Motor Proficiency and Physical Activity in Adult Survivors of Childhood ALL

描述（由申请人提供）：诊断为急性淋巴细胞白血病（ALL）的儿童的五年生存率接近90%，这使得对其长期疾病和治疗相关结果的检查成为一个重大的公共卫生问题。儿童期ALL幸存者患早期死亡、二次恶性肿瘤、肥胖和心脏病的风险增加，由于癌症的影响或治愈所需的治疗，这些疾病往往不可避免。长期结果也受到生活方式选择的影响，并且在身体残疾无法参加常规体育活动的ALL幸存者中可能会加剧。本应用程序的主要目的是在大量儿童ALL幸存者中提供有关肌肉骨骼健康、感觉功能和健康受损的全面客观信息，并通过评估导致功能受损的治疗因素来确定高风险人群。此外，对这些损伤对参加定期身体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，并改善因长期残疾而影响健康选择的ALL儿童幸存者参加定期身体活动的机会。我们建议进行一项研究，包括对1980年至1998年期间在St. Jude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、健康和身体活动模式进行直接、客观的评估。在899名ALL幸存者中，所有人都有资格参加机构资助的医学晚期效应临床研究，我们建议招募364人参与我们的评估。我们还建议招募364个人作为对照组，根据种族/民族，年龄和性别进行频率匹配。公共卫生相关性：与儿童ALL成年幸存者互动和治疗的个人将受益于有关疾病的重要后果和相关治疗药物的信息，以便他们能够认识到身体活动受限的潜在预测因素。这将有助于设计干预措施，以改善身体活动的限制，并针对那些在参与促进健康生活方式的活动的能力方面最有可能出现后续限制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.