Abstract
Background
Medical and surgical treatment for musculoskeletal sarcoma (MSS) place survivors at
risk for impairments in muscle properties including muscle strength, muscle size,
and neuromuscular activation. The purpose of this study was to explore muscle properties,
gross motor performance, and quality of life (QoL) and the changes in response to
a 6-week functional strengthening intervention (PT-STRONG) in MSS survivors of childhood
cancer (CCS).
Methods
Eight lower extremity MSS CCS (13–23 years old) performed baseline testing and three
completed PT-STRONG. Participants completed measurements of knee extension strength
using handheld dynamometry, vastus lateralis (VL) and rectus femoris (RF) muscle thickness
using ultrasonography at rest, and neuromuscular activation using electromyography
during strength testing and a step-up task. Participants also completed gross motor
and QoL assessments.
Results
Compared with the non-surgical limb, MSS CCS had lower surgical limb knee extension
strength, VL muscle thickness, and RF step-up muscle rate of activation (RoA). Compared
with normative values, MSS CCS had decreased bilateral knee extension strength, gross
motor performance, and physical QoL. Positive correlations among muscle strength,
muscle thickness, and gross motor performance were identified. After PT-STRONG, MSS
CCS had improvements in VL muscle thickness, VL and RF RoA duing step-up, gross motor
performance, and physical QoL.
Conclusions
Positive association between larger muscle thickness with greater knee extension strength,
and higher knee extension strength with better gross motor performance indicate that
comprehensive physical therapy assessment and interventions that identify and target
impairments in muscle properties to guide clinical decision making should be considered
for MSS CCS into survivorship.
Keywords
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Article info
Publication history
Published online: December 16, 2022
Accepted:
November 29,
2022
Received:
October 26,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
