and without functional mobility deficits. RESULTS FMA demonstrated excellent reliability (ICC [2,1] >or=0.97). Moderate correlations were found between FMA and SF-36v2 (r = 0.60, P < 0.01), FMA and MSTS (r = 0.68, P < 0.01), and FMA and TESS (r = 0.62, P < 0.01). The patients with lower-extremity sarcoma scored lower on the FMA as compared to healthy controls (P < 0.01). CONCLUSION The FMA is a reliable and valid functional outcome measure for patients with lower-extremity sarcoma. This study supports the ability of the FMA to discriminate between patients with varying functional abilities and supports the need to include measures of objective functional mobility in examination of patients with lower-extremity sarcoma.
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Affiliation(s)
- Victoria G Marchese
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA.
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Hopyan S, Tan JW, Graham HK, Torode IP. Function and upright time following limb salvage, amputation, and rotationplasty for pediatric sarcoma of bone. J Pediatr Orthop 2006; 26:405-8. [PMID: 16670557 DOI: 10.1097/01.bpo.0000203016.96647.43] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We wished to determine the relative physical and psychosocial merits of limb-sparing reconstruction, above-knee amputation, and rotationplasty in survivors of childhood and adolescent lower extremity bone sarcoma. In comparing minimum 5-year disease-free survivors, we found that outcome was somewhat dependent on the measuring tool administered. A superior score of statistical significance on the system of evaluation of the Musculoskeletal Tumour Society and a trend toward higher Toronto Extremity Salvage Scores were found among patients with a limb-sparing reconstruction compared with those with an above-knee amputation. Short-Form 36 results and the amount of time spent in the upright position (uptime), as assessed with a remote activity monitor, were similar between these groups. Uptime was highest in patients who had undergone rotationplasty, although statistical assessment of this group was not feasible. Psychosocial outcome was similar between all groups. This information may be useful in discussing reconstruction with patients and their families.
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Affiliation(s)
- Sevan Hopyan
- Department of Orthopaedic Surgery, The Royal Children's Hospital, Parkville, Victoria, Australia.
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Savio C, Garaventa A, Gremmo M, Camoriano R, Manfredini L, Fieramosca S, Dini G, Miano M. Feasibility of integrated home/hospital physiotherapeutic support for children with cancer. Support Care Cancer 2006; 15:101-4. [PMID: 16941134 DOI: 10.1007/s00520-006-0118-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2006] [Accepted: 06/22/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE Children suffering from cancer often have to undergo physiotherapy that either extends the duration of in-patient hospitalisation or requires more frequent visits to the outpatient clinic. To improve care and to decrease the length of hospitalisation of children being treated at the Dept. of Haematoloy/Oncology of the Gaslini Children's Hospital, a programme of Home Care was set up in April 2000. MATERIALS AND METHODS In June 2003, rehabilitation was added to the procedures that were feasible at home and included i.v. therapy administration, blood examinations, transfusion and/or psychological support, as well as palliative care for terminally ill children. The physiotherapy sessions were done in the ward, in the Rehabilitation Unit Gym, or at home, depending on the clinical conditions and the needs of the child and the family. RESULTS Between June 2003 and May 2005, 46 children, whose median age was 7 years (range 6 months-21 years) suffering from CNS tumours (13), leukaemia (13), neuroblastoma (7), bone tumours (6), sarcoma (4) and lymphoma (3), underwent 1,398 physiotherapy sessions for neuro-motor re-education (534), motor rehabilitation (485), strain re-education and training (250), respiratory care (79), or to improve comfort during the terminal phase of the disease (50). To maintain continuity of care, the treatments were performed at home (931), in the hospital ward (282), or in the gymnasium of our Physiotherapy Service (185). CONCLUSION The physiotherapist was able to start or to continue assistance at home or in the hospital, and to keep up the programme based on the child's needs. Integrated home/hospital physiotherapy for children suffering from cancer is feasible and is useful for maintaining continuity of treatment without lengthening hospitalisation.
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Affiliation(s)
- Christian Savio
- Department of Paediatric Haematology/Oncology, Giannina Gaslini Children's Hospital, Largo G. Gaslini 5, 16148, Genoa, Italy
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Schreiber D, Bell RS, Wunder JS, O'Sullivan B, Turcotte R, Masri BA, Davis AM. Evaluating function and health related quality of life in patients treated for extremity soft tissue sarcoma. Qual Life Res 2006; 15:1439-46. [PMID: 16732468 DOI: 10.1007/s11136-006-0001-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2006] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate how functional disability impacts on health related quality of life (HRQOL) of patients with extremity soft tissue sarcoma (STS) at 1 year post-surgery. DESIGN AND SETTING Survey of extremity STS patients pre-surgery and one-year post-treatment. PARTICIPANTS 100 participants who were treated for extremity STS between 2001 and 2003 at four Canadian hospitals. Patients were over 16 years, non-metastatic at diagnosis, and had limb salvage surgery. OUTCOME MEASURES Musculoskeletal Tumor Society Rating Scale (MSTS), a measure of impairment; Toronto Extremity Salvage Score (TESS), a measure of activity limitations; Reintegration to Normal Living Index (RNL), a measure of participation restrictions; and EQ-VAS, a measure of HRQOL. RESULTS After adjusting for demographic and clinical variables, impairment explained 54%, activity limitations explained 48%, and participation restrictions explained 61% of the variation in HRQOL. After adjustment, when all three functional measures were included in the model, only participation restrictions had a significant impact on HRQOL explaining 63% of the variation. CONCLUSION Impairment and activity limitations affect the daily activities a patient can perform, but it is the restriction in participation of life roles and situations that has the greatest effect on patient's HRQOL.
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Affiliation(s)
- Daphne Schreiber
- Division of Outcomes and Population Health, Toronto Western Research Institute, Toronto, Ontario, Canada
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Marchese VG, Spearing E, Callaway L, Rai SN, Zhang L, Hinds PS, Carlson CA, Neel MD, Rao BN, Ginsberg J. Relationships among range of motion, functional mobility, and quality of life in children and adolescents after limb-sparing surgery for lower-extremity sarcoma. Pediatr Phys Ther 2006; 18:238-44. [PMID: 17108796 DOI: 10.1097/01.pep.0000232620.42407.9f] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The study was designed to examine relationships between range of motion (ROM), functional mobility, and quality of life (QL) in patients with lower-extremity sarcoma (LES) after limb-sparing surgery METHODS Sixty-eight patients with LES (age, 10-26 years) participated. The patients performed hip flexion, hip extension, knee flexion, and knee extension, Timed Up and Down Stairs (TUDS), Timed Up and Go (TUG), nine-minute run-walk (9-min), and completed the QL measure, Short-Form-36 version two (SF-36v2). RESULTS Significant correlations (p < 0.01) were found between hip extension and SF-36v2 physical component scale (PCS; r = 0.33), TUDS (r = -0.32), TUG (r = -0.33); hip flexion and TUDS (r = -0.31), TUG (r = -0.39), 9-min (r = 0.44); knee flexion and TUDS (r = -0.52), TUG (r = -0.40), 9-min (r = 0.37); SF-36v2 PCS and TUDS (r = -0.56), TUG (r = -0.51), 9-min (r = 0.60). CONCLUSION ROM correlates with functional mobility and QL in patients with LES after limb-sparing surgery. ROM exercises are important component of a physical therapy program for children and adolescents with LES.
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Affiliation(s)
- Victoria G Marchese
- Department of Epidemiology and Cancer Control, St. Jude's Children's Research Hospital, Memphis, Tennessee 38105-2794, USA.
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Pakulis PJ, Young NL, Davis AM. Evaluating physical function in an adolescent bone tumor population. Pediatr Blood Cancer 2005; 45:635-43. [PMID: 16047380 DOI: 10.1002/pbc.20383] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Survival rates for patients with bone tumors have increased dramatically over the past few decades. Unfortunately, many patients face functional limitations resulting from disease management, but there is little evidence regarding physical functioning in adolescents with bone tumors. This lack is largely due to the absence of a standardized measure for evaluating adolescent sarcoma physical functioning. This review discusses considerations in searching for a measure of adolescent physical functioning, evaluates measures previously used in assessing functional outcome in young sarcoma patients, reviews self-report measures of pediatric physical functioning, and makes recommendations for future research. PROCEDURE Electronic databases were searched for studies published between 1980 and 2004. Studies examining physical functioning in adolescent sarcoma patients and those describing measures of pediatric physical functioning were included. RESULTS The study includes measures previously used in the adolescent bone tumor literature (Musculoskeletal Tumor Society, Mankin, Groningen Activity Restriction Scale, Toronto Extremity Salvage Score [TESS]), and three measures of pediatric physical function (Functional Disability Inventory, Pediatric Outcomes Data Collection Instrument [PODCI], Activities Scale for Kids [ASK]). The TESS, PODCI, and ASK each met at least four of the outlined applicability and feasibility components. CONCLUSION The search for a measure of physical functioning for adolescent sarcoma patients requires an exploration of many developmental and measurement issues. Based on the sensibility review presented, the TESS, PODCI, and ASK are recommended for further evaluation of content and of the measurement properties of reliability, validity, and responsiveness, prior to their use in evaluating adolescent sarcoma patients.
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Affiliation(s)
- P Janine Pakulis
- Department of Rehabilitation, Hospital for Sick Children, Toronto, Ontario, Canada.
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Koopman HM, Koetsier JA, Taminiau AHM, Hijnen KE, Bresters D, Egeler RM. Health-related quality of life and coping strategies of children after treatment of a malignant bone tumor: a 5-year follow-up study. Pediatr Blood Cancer 2005; 45:694-9. [PMID: 15924359 DOI: 10.1002/pbc.20408] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was designed to evaluate the development of health-related quality of life (HRQoL) and coping strategies of children and young adults, who have undergone surgery for a malignant bone tumor in childhood. PATIENTS AND INSTRUMENTS: In this single center follow-up study 20 patients were included. The patients were tested 3 and 8 years after treatment. At the 3-year mark the parents participated as well. To measure the HRQoL and coping strategies the TACQOL and the TAAQOL questionnaires and the Utrecht Coping List for Adolescents (UCLA) were used. All measurements were compared to a control group of healthy peers (n = 1,122 and n = 272, respectively). RESULTS At the first measurement (3 years after treatment) both the study patients and their parents reported significantly lower HRQoL scores on two domains: motor functioning and autonomy (P < 0.05). In addition parents reported their children to have significantly lower HRQoL scores on cognitive functioning and experiencing positive emotions. Five years later (8 years after treatment) the young adults reported comparable HRQoL on motor functioning and autonomy, and significantly higher HRQoL scores on cognitive functioning, social contacts and negative emotions (less depressive moods). With regard to coping strategies no significant differences between the two measurements in the study population and the reference group were found. CONCLUSIONS Three years after surgery for a malignant bone tumor, patients and their parents reported lower HRQoL scores on different domains compared with a reference group. Eight years after surgery the young adults surprisingly reported comparable or higher HRQoL scores. These patients treated for bone cancer were able to adapt well after treatment and showed no long-term emotional or social problems.
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Affiliation(s)
- Hendrik M Koopman
- Departments of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
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Tabone MD, Rodary C, Oberlin O, Gentet JC, Pacquement H, Kalifa C. Quality of life of patients treated during childhood for a bone tumor: assessment by the Child Health Questionnaire. Pediatr Blood Cancer 2005; 45:207-11. [PMID: 15602713 DOI: 10.1002/pbc.20297] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To determine which factors impact on quality of life of patients with bone tumor, we used the Children Health Questionnaire French version. Thirty-seven patients (25 males, 19 osteosarcoma, 18 Ewing sarcoma) were studied. At assessment, median age was 15 years, median follow-up was 4 years. Mean scores were 60, 81, 76, 74, 70, 87 for general health, physical functioning, pain, mental health, self-esteem, and family activity, respectively. Lower results were observed for mental health in girls, for physical functioning, and self-esteem in patients with endoprosthesis, and for family activity and pain in patients who had relapsed.
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Affiliation(s)
- Marie-Dominique Tabone
- Department of Haematology and Oncology, Armand Trousseau Children's Hospital, Paris, France.
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Nagarajan R, Clohisy DR, Neglia JP, Yasui Y, Mitby PA, Sklar C, Finklestein JZ, Greenberg M, Reaman GH, Zeltzer L, Robison LL. Function and quality-of-life of survivors of pelvic and lower extremity osteosarcoma and Ewing's sarcoma: the Childhood Cancer Survivor Study. Br J Cancer 2005; 91:1858-65. [PMID: 15534610 PMCID: PMC2410143 DOI: 10.1038/sj.bjc.6602220] [Citation(s) in RCA: 118] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Limb-sparing surgeries have been performed more frequently than amputation based on the belief that limb-sparing surgeries provide improved function and quality-of-life (QOL). However, this has not been extensively studied in the paediatric population, which has unique characteristics that have implications for function and QOL. Using the Childhood Cancer Survivor Study, 528 adult long-term survivors of pediatric lower extremity bone tumours, diagnosed between 1970 and 1986, were contacted and completed questionnaries assessing function and QOL. Survivors were an average of 21 years from diagnosis with an average age of 35 years. Overall they reported excellent function and QOL. Compared to those who had a limb-sparing procedure, amputees were not more likely to have lower function and QOL scores and self-perception of disability included general health status, lower educational attainment, older age and female gender. Findings from this study suggest that, over time, amputees do as well as those who underwent limb-sparing surgeries between 1970 and 1986. However, female gender, lower educational attainment and older current age appear to influence function, QOL and disability.
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Affiliation(s)
- R Nagarajan
- Division of Pediatrics, Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Mayo Mail Code 484, 420 Delaware St., SE Minneapolis, MN 55455, USA.
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Abstract
Osteosarcoma is the most common solid tumour of childhood. Chemotherapy has substantially improved survival, but surgical resection remains essential for cure. Limb-salvage surgery is now common and can be done for up to 85% of children with osteosarcoma. The main surgical challenge in children is how to reconstruct the limb after removal of the tumour. Knowledge of probable outcomes, risks, and benefits of each surgical option is essential for comparison of reconstruction with amputation, which is still the safest and most suitable option in some children.
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Abstract
With the goal of studying perceived distress among adolescents recently diagnosed with cancer, 56 adolescents were interviewed by telephone 4 to 8 weeks after diagnosis. The interviews included a structured interview guide, the Hospital Anxiety and Depression Scale, and the subscales Mental Health and Vitality from SF-36. "Losing hair" and "missing leisure activities" were identified as the most prevalent aspects of distress, whereas "missing leisure activities" and "fatigue" were rated with the highest levels of distress. "Worry about not getting well," "mucositis," "nausea," "pain from procedures and treatments," and "worry about missing school" were rated as the overall worst aspects by most adolescents. Twelve percent reached the cutoff score for potential clinical anxiety and 21% for potential clinical depression. Ratings of Mental Health and Vitality were lower than norm values. Prevalence of pain from procedures/treatments was higher among those who scored in the clinical range of depression, and more adolescents who were treated at a local hospital scored in the clinical range of anxiety. The findings show that ratings of prevalence, levels, and aspects perceived as the worst are not necessarily in accordance, that adolescents scoring in the clinical range of psychological distress are in the minority, and that the adolescents experience reduced physical and mental well-being.
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Affiliation(s)
- Mariann Hedström
- Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
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