Šnajdrová Tereza, Patrmanová Eliška, Jevič Filip, Bořilová Karolína, Hrdoušková Monika, Musálek Martin
Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia.
Faculty of Physical Education and Sport, Charles University, Prague, Czechia.
Front Pediatr. 2023 Apr 3;11:1071572. doi: 10.3389/fped.2023.1071572. eCollection 2023.
Acute lymphoblastic leukaemia (ALL) ranks among paediatrics' most common oncological malignancies. Monitoring motor performance levels associated with self-sufficiency in the everyday activities of ALL patients is extremely important during treatment. The motor development of children and adolescents with ALL is most often assessed using the Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT-2) complete form (CF) with 53 items or the short form (SF) with 14 items. However, there is no evidence in research that BOT-2 CF and SF give comparable results in the population of patients with ALL.
This study aimed to determine the compatibility of motor proficiency levels achieved from BOT-2 SF and BOT-2 CF in ALL survivors.
The research sample consists of = 37 participants (18 girls, 19 boys) aged 4-21 years (10.26, ± SD 3.9) after treatment for ALL. All participants passed BOT-2 CF and were at least 6 months and a maximum of 6 years from the last dose of vincristine (VCR). We used ANOVA with repeated measures, considering the sex, intra-class correlation (ICC) for uniformity between BOT-2 SF and BOT-2 CF scores and Receiving Operating Characteristic.
BOT-2 SF and BOT-2 CF assess the same underlying construct, and BOT-2 SF and CF standard scores have good uniformity: ICC = 0.78 for boys and ICC = 0.76 for girls. However, results from ANOVA showed that the participants achieved a significantly lower standard score in SF (45.1 ± 7.9) compared to CF (49.1 ± 9.4) ( < 0.001; Hays = 0.41). ALL patients performed the worst in Strength and Agility. According to the ROC analysis, BOT-2 SF obtains acceptable sensitivity (72.3%) and high specificity (91.9%) with high accuracy of 86.1%, and the fair value of the Area Under the Curve (AUC) = 0.734 CI95% (0.47-0.88) in comparison to BOT-2 CF.
To reduce the burden on ALL patients and their families, we recommend using BOT-2 SF instead of BOT-2 CF as a useful screening tool. BOT-SF can replicate motor proficiency with as high probability as BOT-2 CF but systematically underestimates motor proficiency.
急性淋巴细胞白血病（ALL）是儿科最常见的肿瘤恶性疾病之一。在治疗期间，监测ALL患者日常活动中与自理能力相关的运动表现水平极为重要。ALL患儿和青少年的运动发育通常使用布鲁因inks - 奥塞列茨基运动熟练度测试第二版（BOT - 2）完整形式（CF）（共53项）或简短形式（SF）（共14项）进行评估。然而，研究中没有证据表明BOT - 2 CF和SF在ALL患者群体中能得出可比的结果。
本研究旨在确定ALL幸存者通过BOT - 2 SF和BOT - 2 CF所达到的运动熟练度水平的兼容性。
研究样本包括37名年龄在4 - 21岁（平均10.26岁，标准差3.9岁）的ALL治疗后参与者（18名女孩，19名男孩）。所有参与者均完成了BOT - 2 CF测试，且距离最后一剂长春新碱（VCR）至少6个月且最长6年。我们使用重复测量方差分析，考虑性别、BOT - 2 SF和BOT - 2 CF分数之间的组内相关性（ICC）以及接受者操作特征。
BOT - 2 SF和BOT - 2 CF评估的是相同的潜在结构，且BOT - 2 SF和CF标准分数具有良好的一致性：男孩的ICC = 0.78，女孩的ICC = 0.76。然而，方差分析结果显示，与CF（49.1±9.4）相比，参与者在SF中的标准分数显著更低（45.1±7.9）（P < 0.001；Hays效应量 = 0.41）。ALL患者在力量和敏捷性方面表现最差。根据ROC分析，与BOT - 2 CF相比，BOT - 2 SF具有可接受的敏感性（72.3%）和高特异性（91.9%），准确率为86.1%，曲线下面积（AUC）的合理值 = 0.734，95%置信区间（0.47 - 0.88）。
为减轻ALL患者及其家庭的负担，我们建议使用BOT - 2 SF而非BOT - 2 CF作为一种有用的筛查工具。BOT - SF能够以与BOT - 2 CF几乎相同的概率复制运动熟练度，但会系统性地低估运动熟练度。
