Management of Physical Impairments, Activity Limitations and Participation Restrictions in Survivors of Childhood Acute Lymphoblastic Leukemia: Perspectives From Physiotherapists
Bibliographic record
Abstract
Background: Survivors of childhood acute lymphoblastic leukemia (cALL) present a high risk of long-term neuromusculoskeletal (NMSK) sequelae. Clinical guidelines for specific management of these complications are still lacking. The aim of this study is to (1) describe current physiotherapy practice with cALL survivors at one of Canada’s specialized pediatric oncology centers, (2) explore perceived optimal management of long-term NMSK sequelae by physiotherapists, and (3) identify the barriers and facilitators for its in-clinic implementation. Methods: This qualitative descriptive study with a focus group using a semi-structured interview guide was conducted with physiotherapists (n = 6) from one of Canada’s specialized pediatric oncology centers. We performed a hybrid analysis including both a deductive and an inductive approach using the International Classification of Functioning, Disability, and Health and Consolidated Framework for Implementation Research. Results: Even though the participants were experts in managing NMSK sequelae in survivors of cALL, standardized management of these patients is lacking. Physiotherapists described their perceived optimal management of NMSK sequelae as systematic and interdisciplinary. Barriers (eg, relative priority and availability of resources) and facilitators (eg, relative benefit and commitment) for implementing this perceived optimal management were identified. Conclusion: Physiotherapy management could improve care and services offered to survivors of cALL. The identification of barriers and facilitators to best practice offers relevant potential solutions to explore in order to improve and optimize management of this patient group.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.006 | 0.004 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".