Emma Verwaaijen, pediatric physical therapist and PhD student, explored a tool to easily detect muscle strength. She says: ‘Muscle weakness is a common problem in children being treated for hemato-oncological diseases, such as lymphoma and leukemia. It is sometimes difficult for the pediatric oncologist or the nursing specialist to recognize muscle weakness in time, for example because a child may also not feel well and therefore moves less. A screening tool with targeted questions about physical activities, such as: how much effort does it take you to walk up and down the stairs, gives an immediate impression of how things are going.'
Participation in daily life
Muscle weakness in children with cancer is undesirable because it affects physical functioning in daily life, whether a child can still walk up the stairs independently or stand up from the floor without needing help. Thus, it directly affects the quality of life of these children. Emma: 'From previous studies there are indications that the loss of muscle strength (and muscle mass) also has consequences for infections, continuation of treatment and the outcome of treatment. We know that exercise is important, even during treatment; muscle weakness makes exercise increasingly difficult.'
Screening tool
'We adapted the SARC-F screening tool and made a version for children: the PED-SARC-F,' says Emma. 'We tested this tool for accuracy in recognizing muscle weakness and functional problems in children with leukemia and lymphoma. We concluded that the tool can predict very well, up to 90% accurately, whether children have muscle weakness. Such a user-friendly screening instrument will facilitate the recognition of children with muscle weakness in the outpatient clinic, allowing timely referral for physical therapy interventions or participation in the Maximaal Bewegen program. As pediatric physical therapists, we can use simple interventions or advice to ensure that a child's decline is less severe.'