Assessment of gait parameters and physical function in patients with advanced cancer participating in a 12-week exercise and nutrition programme: A controlled clinical trial.

Kristin Schink, Heiko Gaßner, Dejan Reljic, Hans J Herrmann, Wolfgang Kemmler, Raphaela Schwappacher, Julia Meyer, Björn M Eskofier, Jürgen Winkler, Markus F Neurath, Jochen Klucken, Yurdagül Zopf

Journal: European journal of cancer care 2021;29(2):e13199

PMID: 31829481

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Abstract

OBJECTIVE

Gait is a sensitive marker for functional declines commonly seen in patients treated for advanced cancer. We tested the effect of a combined exercise and nutrition programme on gait parameters of advanced-stage cancer patients using a novel wearable gait analysis system.

METHODS

Eighty patients were allocated to a control group with nutritional support or to an intervention group additionally receiving whole-body electromyostimulation (WB-EMS) training (2×/week). At baseline and after 12 weeks, physical function was assessed by a biosensor-based gait analysis during a six-minute walk test, a 30-s sit-to-stand test, a hand grip strength test, the Karnofsky Index and EORTC QLQ-C30 questionnaire. Body composition was measured by bioelectrical impedance analysis and inflammation by blood analysis.

RESULTS

Final analysis included 41 patients (56.1% male; 60.0 ± 13.0 years). After 12 weeks, the WB-EMS group showed higher stride length, gait velocity (p < .05), six-minute walking distance (p < .01), bodyweight and skeletal muscle mass, and emotional functioning (p < .05) compared with controls. Correlations between changes in gait and in body composition, physical function and inflammation were detected.

CONCLUSION

Whole-body electromyostimulation combined with nutrition may help to improve gait and functional status of cancer patients. Sensor-based mobile gait analysis objectively reflects patients' physical status and could support treatment decisions.

Address: Department of Medicine 1, Hector Center for Nutrition, Exercise and Sports, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany.; Department of Molecular Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.; Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.; Machine Learning and Data Analytics Lab, Department of Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.; Department of Medicine 1 - Gastroenterology, Pneumology and Endocrinology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.

DOI: 10.1111/ecc.13199

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MeSH Terms: Adult, Aged, Body Composition, Counseling, Dietary Supplements, Electric Impedance, Electric Stimulation Therapy, Exercise Therapy, Female, Gait, Gait Analysis, Gastrointestinal Neoplasms, Genital Neoplasms, Female, Humans, Karnofsky Performance Status, Lung Neoplasms, Male, Middle Aged, Muscle, Skeletal, Neoplasm Staging, Neoplasms, Nutritional Support, Patient Reported Outcome Measures, Physical Functional Performance, Pilot Projects, Quality of Life, Urologic Neoplasms, Walk Test, Walking Speed