Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi 2587-2427 Aydin Adnan Menderes University Health Care Administration Sağlık Kurumları Yönetimi Musculoskeletal System Status, Sleep and Quality of Life of Children with Acute Lymphoblastic Lymphoma During Hospitalization: A Descriptive Pilot Study AKUT LENFOBLASTİK LENFOMA'LI ÇOCUKLARDA HOSPİTALİZASYON SÜRECİNDE KAS İSKELET SİSTEMİNİN DURUMU, UYKU VE YAŞAM KALİTESİ: TANIMLAYICI PİLOT ÇALIŞMA Numanoğlu Akbaş Ayşe Cumhuriyet Üniversity Uysal Muhammet Fatih ABANT İZZET BAYSAL ÜNİVERSİTESİ Özengin Nuriye ABANT İZZET BAYSAL ÜNİVERSİTESİ 01 17 2018 2 1 31 38 06 22 2017 08 17 2018 Copyright © 2017, Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi 2017 Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi

Aim: The aim of this study is to analyze and present thestatus about muscle strength, gross motor function, functional mobility, sleepand quality of life of children with Acute Lymphoblastic Lymphoma (ALL) duringhospitalization. Methods:Childrendiagnosed as ALL, between 4-18 ages, having medical treatment at hospital wereincluded in this study. Children with any other neurologic or metabolicdiseases and children whose cancer reoccurred didn’t include. For all of thechildren information recorded about age (year), height (cm), body mass (kg),gender, exercise background, recurrent of the cancer and medical treatment.Assessment scales that are used in this study were; Gross Motor FunctionsMeasurement (GMFM), Timed Up and Go (TUG) test,sit-to-stand test,1 minute walk test (1 MWT), FunctionalIndependence Measure for Children (WeFIM), Impact on Family Scale (IPFAM), Pediatric Quality of Life Inventory (PedsQL) (Cancer Module) Parent Proxy Report and Children’sSleep Habits Questionnaire Short Form (CSHQ). We presented descriptive analyses as minimums,maximums, means and standard deviations for continuous variables and minimums,maximums, medians and standard errors for categorical variables. We set thelevel of significance at p<0.05.Results:We included 7children (5 girls and two boys) and parents in this study. Mean age of thechildren was 6.86 ±4.48. In our sample mean value of GMFM-66 was67.65±15.57, TUG was 11.69±5.10, 1 MWT was 55.81±23.81, sit-to-stand test was23.69±6.81, IPFAM total score was 72.71±4.34, CSHQ total score was 48.71±2.87, WeeFIMtotal score was 100.57±7.27 and PedsQL totalscore was 64.29±19.17Conclusion:According to thestudy ALL affects musculoskeletal status, quality of life, family impairmentand sleep habits of the children. We think muscle strengthening exercises andactivity focused interventions could be effective and should be studied in newresearch in the rehabilitation of ALL.

Amaç: Bu çalışmanın amacı Akut Lenfoblastik Lenfoma'lı (ALL)çocuklarda hospitalizasyon sürecinde kas kuvveti, kaba motor fonksiyon, fonksiyonelmobilite, uyku ve yaşam kalitesi ile ilgili durumları analiz etmek vesunmaktır.Metod: Bu çalışmaya, ALL teşhisi konulan 4-18 yaşlararasında, hastanede tıbbi tedavi gören çocuklar dâhil edildi. Başka birnörolojik veya metabolik hastalığı olan çocuklar ile kanseri tekrarlayançocuklar dâhil edilmedi. Tüm çocuklar için; yaş (yıl), boy (cm), vücut ağırlığı(kg), cinsiyet, egzersiz geçmişi, kanserin tekrarlayıp tekrarlamadığı ve tıbbitedavileri hakkında bilgiler kaydedildi. Bu çalışmada kullanılan değerlendirmeölçekleri; Kaba Motor Fonksiyon Ölçümü (GMFM), Zamanlı Kalk Yürü Testi (TUG),Otur-Kalk Testi, 1 Dakikalık Yürüme Testi (1 MWT), Çocuklar için FonksiyonelBağımsızlık Ölçeği (WeFIM), Aile Etkilenim Ölçeği (IPFAM), Pediatrik YaşamKalitesi Envanteri Ebeveyn Raporu (PedsQL) (Kanser Modülü) ve Çocuk Uyku Alışkanlıkları Anketi KısaFormu'ydu (CSHQ). Tanımlayıcı analizler;sürekli değişkenler için minimum, maksimum, ortalama ve standart sapma vekategorik değişkenler için minimum, maksimum, medyan ve standart hata olaraksunuldu. İstatistiksel anlamlılık seviyesi olarak p <0.05'i belirlendi.Bulgular: Çalışmaya 7 çocuk (5 kız, iki erkek) ve anne-baba dâhil edildi. Çocukların yaş ortalaması 6.86 ± 4.48 idi. Örneklemden elde edilen ortalama değerler; GMFM-66: 67.65 ± 15.57, TUG: 11.69 ± 5.10, 1 MWT: 55.81 ± 23.81, Otur-Kalk Testi: 23.69 ± 6.81, IPFAM toplam puanı: 72.71 ± 4.34, CSHQ toplam puanı: 48.71 ± 2.87, WeeFIM toplam puanı: 100.57 ± 7.27 ve PedsQL toplam puanı: 64.29 ± 19.17 şeklindeydi.Sonuç:Çalışmamızın sonuçlarına göre, ALL; hospitalizasyon sürecindekas iskelet sistemini, yaşam kalitesini, aile etkilenimini ve çocukların uykualışkanlıklarını etkilemektedir. Kas güçlendirme egzersizleri ve aktiviteyeodaklı müdahalelerin ALL'nin rehabilitasyonunda etkili olabileceğini, yeniçalışmalarda araştırılması gerektiğini düşünüyoruz.

 Akut Lenfoblastik Lenfoma Fizyoterapi Kaba Motor Fonksiyon Uyku Acute Lymphoblastic Lymphoma Physiotherapy Gross Motor Function Sleep 1. Kaatsch P. Epidemiology of childhood cancer. Cancer treatment reviews. 2010;36(4):277-85. 2. Ness KK, Kaste SC, Zhu L, Pui C-H, Jeha S, Nathan PC, et al. Skeletal, neuromuscular and fitness impairments among children with newly diagnosed acute lymphoblastic leukemia. Leukemia & lymphoma. 2015;56(4):1004-11. 3. Rosen GM, Shor AC, Geller TJ. Sleep in children with cancer. Current opinion in pediatrics. 2008;20(6):676-81. 4. Rosen G, Brand SR. Sleep in children with cancer: case review of 70 children evaluated in a comprehensive pediatric sleep center. Supportive Care in Cancer. 2011;19(7):985-94. 5. Wang T-H, Liao H-F, Peng Y-C. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clinical rehabilitation. 2012;26(7):664-71. 6. Russell DJ, Rosenbaum PL, Avery LM, Lane M. Gross motor function measure (GMFM-66 and GMFM-88) user's manual: Cambridge University Press; 2002. 7. Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed ‘up & go’test in children. Developmental Medicine & Child Neurology. 2005;47(8):518-24. 8. McDowell BC, Kerr C, Parkes J, Cosgrove A. Validity of a 1 minute walk test for children with cerebral palsy. Developmental medicine & child neurology. 2005;47(11):744-8. 9. Hamilton B, Granger C. Functional Independence Measure for Children (WeeFIM). Buffalo, NY: Research Foundation of the State University of New York. 1991. 10. Bek N, Simsek IE, Erel S, Yakut Y, Uygur F. Turkish version of impact on family scale: a study of reliability and validity. Health and quality of life outcomes. 2009;7(1):4. 11. Varni JW, Burwinkle TM, Katz ER, Meeske K, Dickinson P. The PedsQL™ in pediatric cancer. Cancer. 2002;94(7):2090-106. 12. Fiş NP, Arman A, Ay P, TOPUZOĞLU A, GÜLER AS, İMREN SG, et al. Çocuk Uyku Alışkanlıkları Anketinin Türkçe geçerliliği ve güvenilirliği. Anadolu Psikiyatri Dergisi. 2010;11:151-60. 13. Hoffman MC, Mulrooney DA, Steinberger J, Lee J, Baker KS, Ness KK. Deficits in physical function among young childhood cancer survivors. Journal of clinical oncology. 2013;31(22):2799-805. 14. Ness KK, Baker KS, Dengel DR, Youngren N, Sibley S, Mertens AC, et al. Body composition, muscle strength deficits and mobility limitations in adult survivors of childhood acute lymphoblastic leukemia. Pediatric blood & cancer. 2007;49(7):975-81. 15. Reinders-Messelink H, Schoemaker M, Snijders T, Göeken L, van den Briel M, Bökkerink J, et al. Motor performance of children during treatment for acute lymphoblastic leukemia. Medical and pediatric oncology. 1999;33(6):545-50. 16. Wright MJ, Halton JM, Martin RF, Barr RD. Long‐term gross motor performance following treatment for acute lymphoblastic leukemia. Medical and pediatric oncology. 1998;31(2):86-90. 17. Nicolini‐Panisson RDA, Donadio MV. Normative values for the Timed ‘Up and Go’test in children and adolescents and validation for individuals with Down syndrome. Developmental Medicine & Child Neurology. 2014;56(5):490-7. 18. Gocha Marchese V, Chiarello LA, Lange BJ. Strength and functional mobility in children with acute lymphoblastic leukemia. Medical and pediatric oncology. 2003;40(4):230-2. 19. Zupanec S, Jones H, Stremler R. Sleep habits and fatigue of children receiving maintenance chemotherapy for ALL and their parents. Journal of Pediatric Oncology Nursing. 2010;27(4):217-28. 20. Gordijn MS, van Litsenburg RR, Gemke RJ, Huisman J, Bierings MB, Hoogerbrugge PM, et al. Sleep, fatigue, depression, and quality of life in survivors of childhood acute lymphoblastic leukemia. Pediatric blood & cancer. 2013;60(3):479-85. 21. Eiser C, Eiser JR, Stride CB. Quality of life in children newly diagnosed with cancer and their mothers. Health and quality of life outcomes. 2005;3(1):1. 22. Patterson JM, Holm KE, Gurney JG. The impact of childhood cancer on the family: a qualitative analysis of strains, resources, and coping behaviors. Psycho‐Oncology. 2004;13(6):390-407.