Special Interest Group
Pediatric oncology is a growing field within the physical therapy profession. Children who are treated for cancer are at risk for impairments of all body systems directly related to their cancer diagnosis and treatment. Physical therapists have an important role in identifying impairments and providing evidence-based assessments and interventions to improve a child’s motor skills, cardiovascular endurance, and activity participation.
The Purpose of the Pediatric SIG is
The purpose of the Pediatric SIG is to provide a forum where APTA Oncology members who have a common interest in evidence-based assessment and intervention of children with cancer can exchange ideas, collaborate in research and clinical practice, and promote these interests.
The Mission of the Pediatric SIG is
The mission of the Pediatric SIG is to create a collaborative forum for persons whose skills and knowledge in the area of pediatric oncology can be enhanced, collaborated and promoted to benefit the physical therapy profession and the patients they serve.
We will support this by:
- Submitting proposals for sessions at CSM to allow collaboration of and exposure to the field
- Providing education to members
- Supporting the networking and mentoring of therapists treating pediatric patients with oncologic conditions
- Collaborating with clinical researchers and practitioners to improve the speed and quality of research projects in this population
- Establishing collaborative interdisciplinary relationships with other pediatric oncology organizations to promote the role and value of physical therapy in the treatment of children with oncologic diagnoses
Hallie Lenker, PT
SIG Member Resources
Instructional PowerPoint: The Role of Physical Therapy in Pediatric Oncology
This presentation is a starting point for education to other medical professionals. It is meant to be used as a template that can be personalized for each practice setting and/or clinic site. Feel free to expand and adapt this presentation to your target audience as appropriate to provide the best possible information. We would also like to track the utilization of this resource, so please email the SIG chairs with the final version of your presentation. Any feedback is also welcome!
Spotlight on Research
Three interesting articles have been published recently. Braam et al. updated their original systematic review on exercise in children with cancer. The authors continue to believe that because of small sample sizes and poor study design, the effects of exercise in this population remain murky. Despite the poor quality of the evidence, there were some positive intervention effects for cardiorespiratory fitness, bone mineral density, back and leg strength, passive ankle dorsiflexion, and cancer-related items of health-related quality of life. Also of note is the fact that most of the study participants were children diagnosed with acute lymphoblastic leukemia. More high-quality studies are needed!
Kesting et al. evaluated the motor skills of 21 survivors of pediatric bone tumor using the MOON test (test for MOtor performance in pediatric ONcology). The investigators found that survivors (< 2 years) demonstrated impairments in hand-eye coordination, speed, flexibility, muscular explosive strength, and muscular endurance (although not statistically significant) when compared to healthy controls. In regards to hand grip strength and static balance, survivors performed better than healthy controls (although not statistically significant). The authors believe that these results highlight the importance of individualized intervention plans, including physical therapy, to address these physical limitations and to help survivors develop a long-term healthy lifestyle.
Currently, the American Academy of Pediatrics recommends that children spend less than two hours a day on screen time and the Centers for Disease Control recommends that children spend at least 60 minutes a day in moderate to vigorous physical activity. Bogg et al. discovered that physical activity levels and screen time in stem cell transplant survivors was similar to that of healthy populations. However, in the first two years after transplant children report less physical activity and more screen time than healthy children as well as children who are more than two years after transplant. Of those children in the early survivorship phase, females and adolescents are at higher risk for decreased physical activity. The authors propose that education on healthy behaviors be given early in the survivorship phase. They also suggest that while screen time may be appropriate while the child is hospitalized, he or she should be encouraged to adhere to guidelines for screen time and physical activity once their health improves.
- Braam KI, van der Torre P, Takken T, Veening MA, van Dulmen-den Broeder E, Kaspers GJL. Physical exercise training interventions for children and young adults during and after treatment for childhood cancer. Cochrane Database of Systematic Reviews 2016, Issue 3. Art. No: CD008796.
- Kesting SV, Gotte M, Seidel CC, Rosenbaum D, Boos J. Motor performance after treatment for pediatric bone tumors. J Pediatr Hematol Oncol. 2015;37(7):509-514.
- Bogg TFT, Shaw PJ, Cohn RJ, Wakefield CE, Hardy LL, Broderick C, Baumann F. Physical activity and screen-time of childhood haematopoietic stem cell transplant survivors. Acta Paediatr. 2015;104(10), e455-9.”
A systematic review was published by the Children’s Oncology Group (COG) which included 8 studies evaluating the role of formal neuropathy testing for children receiving vincristine. Their final recommendations highlight the importance of formal testing for all pediatric patients receiving vincristine and use of the ped-m TNS or TNS-PV with children > 6 years old as subjective assessments have not demonstrated accuracy when compared to the scales.
Smolik S, Arland L, Hensley MA, Schissel D, Shepperd B, Thomas K, Rodgers C. Assessment tools for peripheral neuropathy in pediatric oncology: A systematic review from the Children’s Oncology Group”. Journal of Pediatric Nursing. 2018: 35(4):267-2765.
Long term impact of an treatment approach is challenging in an pediatric oncology population. A year and a half after completing the Stoplight Program (SLP) children who completed the program demonstrated improved motor performance and higher level of physical activity than those who did not complete the program. Their findings supported that an early physical therapy referral should be considered by all providers caring for pediatric patients with leukemia.
Tanner L, Hooke M. Improving body function and minimizing activity limitations in pediatric leukemia survivors: the lasting impact of the Stoplight Program. Pediatr Blood Cancer. 2019: e27596.
Interested in joining an APTA Oncology Special Interest Group (SIG)?
APTA Oncology has several course offerings looking for partners to host. The host facility will be chosen based on the guarantee that they can draw a minimum of 15 registrants.
APTA Oncology's General Listerv is a very productive messaging system for answering your practice questions. In addition, we maintain specialized listservs for our special interest groups.
Any PT or PTA living in a country other than the US or a healthcare provider from another discipline, not eligible for APTA membership, can take advantage of our membership benefits by becoming a Partner of APTA Oncology.