Dr Sarah Grimshaw APAM is a physiotherapist and postdoctoral researcher at the Murdoch Children’s Research Institute at the Royal Children’s Hospital in Melbourne. 

She has a keen interest in paediatric oncology, physical activity interventions and the impact of cancer treatments on children’s physical function and participation. 

‘I love the challenge of working with children and having an important impact on their lives and development at a crucial time,’ says Sarah. 

‘When I started in oncology, there wasn’t much literature on the benefits of exercise for cancer patients. 

'Since then, the research has grown exponentially and continues to do so. 

'As a profession, we have the potential to make a profound difference in these children’s lives.’ 

The survival rate for acute lymphoblastic leukaemia (ALL) in children is around 85 to 90 per cent, yet it still has many associated issues for survivors, such as premature chronic ill health, frailty and mortality. 

‘There’s research now indicating that children with ALL age earlier than those who haven’t had a cancer diagnosis,’ Sarah explains. 

‘We’re looking at identifying early signs of physical vulnerability during treatment, such as sarcopaenia, so we can implement interventions earlier. 

'We hope that this will help children withstand their treatment better and improve their longterm outcomes.’ 

Sarah’s research project will involve assessing muscle health in children with ALL at the beginning of their treatment to aid in early intervention for those with severe muscle toxicity. 

Sarah says, ‘We plan to recruit 50 children with a diagnosis of ALL. After their first round of treatment, which includes a high dose of steroids, children become very sedentary and are at high risk of muscle toxicity. 

'After five weeks we will assess the children using a novel framework that involves a muscle ultrasound to identify sarcopaenia. 

‘We want a tool that can be used by physiotherapists at the patient’s bedside to quickly and easily identify children with declining muscle function, which hasn’t been done before in paediatric cancer at such an acute time point. 

'Currently, we’re assessing if this framework could be clinically feasible for physiotherapists.’ 

By focusing on the feasibility of this new assessment tool, the researchers will gain a greater clinical picture of what sarcopaenia looks like in children with ALL and what other factors are associated with it. 

‘Once we understand this, the next step will be identifying who’s at risk and then designing interventions specifically for this higher-risk group. 

'The interventions would involve structured exercise and support to increase physical activity.’ 

The PRF Seeding Grant will help Sarah employ additional physios to work on the project. 

‘Through the grant we will be able to run the program embedded directly in the ward,’ says Sarah. 

‘This will provide training and upskilling to the clinical physiotherapy team at the Royal Children’s Hospital, improve clinical implementation and open doors to potential application in other populations.

‘Upon finishing your PhD, you’re coming out of a little bubble and you’re wondering what’s possible afterwards so it’s very exciting to be able to get to the next stage in my career as a clinical researcher.’