Marie Ménard, Jean Matthieu L'Orphelin, Antoine Desvergée, Cyril Guillaumé, Mathilde Ducloie, Guillaume Galliou, Delphine Guyet, Charline Frandemiche, Lisa Falquerho, Schroder Sattar, Poppy Evenden, Bérengère Beauplet
Among 288 eligible patients, 83 were included. The median age was 72, 61% were male, and they primarily had digestive, lung, or cutaneous cancer. Ongoing treatments were chemotherapy (28.9%), immunotherapy (37.5%), and otherwise combined treatments. Only half of the participants adhered to World Health Organization guidelines on physical activity for people with chronic illness, with better 6MWT as the sole associated factor (p = 0.004). The 6MWT was severely impaired (<150 m) in 20.5% of participants; 42.2% had a moderate-to-high level of fall risk, and 60.2% had a moderate-to-severe Total Neuropathy Score. Neither age nor sex were associated with any impairment. The 6MWT impairment correlated with higher fall risk (p = 0.002) and neuropathy symptoms (p = 0.004). Overall, 49% (41/83) of participants had limitations requiring physiotherapy referral.
INTRODUCTION: In our regional Physical Activity program dedicated to patients with cancer, older individuals remain underrepresented, despite the offer of an individual home-based option and repeated communication with potential prescribers. We hypothesized that, with aging, functional limitations may prevent patients from undertaking such programs and rather require referrals to an initial physiotherapy rehabilitation. Our objective was, in a sample of older patients treated for cancer, to assess their physical limitations and identify the proportion who should be referred to physiotherapy rehabilitation. Secondary objectives explored factors associated with severe limitations.
MATERIALS AND METHODS: This monocentric exploratory study recruited consecutive patients aged ≥65 over five weeks treated at the oncology ambulatory care unit. Duration and intensity of weekly physical activity was enquired as well as motivation and pain. The 6 min-Walk Test, pain, Total Neuropathy Score, and world guidelines-3 key questions to identify the level of fall risk were collected by a physiotherapist to categorize the limitations. A required referral to rehabilitation by a physiotherapist was identified when 6MWT <150 m or not feasible and/or a moderate-to-high level of fall risk and/or neuropathy score ≥ 15.
RESULTS: Among 288 eligible patients, 83 were included. The median age was 72, 61% were male, and they primarily had digestive, lung, or cutaneous cancer. Ongoing treatments were chemotherapy (28.9%), immunotherapy (37.5%), and otherwise combined treatments. Only half of the participants adhered to World Health Organization guidelines on physical activity for people with chronic illness, with better 6MWT as the sole associated factor (p = 0.004). The 6MWT was severely impaired (<150 m) in 20.5% of participants; 42.2% had a moderate-to-high level of fall risk, and 60.2% had a moderate-to-severe Total Neuropathy Score. Neither age nor sex were associated with any impairment. The 6MWT impairment correlated with higher fall risk (p = 0.002) and neuropathy symptoms (p = 0.004). Overall, 49% (41/83) of participants had limitations requiring physiotherapy referral.
DISCUSSION: The physical assessment should include fall risk and neurological examination, to identify the professional profile required for supervised rehabilitation. Before being able to undertake our Physical Activity program, half of patients under systemic cancer treatment required first a referral to physiotherapists due to severe limitations.