Balance impairment in survivors of pediatric brain cancers: risk factors and associated physical limitations

Varedi, Mitra; Lu, Lu; Phillips, Nicholas S.; Partin, Robyn E.; Brinkman, Tara M.; Armstrong, Gregory T.; Chase, Emma; Khan, Raja B.; Powell, Douglas W.; McKenna, Raymond; Robison, Leslie L.; Hudson, Melissa M.; Ness, Kirsten K.

doi:10.1007/s11764-020-00932-5

Cited by 10 publications

(10 citation statements)

References 52 publications

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“…They found differences between their cohort and normative data for body coordination and strength and agility of the BOT-2, of which the first scale was similarly reported in our study. Varedi evaluated balance with the sensory organization test in adult survivors of pediatric brain tumors and found balance impairment in 48% of the survivors, which is also in line with our findings [ 14 ]. Regarding the 6MWT, 17 out of 50 children walked a significantly shorter distance than their peers, suggesting a reduced functional walking capacity and endurance in childhood brain tumor survivors.…”

Section: Discussionsupporting

confidence: 89%

“…Their results revealed significant differences between children with brain tumors and normative data for body coordination and strength and agility using the BOT-2. Varedi et al [ 14 ] observed balance impairments in 48% of adult survivors of pediatric central nervous tumors. Another study evaluated cardiorespiratory fitness with VO 2 max testing in pediatric fossa posterior tumor survivors.…”

Section: Introductionmentioning

confidence: 99%

“…Regarding potential risk factors, Piscione et al [ 13 ] reported vermis infiltration of the tumor as risk factor for lower body coordination scores and chemo- and radiotherapy for lower strength and agility scores, whereas age at diagnosis (< 3 years versus older) and time since diagnosis were not significant risk factors. Varedi et al [ 14 ] reported that balance impairments were associated with infratentorial tumor location, shunt placement, increased body fat percentage, hearing loss, flexibility limitations, peripheral neuropathy, and cognitive deficits.…”

Section: Introductionmentioning

confidence: 99%

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Better detection of reduced motor functioning in brain tumor survivors based on objective motor assessments: an incentive for improved standardized follow-up

et al. 2022

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Long-term sequelae are well-known in childhood brain tumor survivors, but motor functioning remains poorly described. This cross-sectional study aimed to assess objective motor functioning, patient-specific risk factors, and parental perceptions. Fifty-two childhood brain tumor patients (pilocytic astrocytoma, medulloblastoma, and other types) who were at least 6 months out of treatment were evaluated. Mean age at testing was 11.7 years. Objective motor functioning was assessed with the Movement Assessment Battery for Children (MABC-2-NL) and/or Bruininks-Oseretsky test of motor proficiency (BOT-2). Functional walking capacity was assessed with the 6-min walk test (6MWT). Parent-reported motor functioning was addressed using the ABILHAND-Kids, ABILOCO-Kids questionnaires, and a standardized anamnesis. Patients showed impaired motor functioning in all domains (p < 0.001). Regarding risk factors, younger age at diagnosis (< 5 year) was significantly associated with lower scores on body coordination (p = 0.006). Adjuvant treatment resulted in lower scores for fine manual control of the BOT-2 (p = 0.024) and balance of MABC-2-NL (p = 0.036). Finally, questionnaires revealed an underestimation of motor problems as perceived by the parents. In conclusion, many children who are in follow-up for a brain tumor show impaired motor functioning on multiple aspects, with younger age at diagnosis and adjuvant treatment as specific risk factors. Based on the questionnaires and anamnesis, motor problems appear to be underestimated by the parents. Conclusion: These findings point to the need for timely prospective screening of motor functioning. Based on a screening assessment, adequate rehabilitation programs can be applied in childhood brain tumor survivors, aiming to reduce the adverse impact on their daily lives, both for functional activities and cardiovascular fitness. What is Known:• A pediatric brain tumor and its treatment are associated with potential long-term motor sequelae.• Test assessments could enable us to objectify motor functioning of these patients. What is New:• Pediatric brain tumors survivors show lower motor performance compared to the norm, which is often underestimated by parents.• Younger age at diagnosis and adjuvant treatment could be specific risk factors.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Better detection of reduced motor functioning in brain tumor survivors based on objective motor assessments: an incentive for improved standardized follow-up

et al. 2022

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“…Varedi et al found that among adult survivors of pediatric CNS tumors, 48% continued to experience balance impairments in adulthood. 22…”

Section: Balancementioning

confidence: 99%

Neurorehabilitation for Adults with Brain and Spine Tumors

Hunter,

Qin,

Wallingford

et al. 2023

Semin Neurol

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Central nervous system (CNS) malignancies (i.e. brain and spine tumors) and their treatments can result in a multitude of neurologic deficits. Patients with CNS malignancies experience physical, cognitive, and psychosocial sequelae that can impact their mobility and quality of life. Neurorehabilitation can play a critical role in maintaining independence, preventing disability, and optimizing safety with activities of daily living. This review provides an overview of the neurorehabilitation approaches for patients with CNS malignancies, neurologic impairments frequently treated, and rehabilitation interventions in various health care settings. In addition, we will highlight rehabilitative outcomes between patients with nononcologic neurologic conditions compared to brain and spine tumors. Finally, we address medical challenges that may impact rehabilitation care in these medically complex cancer patients.

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“…Vincristine is known to cause sensorimotor chemotherapy-induced peripheral neuropathies (CIPNs) and is prevalent in chemotherapy regimens for many pediatric cancers including liquid tumors, solid tumors, and central nervous system tumors 2. Additional treatment-induced impairments that may impact balance include general deconditioning, steroid-induced proximal myopathy, and cancer-related cognitive impairment 8,9. Moreover, balance deficits can vary in presentation throughout and after oncology treatment.…”

mentioning

confidence: 99%