Maintenance of Ankle Range of Motion in Children Treated for Acute Lymphoblastic Leukemia

PURPOSE: This study documented ankle dorsiflexion range of motion (DF-ROM) in children during treatment for leukemia and studied the effects of preventative education and individualized intervention as a standard of care. METHODS: Active and passive DF-ROM were measured throughout a two-year treatment period and one year after treatment in 40 subjects. Children without health problems and historical controls who had not received therapeutic input were used for comparison. RESULTS: Active DF-ROM showed an average tendency to decline significantly during treatment, whereas passive DF-ROM did not. Both increased significantly following the end of treatment. There were substantial individual differences around these patterns of average change. Gender (female) was a predictor of negative change in DF-ROM during treatment. Average DF-ROM one year after treatment was significantly greater than for the historical controls and not significantly different from the healthy controls. None of the children required surgical intervention, in contrast to the historical controls. CONCLUSIONS: Education and intervention appears to have improved DF-ROM outcome in children treated for leukemia.