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European Journal of Physical and Rehabilitation Medicine 2021 Jul 12

DOI: 10.23736/S1973-9087.21.06854-4

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

The feasibility and efficacy of short-term visual-motor training in pediatric posterior fossa tumor survivors

Vladimir KASATKIN 1, Alena DEVIATERIKOVA 1, 2 , Marina SHURUPOVA 1, 3, 4, Alexander KARELIN 1

1 Department of Neurocognitive, Psychophysiological Research and Physical Rehabilitation in Rehabilitation Center Russian Field, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia; 2 Department of Visual Perception, Russian Academy of Education, Moscow, Russia; 3 Department of Medical Rehabilitation, Federal Center of Brain and Neurotechnologies, Moscow, Russia; 4 Department of High Nervous Activity, Lomonosov Moscow State University, Moscow, Russia


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BACKGROUND: Pediatric posterior fossa tumor (PFT) survivors experience a range of cognitive and motor impairments that require timely rehabilitation of these functions. In Russia, rehabilitation services are only just beginning to be formed; therefore, it is necessary to test rehabilitation protocols for children surviving cancer.
AIM: To evaluate the efficacy of short-term cognitive and motor training (CMT) aimed on visualmotor integration in PFT survivors using training devices.
DESIGN: "Single center" quasi randomized controlled experiment.
SETTING: Outpatient Clinical Research Rehabilitation Center ‘Russkoe Pole’.
POPULATION: The 63 children cancer survivors between the ages of 6 and 17 years.
METHODS: The baseline level of cognitive and motor functions was assessed in all participants. Then the sample of patients split into two subgroups of equal sex, age, and diagnosis. The intervention subgroup received 6 sessions of CMT for two weeks, and the other subgroup underwent ‘empty’ two weeks with no intervention. Reassessment of motor and cognitive functions was conducted in all participants. Then the subgroups changed: the first subgroup underwent ‘empty’ two weeks, and the second subgroup completed the CMT, and further reassessment was provided.
RESULTS: The primary results demonstrate an increase in gross and fine motor skills, motor coordination, visual-motor integration, and visual processing after CMT. Secondary results show that the age at onset is an important factor in the subsequent decline in cognitive, motor functions, and eye movements. Children with medulloblastoma perform worse on motor tests than children with astrocytoma. A tumor in the IV ventricle is the most harmful, and a tumor in the cerebellar hemispheres is the least harmful to a child's cognitive and motor development.
CONCLUSIONS: This study shows the effectiveness of a short-term CMT program for children who survived PFT. The study also found that cognitive, motor, and visual-motor functions are affected by the tumor's localization, malignancy, and the child's age at onset.
CLINICAL REHABILITATION IMPACT: Short-term rehabilitation methods can be useful in pediatric oncological practice. Reconstruction of cognitive functions can occur during the training of more "simple" functions, such as hand-eye integration. The study makes a significant contribution to the methods of short-term rehabilitation in children who survived cancer.


KEY WORDS: Short-term training program; Pediatric cancer; Localization of the tumor; IV ventricle; Cerebellum

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