Decrease in peripheral muscle strength and ankle dorsiflexion as long-term side effects of treatment for childhood cancer

Pediatr Blood Cancer. 2008 Apr;50(4):833-7. doi: 10.1002/pbc.21325.

Abstract

Background: This study investigated muscle strength, passive ankle dorsiflexion, and their association with motor performance in children after treatment for acute lymphoblastic leukemia, Wilms tumor, B-non-Hodgkin lymphoma, and malignant mesenchymal tumors.

Procedure: Muscle strength was assessed with a hand-held dynamometer and ankle dorsiflexion with a goniometer in 92 and 64 survivors, respectively. Motor performance was measured with the Movement Assessment Battery for Children (movement-ABC). Age at testing: 6.1-12.9 years. Mean time since completing treatment: 3.3 years. Results were compared to 155 healthy controls.

Results: Muscle strength of the survivors was reduced in ankle dorsiflexors on both sides (P < 0.001), wrist dorsiflexors on the non-dominant side (P < 0.001), and pinch grip on the non-dominant (P = 0.001) and dominant side (P = 0.01). Passive ankle dorsiflexion of the survivors was significantly less on both sides (P < 0.01). Movement-ABC percentile score was affected by pinch grip strength on the non-dominant (P < 0.004), and dominant side (P = 0.024) but not by strength of other muscle groups or by passive ankle dorsiflexion.

Conclusion: Peripheral muscle strength and ankle dorsiflexion are reduced in the long-term in children treated for cancer with chemotherapy. However, neither decreased muscle strength nor reduced ankle dorsiflexion could completely explain reduced scores on the movement-ABC.

MeSH terms

  • Ankle / physiology*
  • Antineoplastic Agents / adverse effects*
  • Child
  • Dexamethasone / administration & dosage
  • Female
  • Humans
  • Male
  • Motor Activity / drug effects*
  • Muscle Strength / drug effects*
  • Muscle Strength Dynamometer
  • Muscle, Skeletal / drug effects
  • Neoplasms / drug therapy*
  • Prednisone / administration & dosage
  • Range of Motion, Articular / drug effects
  • Time
  • Vincristine / administration & dosage
  • Vincristine / adverse effects

Substances

  • Antineoplastic Agents
  • Vincristine
  • Dexamethasone
  • Prednisone