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

Eur J Cancer Care (Engl). 2020 Mar;29(2):e13199. doi: 10.1111/ecc.13199. Epub 2019 Dec 12.

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.

Keywords: cancer; exercise; gait; nutrition; physical function; whole-body electromyostimulation.

Publication types

  • Controlled Clinical Trial

MeSH terms

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