Ankle movement alterations during gait in children with acute lymphoblastic leukemia with suspected peripheral mononeuropathy. A cross-sectional study.

BACKGROUND: Peripheral neuropathy due to chemotherapeutic drugs causes alterations in ankle movement during gait. This study aimed to describe the spatiotemporal parameters and ankle kinematics during gait in schoolchildren with acute lymphoblastic leukemia with clinically suspected peripheral neuropathy. METHODS: In children with acute lymphoblastic leukemia in the maintenance phase, we calculated spatiotemporal and kinematic parameters of the ankle during gait using Kinovea® software. Furthermore, we identified alterations in the parameters obtained considering the values of the normality data from a stereophotogrammetry system as the reference values. Finally, we represented the kinematic parameters of the ankles calculated with Kinovea® compared to the normality values of the stereophotogrammetry. FINDINGS: We evaluated 25 schoolchildren; 13 were male (52.0%) with a median age of 88.0months and a median of 60.0 weeks in the maintenance phase, and 54.8% were classified as standard risk. Spatiotemporal parameters: cadence (steps/min), bilateral step length (m), and average gait speed (m/s) in ALL children were significantly lower than reference values (p < 0.001). Except for right mid-stance and bilateral foot strike, initial swing showed that both ankles maintained plantar flexion values during gait, significantly lower in ALL patients (p < 0.05). INTERPRETATION: We identified spatiotemporal and kinematics alterations in schoolchildren with acute lymphoblastic leukemia during all phases of the gait suggestive of alteration in ankle muscles during movement, probably due to peripheral neuropathy; nevertheless, our results should be taken with caution until the accuracy and reliability of Kinovea® software as a diagnostic test compared to the stereophotogrammetric system in children with ALL and healthy peers is proven.

Impairments in fine motor skills in children with Acute Lymphoblastic Leukaemia. A cross-sectional study.

AIM: We evaluated fine motor skills; precision, motor integration, manual dexterity, and upper-limb coordination according to sex and risk stratification in children with Acute Lymphoblastic Leukaemia (ALL). METHODS: We evaluated twenty-nine children in the maintenance phase aged 6 to 12 years with the Bruininks-Oseretsky Test of Motor Proficiency-second edition (BOT-2), and sex and age-specific norm values of BOT-2 were used to compare our results. RESULTS: We found lower scores on the upper-limb coordination subtest, p = 0.003 and on the manual coordination composite, p = 0.008, than normative values. Most boys performed "average" on both the subtests and the composites, but girls showed lower scores with a mean difference of 7.69 (95%CI; 2.24 to 3.14), p = 0.009. Girls' scale scores on the upper-limb coordination subtest were lower than normative values, with mean difference 5.08 (95%CI; 2.35 to 7.81), p = 0.006. The mean standard score difference in high-risk patients was lower than normative on the manual coordination composite, 8.18 (95%CI; 2.26 to 14.1), p = 0.015. High-risk children also performed below the BOT-2 normative on manual dexterity 2.82 (95%CI; 0.14 to 5.78), p = 0.035 and upper limb coordination subtest 4.10 (95%CI; 1.13 to 7.05), p = 0.028. We found a decrease in fine motor precision in children with a higher BMI, rho= -0.87, p = 0.056 and a negative correlation between older age and lower manual dexterity, r= -0.41 p = 0.026; however, we did not find any correlation with the weeks in the maintenance phase. CONCLUSIONS: Fine motor impairments are common in children with ALL in the maintenance phase; it is important to identify these impairments to early rehabilitation.

Association between physical activity and affects in college students during the COVID-19 pandemic: A cross-sectional study / Asociación entre actividad física y afectos en estudiantes universitarios durante la pandemia de COVID-19: estudio transversal

Abstract Introduction The COVID-19 pandemic has negatively impacted physical and mental health worldwide. It is essential to continue exploring the population's psychological manifestations and the pandemic's impact on lifestyles (physical activity, quality of sleep). Objective This research aimed to describe the relationship between affect (positive and negative) and physical activity (PA) in college students during the COVID-19 pandemic. Method A cross-sectional survey was conducted on health sciences students from three universities in Mexico and Colombia. PA was assessed using the short version of the International Physical Activity Questionnaire (IPAQ-S), and affects were measured using the PANAS index. A logistic regression model was used to assess the association between PA and affect. Results We included 430 participants between 16 and 40 years. We found no differences between the male and female participants regarding age, weight (BMI), PA, or the number of hours of sitting per day. The monthly consumption of alcohol and tobacco was more frequent in males (p < .05), and women expressed having worse sleep quality (p < .05). Adjusting for the number of hours spent sitting per day, gender, BMI, age, sleep quality, smoking and alcohol consumption habits, participants reported having more positive affect when they engaged in greater PA. No association was found between PA and negative affect. Discussion and conclusion Prioritizing mental health and assessments that determine the late impact of the COVID-19 pandemic on psychological well-being is critical. Promoting PA in university communities is considered a priority to positively impact students' mental health and provide tools to facilitate coping.

Resumen Introducción La pandemia de COVID-19 impactó negativamente la salud tanto física como mental a lo largo del mundo. Es importante identificar las manifestaciones psicológicas de la población y el impacto de la pandemia en los estilos de vida (actividad física, calidad del sueño). Objetivo Describir la relación entre el afecto (positivo y negativo) y la actividad física (AF) en estudiantes universitarios durante la pandemia de COVID-19. Método Se realizó una encuesta transversal a estudiantes de ciencias de la salud pertenecientes a tres instituciones de educación superior en México y Colombia. La AF se evaluó mediante la versión corta del Cuestionario Internacional de Actividad Física (IPAQ-S), y los afectos se midieron mediante el Índice PANAS. Se utilizó un modelo de regresión logística para evaluar la asociación entre AF y afectos. Resultados Se incluyeron 430 participantes entre 16 y 40 años. No encontramos diferencias entre hombres y mujeres en cuanto a edad, peso (IMC), nivel de AF ni el número de horas sentados por día, sin embargo, el consumo mensual de alcohol y tabaco fueron más frecuentes en hombres (p < .05) y las mujeres expresaron tener peor calidad de sueño (p < .05). Al ajustar por la cantidad de horas que pasaban sentados por día, el género, IMC, edad, calidad del sueño y los hábitos de consumo de tabaco y alcohol, los participantes expresaron tener más afectos positivos cuando realizaban mayor AF, sin embargo, no encontramos asociación entre AF y los afectos negativos. Discusión y conclusión Es fundamental priorizar la salud mental y las evaluaciones que determinan el impacto tardío de la pandemia de COVID-19 en el bienestar psicológico. Se considera necesario promover la AF en las comunidades universitarias para impactar positivamente en la salud mental de los estudiantes y brindar herramientas que faciliten el afrontamiento.

Gross motor disorders in pediatric patients with acute lymphoblastic leukemia and survivors: A systematic review.

Acute Lymphoblastic Leukemia (ALL) is the most common cancer in children and toxicities related to treatment are common. One of these adverse effects is related to the musculoskeletal system and especially to gross motor skills that allow body movements: walking, running, jumping, and balance. This systematic review aims to describe gross motor impairments in pediatric patients with ALL during and after chemotherapeutic treatment and to identify the most commonly used tools for their assessment. Multiple electronic databases were searched for observational studies describing gross motor skills in children with ALL and the assessment tool used. The STROBE checklist was used to assess the reporting quality of each study. Ten studies were included in this review with assessments of gross motor skills in children with ALL undergoing treatment and survivors. Evidence suggests impairments in the performance of daily life activities during intensification and maintenance and persists up to 5 to 6 years after treatment´s cessation. Balance problems are noted at the start of treatment when the cumulative dose of vincristine is low and, in the survivors, it was the most reported alteration. These skills are essential for an adequate performance of children in daily life activities, recreation and leisure. We emphasize the need to assess gross motor skills and implement interventions that include physiotherapy and occupational rehabilitation in children with ALL.

A.L.L. Y.O.U. N.E.E.D. I.S. L.O.V.E. Manual on health self-management and patient-reported outcomes among low-income young adult Mexicans on chronic dialysis: Feasibility study.

PURPOSE: We evaluated disease knowledge/self-management skills among low-income Mexican young adults maintained on dialysis and to test the effectiveness of the A.L.L. Y.O.U. N.E.E.D. I.S. L.O.V.E (AYNIL) Manual - Spanish Version on patient-reported outcomes. This is a low literacy teaching tool designed with patients and educators' input. DESIGN AND METHODS: A quasi-experimental study was conducted in 17 chronic dialysis patients at Mexico City's Hospital General de México, Dr. Eduardo Liceaga. Ages 18-30-year-old completed disease knowledge/self-management and quality of life measures before the intervention and 6 weeks later. RESULTS: Significant increases were observed on disease knowledge/self-management scores in the STARx questionnaire from 47 (IQ: 40,51) to 50 (IQ: 48,54) p = 0.04. The UNC-TRxANSITION Index increased significantly from 4.8 (IQ: 3.9,5.7) to 7.7 (IQ: 7.5,8.2) p ≤0.001. Significant increases in scores were detected in the "Burden of kidney disease" (p = 0.008), "Effects of kidney disease" " (p = 0.03) and " Dialysis staff encouragement" (p = 0.027) based on the KDQoL survey. CONCLUSIONS: In this vulnerable population, the Spanish version of the A.L.L. Y.O.U. N.E.E.D. I.S. L.O.V.E. - AYNIL Manual improved CKD/ESRD disease knowledge/self-management skills and HRQoL. This study highlighted the need for low-literacy educational tools to improve patient-reported outcomes. PRACTICE IMPLICATIONS: Young adults with CKD/ESRD can benefit from patient-centered educational interventions to enhance their autonomy and the development of self-management behaviors that improve patient-reported outcomes and potential complications of the disease. Special attention is needed in low-income patients with low rates of adherence to treatments and poor self-management skills.