Associations between motor performance, gait characteristics, and gait variability in pediatric oncology: a cross-sectional correlation study

Introduction Advances in childhood cancer treatment have improved survival rates, shifting attention towards treatment-related physical limitations. However, evidence on gait alterations and motor correlates in pediatric oncology remains scarce. This cross-sectional correlation study explores relationships between physical performance and gait in childhood cancer patients. Materials and Methods Sixty-four childhood cancer patients (mean age 9.75 ± 4.01 years, range 4-20) underwent gait analysis and physical performance assessments during and post-treatment. Wilcoxon signed-rank tests compared participants with age- and sex-matched normative values. Spearman's rank correlations assessed associations between physical performance and gait, adjusted for age, height, and weight. Results Participants' gait differed significantly from norms, with reduced step length (-11.33%) and walking velocity (-10.59%) and increased base of support (+19.68%; all p <.001). Lower limb strength (-41.60% to -56.65%, p <.001), joint range of motion (-2.56% to -47.03%; p <.05), and BBS and FGA scores were reduced (-1.79 and -2.67 points; p <.001). Several associations between physical performance and gait remained significant after adjustment for age, height, and weight, with the strongest observed for knee flexor strength and step length (ρ =.439), BBS and base of support (ρ = -.448), as well as BBS and FGA with step duration variability (ρ = -.535 and ρ = -.507; all p <.01). Conclusions These findings emphasize the relationship between physical performance and gait in childhood cancer patients. Clinically feasible assessments may help identify motor performance limitations associated with altered gait and guide rehabilitation strategies in pediatric oncology. Trial registration NCT05867186 (registered on: 06.04.2023)