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Gait Patterns in Children With Cancer and Vincristine Neuropathy
1Cancer and Blood Disorders Program (Dr Gilchrist) and Rehabilitation Services (Ms Tanner), Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota; Doctor of Physical Therapy Program (Dr Gilchrist), St. Catherine University, Minneapolis, Minnesota.
Insights
Children with chemotherapy-induced peripheral neuropathy (CIPN) exhibit altered gait, including slower walking speed and shorter steps. Ankle range of motion, balance, and strength are key factors influencing these gait deficits.
Area of Science:
- Pediatric Oncology
- Neurology
- Biomechanics
Background:
- Vincristine chemotherapy commonly causes peripheral neuropathy in children.
- Chemotherapy-induced peripheral neuropathy (CIPN) can significantly impact a child's quality of life.
- The specific effects of CIPN on gait in pediatric populations remain under-investigated.
Purpose of the Study:
- To investigate the impact of chemotherapy-induced peripheral neuropathy (CIPN) on gait parameters in children and adolescents.
- To identify factors contributing to gait alterations in pediatric cancer survivors with CIPN.
Main Methods:
- Gait analysis using the GaitRite walkway was performed on 52 children/adolescents with CIPN and an age-/sex-matched control group.
- Gait variables were assessed before and after a 6-minute walk test (6MWT).
- Ankle range-of-motion (ROM), balance, and strength tests were also conducted.
Main Results:
- Children with CIPN demonstrated reduced gait velocity and step length compared to controls.
- Ankle ROM and balance were significant predictors of step length variability.
- While both groups improved velocity post-6MWT, the CIPN group maintained slower velocity, shorter step length, and decreased cadence.
Conclusions:
- Ankle range of motion and balance are crucial for addressing step length deficits in pediatric CIPN.
- Muscular strength is an important factor to consider for improving overall walking capacity in this population.
Purpose:
Children treated with vincristine often develop chemotherapy-induced peripheral neuropathy (CIPN), but effects of CIPN on gait have not been reported.
Methods:
Gait variables of 52 children/adolescents treated for non-central nervous system cancers with CIPN were compared with an age- and sex-matched control group. Gait data were collected via GaitRite walkway before and after completing a 6-minute walk test (6MWT). Ankle range-of-motion (ROM) measures, balance, and strength tests were also completed.
Results:
Participants with CIPN had decreased velocity and step length. Ankle ROM and balance explained variability in step length. Both groups increased self-selected velocity after the 6MWT, but participants with cancer walked with slower velocity, shorter step length, and decreased cadence. Strength, neuropathy, and self-selected velocity measured before the 6MWT explained variability in 6MWT scores.
Conclusions:
Ankle ROM and balance are important factors when treating step length deficits, whereas strength is also an important consideration for walking capacity.
