Fine Motor Impairment and Its Impact on Social Outcomes in Survivors of Pediatric Acute Lymphoblastic Leukemia: St. Jude Lifetime Cohort Study.

IF 3.5 4区医学 Q1 ORTHOPEDICS Physical Therapy Pub Date : 2024-11-01 DOI:10.1093/ptj/pzae142

Mayuko Iijima, Geehong Hyun, Tara M Brinkman, Raja B Khan, Deo Kumar Srivastava, Leslie L Robison, Melissa M Hudson, Ching-Hon Pui, Kevin R Krull, Hiroto Inaba, Kirsten K Ness

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Abstract

Aobjective: The impact of fine motor impairment among adult survivors of childhood acute lymphoblastic leukemia (ALL) on life after treatment is unknown.

Methods: This study evaluated prevalence and utilized multivariate logistic regression to identify risk factors for fine motor impairment among survivors of ALL, and associations with educational attainment and social independence. Latent class analysis defined social independence (independent, moderately independent, dependent), using employment, independent living, personal care assistance, routine need assistance, driver's license status, and marital status inputs.

Results: Among 875 survivors who were ≥ 25 years old (age when most adults achieve independence) and ≥ 5 years from diagnosis (mean = 28.97 years), 33.6% had fine motor impairment, with scores at or below the 10th percentile of the scores of community controls (n = 460) on fine motor components of the physical performance test and the grooved peg-board test. Survivors exposed to cranial radiation had more fine motor impairment than those without (45.8% vs 20.2%). Male sex (exposed: odds ratio [OR] = 2.55, 95% confidence interval [CI] = 1.65-3.92; unexposed: OR = 3.02, 95% CI = 1.69-5.38) and lower scores on the Wechsler abbreviated scale of intelligence (exposed: OR = 0.46, 95% CI = 0.36-0.58; unexposed: OR = 0.43, 95% CI = 0.31-0.58) were risk factors for neuropathy. A 1-point-higher total neuropathy score was associated with 8% (95% CI = 1%-17%) increased odds of fine motor impairment. Fine motor impairment was associated with less than a college education (less than high school: OR = 2.23, 95% CI = 1.20-4.14; high school diploma/general equivalency diploma: OR = 2.66, 95% CI = 1.65-4.30; vocational education: OR = 2.07, 95% CI = 1.38-3.13) and less social independence (moderately independent: OR = 1.80, 95% CI = 1.15-2.83; dependent: OR = 2.65, 95% CI = 1.25-5.64).

Conclusion: Fine motor impairment in survivors of childhood ALL may interfere with optimal educational attainment and social independence.

Impact: Early identification of survivors at risk for fine motor impairment, with timely intervention, may improve long-term outcomes.

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小儿急性淋巴细胞白血病幸存者的精细运动障碍及其对社会结果的影响：圣裘德终身队列研究》。

目的：儿童急性淋巴细胞白血病成年幸存者的精细运动障碍对治疗后生活的影响尚不清楚：儿童急性淋巴细胞白血病成年幸存者的精细运动障碍对治疗后生活的影响尚不清楚：本研究评估了急性淋巴细胞白血病幸存者中精细运动障碍的患病率，并利用多变量逻辑回归确定了精细运动障碍的风险因素，以及与受教育程度和社会独立性之间的关联。潜类分析使用就业、独立生活、个人护理协助、日常需求协助、驾照状况和婚姻状况输入来定义社会独立性（独立、中度独立、依赖）：在875名年龄≥25岁（大多数成年人实现独立的年龄）且距离确诊时间≥5年（平均年龄=28.97岁）的幸存者中，33.6%的人存在精细运动障碍，在体能测试（Physical Performance Test）和凹槽木板测试（Grooved Peg-Board Test）中精细运动部分的得分达到或低于社区对照组（460人）得分的第10百分位数。受到颅内辐射的幸存者比未受到颅内辐射的幸存者（45.8% 对 20.2%）更容易出现精细运动障碍。OR=3.02，95.0% CI=1.69-5.38），以及韦氏智力缩略量表（Wechsler Abbreviated Scale of Intelligence）得分较低（暴露：OR=0.46，95.0% CI=1.69-5.38）：暴露：OR = 0.46，95.0% CI = 0.36-0.58；未暴露：OR = 0.43，95.0% CI = 0.31-0.58）是神经病变的风险因素。神经病变总分高 1 分与精细运动障碍几率增加 8%（95.0% CI = 1%-17%）有关。精细运动障碍与大学教育程度以下有关（高中以下：OR = 2.23，95.0% CI = 1.20-4.14；高中文凭/普通同等学历文凭：OR=2.66，95.0% CI=1.65-4.30；职业教育：OR=2.07，95.0% CI=1.38-3.13），社会独立性较差（中度独立：OR=1.80，95.0% CI=1.15-2.83；依赖性：结论：结论：儿童急性淋巴细胞白血病幸存者的精细运动障碍可能会影响其达到最佳教育水平和社会独立性：影响：早期发现有精细动作障碍风险的幸存者并及时干预，可改善长期预后。

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来源期刊

Physical Therapy Multiple-

CiteScore

7.10

自引率

0.00%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.