Hacettepe University Faculty of Physical Therapy and Rehabilitation, 06100, Ankara, Turkey.
Department of Pediatric Hematology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Eur J Pediatr. 2021 Apr;180(4):1081-1088. doi: 10.1007/s00431-020-03833-y. Epub 2020 Oct 16.
Our aim was to determine impairments in physical functions, activity limitations, and participation restrictions with the International Classification of Functioning, Disability and Health version for Children and Youth (ICF-CY) framework in children with acute lymphoblastic leukemia (ALL) receiving treatment. Physical functions were assessed in terms of pain level, fatigue level, handgrip strength, and motor proficiency. Fine motor activities and lower extremity performance were assessed to determine activity limitations. Participation was assessed with a patient-reported questionnaire. Thirty children with ALL (mean age: 8.45 ± 3.33 years) were included. Pain and fatigue level were mild. Poor handgrip strength was found; their mean handgrip strength was 60% of the normative. Fifty-six percent of the children had below-average motor performance. Participation scores were considerably high, except for sport and physical functioning sub-score. Participation level was positively associated with bilateral coordination and duration after diagnosis, while negatively correlated with pain and fatigue level (p ˂ 0.05).Conclusion: The ICF-CY-based evaluation was useful to understand children's limitations in everyday life. Children with ALL need supportive interventions during treatments in terms of physical functioning and participation in activities. Children with ALL with higher pain and fatigue, poor bilateral coordination, and who were in earlier period after diagnosis had higher risk for participation restriction. What is Known: • Children with ALL had physical functioning limitations on treatments. • Participation restrictions were described in children with ALL off treatment. What is New: • The ICY-CY-based health and functioning evaluation allows health care professionals to globally determine limitations of everyday life in children with ALL on treatment. • Impairments in physical functions, pain severity, fatigue severity, and duration after diagnosis are associated with participation to everyday life in children with ALL on treatment.
我们的目的是使用国际功能、残疾和健康分类儿童版(ICF-CY)框架来确定接受治疗的急性淋巴细胞白血病(ALL)儿童的身体功能、活动受限和参与受限情况。身体功能通过疼痛水平、疲劳水平、握力和运动技能来评估。精细运动活动和下肢功能用于评估活动受限。参与度通过患者报告问卷进行评估。共有 30 名 ALL 患儿(平均年龄:8.45 ± 3.33 岁)纳入研究。疼痛和疲劳程度较轻。发现握力较弱,平均握力为正常值的 60%。56%的患儿运动表现低于平均水平。除运动和身体功能子分外,参与度评分相当高。参与水平与双侧协调和诊断后时间呈正相关,而与疼痛和疲劳水平呈负相关(p ˂ 0.05)。结论:基于 ICF-CY 的评估有助于了解儿童日常生活中的局限性。ALL 患儿在治疗期间需要在身体功能和活动参与方面进行支持性干预。疼痛和疲劳程度较高、双侧协调能力较差且诊断后时间较短的 ALL 患儿有更高的参与受限风险。已知情况:• ALL 患儿在治疗期间存在身体功能障碍。• 在停止治疗后描述了 ALL 患儿的参与受限情况。新发现:• 基于 ICF-CY 的健康和功能评估使医疗保健专业人员能够全面确定治疗期间 ALL 患儿日常生活中的局限性。• 身体功能、疼痛严重程度、疲劳严重程度和诊断后时间的损害与治疗期间 ALL 患儿日常生活的参与度相关。