Assessment of Fundamental Movement Skills in Childhood Cancer Patients Fiona L. Naumann, PhD, AEP, 1 * Mitchel Hunt, BMedScHons, 2 Dulfikar Ali, BExPhys, AEP, 2 Claire E. Wakefield, PhD, 3,4 Kevin Moultrie, 5 and Richard J. Cohn, PhD 3,4 INTRODUCTION Over the last 50 years, research and scientific advances have played a pivotal role in transforming childhood cancer from a virtually incurable disease to achieving a 5-year survival rate of approximately 80%.[1] However, improved survival rates for childhood cancer survivors (CCS) present an ongoing challenge of how to effectively manage subsequent complications resulting from treatment.[2] Oeffinger et al.[3] indicated that nearly two-thirds of CCS report at least one severe or life-threatening chronic health condition at and beyond the 5-year survival mark. Despite efforts to decrease the toxicity of cancer treatment, present therapy produces a range of short-term side effects and late effects.[4] These include cardiovascular deficits;[5] metabolic syndrome;[3] cognitive, endo- crine, and pulmonary dysfunction;[6] obesity;[7] osteoporosis;[8] acute peripheral neuropathy;[9] musculoskeletal and neurological deficits; and physical disability,[6] all of which can decrease function and the ability to perform regular daily tasks.[10] Such side effects can also reduce potential participation in physical activity and exercise, further exacerbating the short-term and late effects.[11–13] Childhood is also an important time for the development of rudimentary fundamental movement skills (FMS). FMS form the building blocks or attributes that are the prerequisites of physical activity and sport.[14] There is also evidence to suggest that after 13–14 years of age, it is difficult to correct and reverse FMS deficits, indicating that FMS deficits need to be identified early and corrected if possible.[15] Additional research among school-aged children indicates an important correlation between high levels of FMS and higher levels of physical activity,[16–18] cardiorespira- tory fitness,[19,20] and lower levels of obesity.[21] Unfortunately, FMS are thought to be adversely affected both during and post- cancer treatment due to excessively sedentary behaviour throughout cancer treatments[22] and the toxic effects of the chemotherapeutic drugs used, particularly vincristine.[23] This is particularly concerning as physical activity levels in CCSs are already reported to decline during and after treatment completion[24] and be lower than their “healthy” peers or sibling equivalents.[10,15,25] If FMS deficits are then added to the mix, the ongoing physical activity levels in CCS could be at risk. The aim of this study was, therefore, to examine the impact of cancer treatment upon FMS in pediatric cancer patients aged 5–8 years. Specifically, the aim was to characterize and compare the FMS among pediatric cancer patients who were less than 5 years from completion of cancer treatment with healthy children to determine whether diagnosis and treatment outcomes were associated with lower FMS performance scores. METHODS A cross-sectional study was implemented that incorporated the sampling of children aged 5–8 years. The study recruited both pediatric cancer patients at the Sydney Children’s Hospital (SCH) and a healthy reference group from four Catholic schools in Sydney. Clinical nursing consultants and treating oncology staff identified eligible participants from the hospital clinic registers. Oncology patients were eligible if they had completed cancer treatment within the past 5 years. Children were not eligible to participate if they 1 Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia; 2 School of Medical Sciences, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia; 3 Kids Cancer Centre, Sydney Children’s Hospital, Randwick, New South Wales, Australia; 4 Discipline of Pediatrics, School of Women’s and Children’s Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia; 5 TRANSFORM-US Fitness for Kids Pty Ltd., Sydney, New South Wales, Australia Grant sponsor: National Health and Medical Research Council of Australia; Grant number: APP1067501; Grant sponsor: Cancer Institute of NSW; Grant number: 11/ECF/3-43; Grant sponsor: Kids With Cancer Foundation Conflict of interest: Nothing to declare.  Correspondence to: Fiona L. Naumann, Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Musk Ave., Kelvin Grove, Brisbane, QLD 4059, Australia. E-mail: fiona.naumann@qut.edu.au Received 24 March 2015; Accepted 30 June 2015 Background. The improved treatment protocols and subsequent improved survival rates among childhood cancer patients have shifted the focus toward the long-term consequences arising from cancer treatment. Children who have completed cancer treatment are at a greater risk of delayed development, diminished functioning, disability, compromised fundamental movement skill (FMS) attain- ment, and long-term chronic health conditions. The aim of the study was to compare FMS of childhood cancer patients with an aged matched healthy reference group. Methods. Pediatric cancer patients aged 5–8 years (n ¼ 26; median age 6.91 years), who completed cancer treatment (<5 years) at the Sydney Children’s Hospital, were assessed performing seven key FMS: sprint, side gallop, vertical jump, catch, over-arm throw, kick, and leap. Results were compared to the reference group (n ¼ 430; 6.56 years). Results. Childhood cancer patients scored significantly lower on three out of seven FMS tests when compared to the reference group. These results equated to a significantly lower overall score for FMS. Conclusions. This study highlighted the significant deficits in FMS within pediatric patients having completed cancer treatment. In order to reduce the occurrence of significant FMS deficits in this population, FMS interventions may be warranted to assist in recovery from childhood cancer, prevent late effects, and improve the quality of life in survivors of childhood cancer. Pediatr Blood Cancer 2015; 62:2211– # 2015 Wiley Periodicals, Inc. Key words: assessment; cancer treatment; childhood cancer patient; fundamental movement skills; oncology; pediatrics  C 2015 Wiley Periodicals, Inc. DOI 10.1002/pbc.25676 (wileyonlinelibrary.com). Published online 30 July 2015 in Wiley Online Library Pediatr Blood Cancer 2015;62:2211–2215 2215.