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Investigating fine motor deficits during maintenance therapy in children with acute lymphoblastic leukemia
Silvia Hanna1, Shorouk Elshennawy1, Moatasem El-Ayadi2
1Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
Insights
Children with acute lymphoblastic leukemia (ALL) often have fine motor skill deficits. This study found significant impairments in Egyptian children undergoing ALL maintenance treatment, highlighting the need for early intervention.
Area of Science:
- Pediatric Oncology
- Neurology
- Rehabilitation Medicine
Background:
- Children with acute lymphoblastic leukemia (ALL) are at higher risk for neuromuscular and musculoskeletal issues.
- Fine motor skill development is crucial for childhood development and academic success.
Purpose of the Study:
- To investigate fine motor impairments in Egyptian children diagnosed with ALL.
- To compare fine motor skills between children with ALL and healthy controls.
Main Methods:
- A cross-sectional study involving 54 children (4-7 years) treated for ALL in maintenance phase.
- Fine motor performance assessed using the Bruininks-Oseretsky Test of Motor Proficiency-second edition (BOT-2).
- Comparison with an age- and sex-matched control group using BOT-2 norms.
Main Results:
- Children with ALL demonstrated significantly impaired fine motor skills across all BOT-2 measures (P < 0.00001).
- No significant correlation was found between cumulative chemotherapy doses (vincristine, methotrexate, dexamethasone) and fine motor performance.
- Males generally outperformed females in BOT-2 scores, with exceptions in specific subtests.
Conclusions:
- Approximately 67% of children with ALL on maintenance treatment exhibited fine motor difficulties.
- Periodic evaluation of fine motor skills during chemotherapy is recommended to guide rehabilitation programs.
Objectives:
Children diagnosed with acute lymphoblastic leukemia (ALL) in their early childhood are more susceptible to neuromuscular and musculoskeletal impairments. This cross-sectional study was designed to address different types of fine motor impairments in Egyptian children diagnosed with ALL.
Methods:
Fifty-four children treated for ALL in maintenance phase aged from four to seven years were compared with an age- and sex-matched control group. Fine motor performance was assessed using the total fine motor form of the Bruininks-Oseretsky Test of Motor Proficiency-second edition (BOT-2). Sex- and age-specific norms of BOT-2 were used to calculate scale and standard scores in both groups.
Results:
Children with ALL had significantly impaired fine motor skills in all subtests and composites of BOT-2 compared with the typically developing group (P < 0.00001). Cumulative doses of vincristine, methotrexate, and dexamethasone revealed no significant correlation with any BOT-2 measure. Males performed significantly better than females in all BOT-2 scores except for the fine motor integration subtest and the total fine motor control composite as no significant differences were observed. The protocol risk stratum, duration of maintenance treatment, and the age at assessment did not significantly affect the BOT-2 measures.
Conclusion:
About 67% of children with ALL on maintenance treatment experienced fine motor difficulties. Periodic evaluation along the course of chemotherapy could identify specific impaired fine motor domains providing the base for a successful rehabilitation program.
