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01-04-2021

Balance impairment in survivors of pediatric brain cancers: risk factors and associated physical limitations

Authors: Mitra Varedi, Lu Lu, Nicholas S. Phillips, Robyn E. Partin, Tara M. Brinkman, Gregory T. Armstrong, Emma Chase, Raja B. Khan, Douglas Powell, Raymond F. McKenna, Leslie L. Robison, Melissa M. Hudson, Kirsten K. Ness

Published in: Journal of Cancer Survivorship | Issue 2/2021

Abstract

Purpose

The study aims were to determine the prevalence of balance impairments in adult survivors of pediatric central nervous system (CNS) tumors, and to identify predictors of and limitations associated with balance impairments.

Methods

Participants were adult survivors (N = 329) of pediatric CNS tumors. Balance was considered impaired among those with composite scores < 70 on the sensory organization test. Potential predictors of impaired balance were evaluated with generalized linear regression. Multivariable logistic regression was used to evaluate associations between balance impairment and function.

Results

Balance impairment was observed in 48% of survivors, and associated with infratentorial tumor location (OR = 4.0, 95% CI, 2.0–7.6), shunt placement (OR = 3.5, 95% CI, 1.8–6.7), increased body fat percentage (OR = 1.1, 95% CI, 1.0–1.1), hearing loss (OR = 11.1, 95% CI, 5.6–22.2), flexibility limitations (OR = 2.0, 95% CI, 1.0–3.9), peripheral neuropathy (OR = 2.4, 95% CI, 1.2–4.5), and cognitive deficits (OR = 2.2, 95% CI, 1.1–4.7). In adjusted models, impaired balance was associated with limitations in overall physical performance (OR = 3.6, 95% CI, 2.0–6.3), mobility (OR = 2.6, 95% CI, 1.5–4.4), diminished walking endurance (OR = 2.9, 95% CI, 1.7–5.0), and non-independent living (OR = 2.0, 95% CI, 1.0–4.3).

Conclusions

Nearly half of adult survivors of pediatric CNS tumors have impaired balance, which is associated with mobility and physical performance limitations. Interventions to address the complex needs of this population should be prioritized.

Implications for Cancer Survivors

Survivors with identified risk factors should be closely evaluated for presence of balance impairment. Interventions tailored to improve balance also can positively affect function and mobility in survivors.

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Title: Balance impairment in survivors of pediatric brain cancers: risk factors and associated physical limitations
Authors: Mitra Varedi
Lu Lu
Nicholas S. Phillips
Robyn E. Partin
Tara M. Brinkman
Gregory T. Armstrong
Emma Chase
Raja B. Khan
Douglas Powell
Raymond F. McKenna
Leslie L. Robison
Melissa M. Hudson
Kirsten K. Ness
Publication date: 01-04-2021
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 2/2021
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-020-00932-5

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Abstract

Purpose

Methods

Results

Conclusions

Implications for Cancer Survivors

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