Pediatr Blood Cancer 2014;61:46–52 Assessment of Gross Motor Skills and Phenotype Profile in Children 9–11 Years of Age in Survivors of Acute Lymphoblastic Leukemia Mario Leone, PhD, 1,2 * Pierre Viret, MSc, 3 Hung Tien Bui, PhD, 2 Caroline Laverdie `re, MD, 4 E ´ milia Kalinova, PhD, 3,2 and Alain-Steve Comtois, PhD 3,2 INTRODUCTION Acute lymphoblastic leukemia (ALL) is the most common cancer in children. In Canada, 1,257 new ALL cases have been reported among children 0–19 years of age from 2003 to 2007 with an average age at diagnosis of 4 years. According to the CCS report in 2011 [1], the mortality rate for those children was less than 10% in 2007, while it was nearly twice as much (20%) in 1985. The improvement of the survival rate in recent years has led the scientific community to focus on issues other than the cure of the disease itself long-term consequence of ALL treatments are now well described and are various. However, few studies have looked specifically at GMS which are particularly important for young children [2–6]. Among these factors, gross motor skills (GMS) are suspected to be particularly affected, even during and after chemotherapy treatment [7–9]. The GMS is a component of motor skills that involves the simultaneous participation of most body parts, as in the case of activities such as walking, running and jumping [10]. One of the first studies related in part to the development of GMS in children with ALL was conducted by Reinders-Messelink et al. [11]. Since that time, only a handful of studies were undertaken [7,8,12–14]. These studies suggest possible motor skill impairments in children suffering from or having suffered from ALL. However, because of the limited number of motor skills variables analyzed in these studies, it is difficult to establish a comprehensive developmental GMS profile for this population. Nonetheless, most of the evidence presented appears to suggest that children who are or have been affected by ALL could see their GMS development altered. Excessive sedentary lifestyle is perhaps an important factor that explains the possible delay in the development of GMS in ALL children [15,16]. This is particularly alarming since physical inactivity tends to continue even when the disease is overcome [14,17,18]. Recently, a team composed by researchers from University of Que ´bec in Chicoutimi (UQAC), and from University of Que ´bec in Montre ´al (UQAM) has proposed a motor skills test battery called UQAC–UQAM. More than 3,000 children 6–12 years of age from two Canadian provinces have been tested on 13 GMS tests [19]. Normative values have been produced for each of the 7 age groups (6–12 years) for both genders. The availability of specific population-based normative values is very important when the goal concerns their utilization for comparison purposes [20]. Thus, the aim of this study is to determine the usefulness of the UQAC–UQAM test battery as a tool to assess the level of GMS development and/or disorders in ALL survivors who have been off therapy for at least 1 year. Furthermore, the information yielded may prove helpful in identifying the motor skill factors that are most affected by the disease. METHODS Participants Twenty children (10 males and 10 females) 9–11 years of age have participated in this research (mean age: 10.56  0.65 years). Two main reasons led us to choose this limited range of age. First, because of the growth process, a larger range of age would create a greater variability in the results, which would make interpretation of Background. The purpose of this study was to evaluate the usefulness of a new gross motor skill test battery in acute lymphoblastic leukemia (ALL) children who have been off therapy for at least 1 year and to assess its discriminatory power (discriminant analysis) from healthy children. Procedure. Twenty children (10 males and 10 females) 9–11 years of age (median age ¼ 10.6 years) were assessed by the UQAC–UQAM test battery and then compared to recent provincial norms. This pilot study was also an opportunity to validate this test battery as a reliable tool for clinical or research purposes in the area of chronic or disabling diseases in children. Eleven motor skill variables grouped into five factors have been measured (speed, agility, balance, coordination, and reaction time). Results. Scores from 10 of the 11 motor skill tests showed significant differences when compared to the control group (P  0.05). Nearly 50% of patients obtained an average score below the 15th percentile. Furthermore, stepwise discriminant analysis allowed classifying successfully 88.4% of children in the correct group (ALL or Control). The normal development of GMS among children affected by ALL appears to have been compromised. The UQAC–UQAM test battery seems to be sensitive enough to quantify with precision the extent of the motor impairment in these children. Conclusion. The UQAC– UQAM test battery appears to be a useful tool to evaluate the extent to which ALL survivors are affected. Early motor intervention should be considered for those patients even during the treatment periods. Pediatr Blood Cancer 2014;61:46–52. # 2013 Wiley Periodicals, Inc. Key words: acute lymphoblastic leukemia; children; gross motor skills; survivors 1 Kinesiology Department of Health Sciences, Kinesiology Division and Health Sciences Department, University of Que ´bec in Chicoutimi, Saguenay, Que ´bec, Canada; 2 Centre de Recherche Interdisciplinaire sur la Qualite ´ et les Saines Habitudes de vie, University of Que ´bec in Chicoutimi, Saguenay, Que ´bec, Canada; 3 Kinanthropology Depart- ment, University of Que ´bec in Montre ´al, Montre ´al, Que ´bec, Canada; 4 Oncology Department, Faculty of Medicine, University of Montre ´al, Montre ´al, Que ´bec, Canada Conflict of interest: Nothing to declare.  Correspondence to: Mario Leone, Department of Health Sciences, Kinesiology Division, University of Que ´bec in Chicoutimi, 555, Boulevard de l’Universite ´, Saguenay, QC, Canada G7H 2B1. E-mail: mario.leone@uqac.ca Received 10 May 2013; Accepted 18 July 2013  C 2013 Wiley Periodicals, Inc. DOI 10.1002/pbc.24731 Published online 21 September 2013 in Wiley Online Library (wileyonlinelibrary.com).