Modifying bone mineral density, physical function, and quality of life in children with acute lymphoblastic leukemia
Bibliographic record
Abstract
Abstract Background The early effects of childhood acute lymphoblastic leukemia (ALL) include decreased physical function, bone mineral density (BMD/g/cm 2 ), and health‐related quality of life (HRQL). We assessed the capacity of a physical therapy and motivation‐based intervention, beginning after diagnosis and continuing through the end of treatment, to positively modify these factors. Procedure A 2.5‐year randomized controlled trial of 73 patients aged 4–18.99 years within 10 days of ALL diagnosis assessed BMD at baseline (T 0 ) and end of therapy (T 3 ), strength, range of motion, endurance, motor skills, and HRQL at baseline (T 0 ), 8 (T 1 ), 15 (T 2 ), and 135 (T 3 ) weeks. Results There were no significant changes between groups (intervention, n = 33; usual care, n = 40) in BMD ( P = 0.059) at T 3 or physical function and HRQL at T 0 –T 3 . While BMD declined in both the intervention (T 0 = −0.21, T 3 = −0.55) and usual care (T 0 = −0.62, T 3 = −0.78) groups, rates of decline did not differ between groups ( P = 0.56). Univariate analysis (n = 73) showed associations of higher T 3 bone density with body mass index T 1 ( P = 0.01), T 2 ( P = <0.0001), T 3 ( P = 0.01), T 3 ankle flexibility/strength ( P = 0.001), and T 2 parent ( P = 0.02)/T 0 child ( P = 0.03) perceptions of less bodily pain. Conclusions The intervention delivered during treatment was not successful in modifying BMD, physical function, or HRQL. Physical activity, at the level and intensity required to modify these factors, may not be feasible during early treatment owing to the child's responses to the disease and treatment. Future studies will consider intervention implementation during late maintenance therapy, extending into survivorship.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".