Date of Paper/Work
Type of Paper/Work
Doctor of Physical Therapy (DPT)
Background and Purpose: Pediatric cancers affect over ten thousand children in the United States each year. Although survival rates continue to climb, debilitating long-term side effects from cancer treatment are surfacing. The purpose of this study was to investigate the effects of chemotherapy on selected gait characteristics in children ages five to twenty-two.
Methods: This was a prospective, cross-sectional study that investigated the differences found in and between children undergoing cancer treatment for non-central nervous system cancers and children without cancer. The data was collected in the oncology program of the two campuses of Children’s Hospitals and Clinics of Minnesota. Sixty children with cancer and thirty-six children without cancer (controls) participated in this study. Each participant completed impairment testing including: ankle range of motion, ankle strength, and neuropathy rating using the ped-mTNS. Their gait pattern was recorded using the GaitRite Gait Analysis System and then each subject completed a 6 minute walk test.
Results: Using MANOVA procedures, we found that subjects with cancer demonstrated significantly slower walking velocity, decreased cadence, and shorter step length (α≤.05) compared to controls. No significant gait differences were found between cancer patients who received vincristine and those who received IT methotrexate in addition to vincristine (α≥.05). Within the cancer group, significant correlations were found between underlying impairments of ankle dorsiflexion strength, and neuropathy with selected gait characteristics (α≤.05). Significant correlations were also found between the distance walked in six minutes with velocity and step length (α≤.05).
Conclusions: Children who received chemotherapy treatment had significantly slower velocities, decreased cadence and shorter step lengths when compared to controls. However, adding IT methotrexate in addition to vincristine did not significantly impact gait characteristics. Underlying impairments, such as ankle strength, significantly affected gait characteristics. Finally, the distance children with cancer walked in six minutes was negatively impacted by their decreased velocity and step length. Overall, this study gives insight into the debilitating effects chemotherapy has on selected gait characteristics. Physical therapy may benefit this population by working to improve gait patterns and overall function.
Johnson, Kari; Schwartzhoff, Britta; Silva, Sandy; and Terk, Rina, "The Impact of Chemotherapy on the Neuromuscular Components of Gait" (2013). Doctor of Physical Therapy Research Papers. 27.