Força muscular e atividade em crianças, adolescentes e jovens com câncer

Abstract

INTRODUCTION: During and after childhood cancer treatment, impairments in physical fitness can be observed, as well as reduction in muscle strength, fatigue and changes in body functions. In addition, the reduction in the level of activity during and after treatment can contribute favorably to cardiac deconditioning, atrophy of the musculoskeletal system, reduced muscle strength, loss of range of motion and fatigue, developing limitations on participation, as well as limitations in performing daily activities, self-care and managing household tasks. OBJECTIVE: Compare and investigate the relationship between the isometric strength of the upper and lower limb musculature and the capacity and performance of activities in children, adolescents and young people diagnosed with cancer with children, adolescents and young people with apparent good health. METHODS: This is a crosssectional observational study, with 45 participants, 15 from the cancer group and 30 from the control group. Participants were matched according to sex and age and took into account the 2:1 ratio (for each participant with cancer we compared with two participants with apparent good health). Personal, health condition environmental and anthropometric data were collected, such as weight, height, body-mass index (BMI) and circumference of the middle thigh and calf. Performance (Pediatric Evaluation of Disability Inventory – computer adaptive test - PEDI-CAT), capacity (Timed Up and Go test - TUG and Sit-to-Stand - SS) and activity level (Phyical activity questionnaire for adolescents PAQ-A/ for children - PAQ-C) were also evaluated, in addition to the muscle strength of the upper limbs (JAMAR® portable manual hydraulic dynamometer) and lower limbs (microFET2® portable manual dynamometer). RESULTS: The study had 30 female and 15 male participants, with a mean age in years of 13.67±5.78 in the cancer group and 13.07±5.11 in the control group. According to the cancer group diagnosis, Acute Lymphoid Leukemia (6) and Chronic Myeloid Leukemia (3) predominated. Regarding anthropometric data, the level of physical activity and muscle strength in the upper and lower limbs did not show any significant difference between groups (p>0.05). There were significant differences between the groups (cancer and control) in relation to the capacity of activity tests (TUG and SL) and in the performance of activities (mobility domain - PEDI-CAT) (p=0.001), where the cancer group presented lower results compared to the control group. When comparing the level of physical activity, activity tests and activity performance among children, adolescents and young in the cancer group, it was observed that there were no significant differences between participants. The correlations between muscle strength and the variables mean thigh circumference, calf and activity performance were moderate to strong (0.50<r0.75), indicating that there is a relationship between these variables. CONCLUSION: The cancer group showed low capacity and performance in the activities domain, considered essential for daily life, compared to the control group, and these variables are not associated with muscle weakness and physical activity level. That way it would be recommended to implement in the physiotherapeutic treatment program and follow-up, activities focused on the task, aiming autonomy and functional independence. The relationship between muscle strength and circumferences can serve as an easy and practical assessment measure for clinical practice.