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Proficiency of Balance in Children and Youth Who Have Had Acute Lymphoblastic Leukemia

MJ Wright, PT, BSc, MEd, is Clinical Specialist, McMaster Children's Hospital, and Assistant Clinical Professor, School of Rehabilitation Sciences and Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
V Galea, PhD, is Associate Professor, School of Rehabilitation Sciences, McMaster University
RD Barr, MB, ChB, MD, is Professor, Department of Pediatrics, Hamilton Health Sciences, Hamilton, Ontario, and School of Rehabilitation Sciences, McMaster University

Address all correspondence to Ms Wright at McMaster Children's Hospital, Box 2000, Hamilton, Ontario, Canada, L8N 3Z5 (wrightm{at}hhsc.ca)

Background and Purpose. As the survival rate for acute lymphoblastic leukemia (ALL) in childhood increases, long-term sequelae are a growing concern. This cross-sectional, descriptive study compared the balance skills of children and youth who have had ALL with those of comparable subjects and explored associations with demographics, therapy, physical activity, and health-related quality of life (HRQL). Subjects. Ninety-nine subjects treated previously for ALL and 89 comparison subjects were examined. Methods. Measures included the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) balance subtest, the Children's Self-perceptions of Adequacy in and Predilection for Physical Activity Scale (CSAPPA), and the Health Utilities Index (HUI), a measure of HRQL. Results. The children and youth who had ALL had poorer balance than the comparison subjects (BOTMP=10.55 and 16.30, respectively) and lower CSAPPA scores (57.72 and 63.72, respectively) and HUI scores (0.86 and 0.97, respectively). Regression analyses identified exposure to cranial irradiation, being overweight, lower CSAPPA scores for adequacy, and lower HUI single-attribute scores for cognition as predictors of lower balance scores in subjects who had ALL. Discussion and Conclusion. Balance abilities in subjects treated for ALL were compromised, and several factors were associated with this deficit.

Key Words: Balance • Oncology • Pediatrics

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