Taverna Livia, Tremolada Marta, Bonichini Sabrina, Tosetto Barbara, Basso Giuseppe, Messina Chiara, Pillon Marta
Faculty of Education, Free University of Bolzano-Bozen, Faculty of Education, Brixen, Italy.
Department of Developmental Psychology and Socialization, Faculty of Psychology, University of Padua, Padua, Italy.
PLoS One. 2017 Oct 24;12(10):e0186787. doi: 10.1371/journal.pone.0186787. eCollection 2017.
CNS-directed therapies for the treatment of leukemia can adversely affect the acquisition of new skills, such as reading/writing and math. Two years after the end of treatments, children show gross and fine motor skill delays that may persist even when patients are considered healed. The goal of the present study was to assess motor skills difficulties in pre-school children with leukemia one year after treatment. Particular attention has been paid to those patients who had undergone Hematopoietic Stem Cell Transplantation (HSCT) and to the relationship between motor delays and age bands. Participants were 60 children (median age of 5; inter quartile range: 3.07-5.76), including 31 females and 29 males, 91.7% of them were affected by acute lymphoblastic leukemia (ALL), and 8.3% by acute myeloid leukemia (AML). Five children had undergone HCST. Parents were interviewed by Vineland Adaptive Behavior Scales (VABS) on children's motor skills and filled in the Italian Temperament Questionnaire (QUIT). VABS's total scores were converted into equivalent mental age scores (EMA). A score difference of at least three months between current age and equivalent mental age was considered a developmental delay. Non-parametric analyses were run to understand if HSCT treatment and a specific age band influence children's motor skills. Significant delays were found in global motor skills (56.7%) as well as in fine and gross motor domains. Mann Whitney U tests showed that children with HSCT were reported to have lower gross motor mean ranks (U = 62; p = 0.004; Mean rank = 15.40) than peers without HSCT (Mean rank = 31.87) and lower mean rank values on motor temperament scale (U = 9; p = 0.003; HSCT Mean rank = 4.75 versus no HSCT Mean rank = 27.81). Kruskal Wallis' tests identified the high risk treatment showing that HSCT experience negatively impacted the motor skills and temperamental motor activity of pre-school children one year after the diagnosis of leukemia.
用于治疗白血病的中枢神经系统定向疗法可能会对新技能的习得产生不利影响，如阅读/写作和数学。治疗结束两年后，儿童会出现粗大和精细运动技能延迟，即使在患者被认为已治愈时，这种延迟仍可能持续。本研究的目的是评估白血病学龄前儿童治疗一年后的运动技能困难。特别关注了那些接受过造血干细胞移植（HSCT）的患者以及运动延迟与年龄组之间的关系。研究参与者为60名儿童（中位年龄5岁；四分位间距：3.07 - 5.76），其中包括31名女性和29名男性，91.7%患有急性淋巴细胞白血病（ALL），8.3%患有急性髓细胞白血病（AML）。5名儿童接受了造血干细胞移植。通过文兰适应行为量表（VABS）对家长进行访谈，了解儿童的运动技能，并填写意大利气质问卷（QUIT）。VABS的总分被转换为等效心理年龄分数（EMA）。当前年龄与等效心理年龄之间至少三个月的分数差异被视为发育延迟。进行非参数分析以了解HSCT治疗和特定年龄组是否会影响儿童的运动技能。结果发现，整体运动技能（56.7%）以及精细和粗大运动领域均存在显著延迟。曼 - 惠特尼U检验显示，接受HSCT的儿童的粗大运动平均秩次（U = 62；p = 0.004；平均秩次 = 15.40）低于未接受HSCT的同龄人（平均秩次 = 31.87），并且在运动气质量表上的平均秩次值也较低（U = 9；p = 0.003；HSCT平均秩次 = 4.75，未接受HSCT平均秩次 = 27.81）。克鲁斯卡尔 - 沃利斯检验确定了高风险治疗，表明HSCT经历对白血病诊断一年后的学龄前儿童的运动技能和气质性运动活动产生了负面影响。
