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Adult survivors of Acute Lymphoblastic Leukemia (ALL) enrolled on the SJLIFE protocol

Healthy Individuals with no history of childhood or adult onset cancer, matched on age- and sex

Kristen K Ness, PhD

The purpose of this study is to determine if adult survivors of childhood Acute Lymphoblastic Leukemia (ALL) enrolled on the SJLife (St. Jude Life) protocol are at increased risk for postural control deficits compared to individuals with no cancer history. All participants will be assessed for their ability to maintain an upright posture, walk at their usual speed, and to tandem walk, all while engaged in a cognitive task.

Primary Objective

To compare changes in postural control in ALL survivors to changes in postural control in healthy controls, matched on age- and sex- in simple versus complex standing and walking activities (complex: standing or walking with added cognitive load).

Secondary Objective

To identify demographic and performance related risk factors for decreased postural control during complex standing or walking activities in survivors and controls and to evaluate associations between treatment and the changes in postural control during complex activities among survivors.

Cognitive performance (attention and working memory) will be evaluated using the auditory N-Back test. The 0-back condition and the 2-back condition will be used. After cognitive assessment, participants will perform 3 different postural control tasks (standing balance, regular gait, and tandem gait) in a random order. Postural tasks for each participant will be determined by using random allocation envelopes.

Computerized dynamic posturography will be used to evaluate standing balance with no added cognitive load. Standing balance assessment will be repeated two more times, once with participants engaged in performing the auditory 0-back task, and then with simultaneously performing the auditory 2-back task. Regular gait at participants' preferred speed will be examined using 6 light-weight wearable inertial sensors. The regular walking assessment will be repeated with simultaneous performance of the 0-back task and then with simultaneous engagement in the 2-back task. We have also included a tandem gait (placing one foot directly in front of the other) in order to make the postural task more challenging. The wearable inertial sensors will be used to record participants' gait characteristics while tandem walking. The tandem walk assessment will be repeated once with the participant simultaneously perform the 0-back task and then with the 2-back task. The estimated required time to perform all of the assessments and with inclusion of 3 rest intervals is 2 hours.

In addition, data from the overall SJLIFE assessment will be used in analysis.

Postural Control Under Different Cognitive Loads in Adult Survivors of Acute Lymphoblastic Leukemia and Age-Matched Healthy Individuals

Regular gait will be evaluated in three different testing conditions: regular gait assessment while participants are engaged in performing a challenging cognitive task (2-back), regular gait assessment while participants are engaged in performing an easy cognitive task (0-bak) and regular gait assessment with no additional cognitive load (baseline). In each condition, the difference in gait speed of each survivor and his/her matched control will be obtained. Then the obtained differences at regular gait assessment with no additional cognitive load (baseline) and regular gait while performing the challenging cognitive task (2-bck) will be compared using a paired t-test.

Standing balance ability will be examined in three different testing conditions: standing balance while participants are engaged in performing a challenging cognitive task (2-back), standing balance while participants are engaged in performing an easy cognitive task (0-back), and standing balance assessment with no additional cognitive load. In each condition, the difference in composite score of each survivor and his/her matched control will be obtained. Then the obtained differences at standing balance assessment with no additional cognitive load (baseline) and standing balance assessment while performing the challenging cognitive task (2-back) will be compared using a paired t-test.

St. Jude Children's Research Hospital

Nervous System Diseases

Skin and Connective Tissue Diseases

Behaviors and Mental Disorders

Peripheral Nervous System Diseases

Breast Neoplasms

Breast Diseases

Skin Diseases

Quality of Life

The group will be test prior and three months after a neurotoxic chemotherapy for gynecological cancer.

Aline Reinmann

The aim of this study is to understand the strategies for adapting postural control in patients who have received chemotherapy treatment for gynaecological cancer.

Chemotherapy can cause many side effects, including peripheral neuropathies. Chemotherapy induced peripheral neuropathies (CIPN) are primarily sensory impairments that can alter the signals for somatosensory feedback and thus affect the postural control in the standing position. The objective of this study is to evaluate the impact of chemotherapy and peripheral neuropathies on postural control in the standing position. As balance maintenance is a complex construct involving different systems, this study will evaluate maintenance strategies during sensory disturbances in order to better understand post-chemotherapy coping strategies. These sensory disturbances concern vision (eyes closed) and the alteration of the somatosensory system (foam under the feet and vibration system). In addition, this study will evaluate balance in double task situations and dynamic stability. Given the consequent impact of chemotherapy and peripheral neuropathies on quality of life, a quality of life questionnaire will also be administered.

Influence of Chemotherapy on Postural Control in Women With Cancer

Influence of Chemotherapy on Postural Control and Quality of Life in Women With Gynaecological Cancer: a Prospective Observational Study

De-identified individual participant data for all primary and secondary outcomes will be made available.

The postural control will be assessed by a force platform. Three 30-second tests will be performed for each test condition. The test conditions are as follows: eyes open, eyes closed, firm surface, soft surface, with vibrator, without vibrator, with dual task. The test position will be standing with the feet 10 cm apart at heel level and 15 cm apart at hallux level, with the arms along the body, fixing a point on the wall at 0.90 cm. Parameters of center of pressure and strength will be recorded at a frequency of 100 Hertz.

The standing dynamic stability will be assessed by a force platform with the limits of stability test (LOS). The test position will be standing with the feet 10 cm apart at heel level and 15 cm apart at hallux level, with the arms along the body, fixing a computer at a distance of 0.90 cm. Parameters of center of pressure and strength will be recorded at a frequency of 100 Hertz.

The FACT/GOG-NTX was chosen to assess the quality of life (QoL). This questionnaire assesses physical well-being, family/social well-being, emotional well-being, functional well-being and other concern. Participants will have to answer the different statements by ticking the box corresponding to what they feel is adequate between 0 (not at all) and 4 (a lot). The minimum score is 0 and the maximum score is 152. The higher the score, the better the QoL.

The clinical version of the Total Neuropathy Score will be used to evaluate the presence of peripheral neuropathy. A test of superficial sensitivity, vibration sensitivity, reflexes and strength will be carried out. The minimum score is 0 and the maximum score is 24. A score between 0 and 8 indicates mild peripheral neuropathy, between 9 and 16 a moderate peripheral neuropathy and above 17 a severe neuropathy.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Postural Control Under Different Cognitive Loads in Adult Survivors of Acute Lymphoblastic Leukemia and Age-Matched Healthy Individuals	NCT03581045	Acute Lymphobla...		18 Years - 39 Years	St. Jude Children's Research Hospital
Influence of Chemotherapy on Postural Control in Women With Cancer	NCT04692168	Cancer, Breast Cancer, Gynecol...		18 Years - 65 Years	School of Health Sciences Geneva

Spots Global Cancer Trial Database for postural control