Motor Proficiency and Physical Activity in Adult Survivors of Childhood ALL

描述(申请人提供)：被诊断为急性淋巴细胞白血病(ALL)的儿童的五年存活率接近90%，这使得对他们的长期疾病和治疗结果的检查成为一个重大的公共卫生问题。儿童时期所有幸存者罹患早期死亡、第二次恶性肿瘤、肥胖和心脏病的风险都增加，这往往是由于癌症的影响或治愈所需的治疗而不可避免的。长期结果也受到生活方式选择的影响，对于身体残疾阻碍参加定期体育活动的所有幸存者来说，长期结果可能会加剧。该应用程序的主要目标是提供关于一大群儿童幸存者肌肉骨骼健康、感觉功能和健康受损的全面和客观的信息，并通过评估导致功能受损的治疗因素来确定高危群体。此外，对这些损伤对参加定期体力活动的影响进行评估，将有助于设计考虑到普遍存在的功能丧失的干预措施，并改善所有因长期残疾而健康选择受到影响的儿童幸存者参加定期体力活动的机会。我们建议进行一项研究，包括对1980至1998年间在圣犹大儿童研究医院接受儿童ALL治疗的成年人的肌肉骨骼功能、感觉能力、体能和体力活动模式进行直接、客观的评估。在899名幸存者中，所有人都有资格参加一项由机构资助的关于医学后遗症的临床研究，我们建议招募364人参与我们的评估。我们还建议招募364人作为对照组，在种族/族裔、年龄和性别方面进行频率匹配。公共卫生相关性：与儿童时期成年幸存者互动并接受治疗的个人都将受益于有关疾病和相关治疗因素的重要后果的信息，以便他们能够认识到身体表现有限的潜在预测因素。这将允许设计干预措施以改善体力活动限制，并针对那些在参与促进健康生活方式的活动方面具有最大风险的个人进行有针对性的干预。

DESCRIPTION (provided by applicant): Five year survival rates for children diagnosed with acute lymphoblastic leukemia (ALL) are nearing 90%, making examination of their long-term disease and treatment related outcomes a substantial public health concern. Childhood ALL survivors are at increased risk for early mortality, second malignancies, obesity and heart disease, often unavoidable because of either the effects of the cancer or the treatment required for cure. Long-term outcomes are also influenced by lifestyle choices, and may be exacerbated in ALL survivors whose physical disabilities prevent participation in regular physical activity. The primary goal of this application is to provide comprehensive and objective information on impairments of musculoskeletal health, sensory function, and fitness among a large group of childhood ALL survivors, and to define high risk groups by assessing treatment factors that contribute to impaired function. In addition, an evaluation of the impact of these impairments on participation in regular physical activity will allow for the design of interventions that take into account prevalent functional loss, and improve opportunities for participation in regular physical activity among childhood ALL survivors whose health choices are compromised by long-term disability. We propose to conduct a study that includes a direct, objective evaluation of musculoskeletal function, sensory capacity, fitness and physical activity patterns among adults who were treated for childhood ALL at St. Jude Children's Research Hospital between 1980 and 1998. Among 899 ALL survivors, all of whom are eligible for an institutionally funded clinical study of medical late effects, we propose to recruit 364 to participate in our evaluations. We also propose to recruit 364 individuals for a comparison group, frequency matching on race/ethnicity, age and gender. PUBLIC HEALTH RELEVANCE: Individuals who interact with and treat adult survivors of childhood ALL will benefit from information about the important consequences of disease and associated treatment agents so that they can recognize potential predictors of limited physical performance. This will allow for the design of interventions to ameliorate physical activity limitations, and targeted interventions for those individuals who are at greatest risk for developing subsequent restrictions in their abilities to participate in activities that promote a healthy lifestyle.