Research Corner Outcome Measures in Cardiopulmonary Physical Therapy: Short Physical Performance Battery

Puthoff, Michael

doi:10.1097/01823246-200819010-00005

Cited by 102 publications

(63 citation statements)

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“…When performed with grip strength testing, the SPPB provides a robust assessment of global physical function and can serve as a benchmark for future interventions [11, 12]. SPPB component scores can also be analyzed individually [13]. For example, balance scores have been associated with functional decline in the elderly [14] and are lower in kidney transplant candidates compared to patients with other comorbidities [15].…”

Section: Introductionmentioning

confidence: 99%

Relationship between pre-transplant physical function and outcomes after kidney transplant

et al. 2017

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Background Performance-based measures of physical function predict morbidity following non-transplant surgery. Study objectives were to determine whether physical function predicts outcomes after kidney transplant and assess how physical function changes post-transplant. Methods We conducted a prospective study involving living donor kidney transplants recipients at our center 5/2012 to 2/2014. Physical function was measured using the Short Physical Performance Battery (SPPB) (balance, chair stands, gait speed) and grip strength testing. Initial length of stay (LOS), 30-day rehospitalizations, allograft function and quality of life (QOL) were assessed. Results The majority of the 140 patients in our cohort had excellent pre-transplant physical function. In general, balance scores were more predictive of post-transplant outcomes than the SPPB. Decreased pre-transplant balance was independently associated with longer LOS and increased rehospitalizations but not with post-transplant QOL. 35% of patients experienced a clinically meaningful (≥ 1.0 m/s) improvement in gait speed four months post-transplant. Conclusions Decreased physical function may be associated with longer LOS and rehospitalizations following kidney transplant. Further studies are needed to confirm this association. The lack of relationship between pre-transplant gait speed and outcomes in our cohort may represent a ceiling effect. More comprehensive measures, including balance testing, may be required for risk stratification.

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Section: Introductionmentioning

confidence: 99%

Relationship between pre-transplant physical function and outcomes after kidney transplant

et al. 2017

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“…Based on previously established criteria for grading SPPB scores, there was no meaningful change from baseline physical performance scores in the placebo group (+0.3; Table ). The testosterone group had a clinically meaningful increase in total SPPB score of 1.4 points following treatment due primarily to an increased average chair rise score.…”

Section: Resultsmentioning

confidence: 99%

“…Post‐treatment change from baseline score was determined for the total SPPB score and each subtest. A change in overall SPPB score of one point or greater was considered meaningful …”

Section: Methodsmentioning

confidence: 99%

A randomized trial of adjunct testosterone for cancer‐related muscle loss in men and women

Wright

Dillon

Durham

et al. 2018

J cachexia sarcopenia muscle

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BackgroundCancer cachexia negatively impacts cancer‐related treatment options, quality of life, morbidity, and mortality, yet no established therapies exist. We investigated the anabolic properties of testosterone to limit the loss of body mass in late stage cancer patients undergoing standard of care cancer treatment.MethodsA randomized, double‐blind, placebo‐controlled phase II clinical trial was undertaken to assess the potential therapeutic role of adjunct testosterone to limit loss of body mass in patients with squamous cell carcinoma of the cervix or head and neck undergoing standard of care treatment including chemotherapy and chemoradiation. Patients were randomly assigned in blocks to receive weekly injections of either 100 mg testosterone enanthate or placebo for 7 weeks. The primary outcome was per cent change in lean body mass, and secondary outcomes included assessment of quality of life, tests of physical performance, muscle strength, daily activity levels, resting energy expenditure, nutritional intake, and overall survival.ResultsA total of 28 patients were enrolled, 22 patients were studied to completion, and 21 patients were included in the final analysis (12 placebo, nine testosterone). Adjunct testosterone increased lean body mass by 3.2% (95% confidence interval [CI], 0–7%) whereas those receiving placebo lost 3.3% (95% CI, −7% to 1%, P = 0.015). Although testosterone patients maintained more favourable body condition, sustained daily activity levels, and showed meaningful improvements in quality of life and physical performance, overall survival was similar in both treatment groups.ConclusionsIn patients with advanced cancer undergoing the early phase of standard of care therapy, adjunct testosterone improved lean body mass and was also associated with increased quality of life, and physical activity compared with placebo.

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“…20 It is comprised of a four-meter walk, repeated chair stands and a balance test. Each domain is scored from 0-4 with 0 being “unable to complete the task” and 4 being “at the highest level of performance.” 21 Impairment was defined as a score of 9 or less out of a total score of 12 based on previous studies that demonstrate that scores 9 or below are associated with disability, nursing home placement and mortality. 22,23 …”

Section: Methodsmentioning

confidence: 99%

Associations of sleep disturbance with physical function and cognition in older adults with cancer

Loh

Pandya

Zittel

et al. 2017

Support Care Cancer

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Purpose Although sleep disturbances are common in older adults, studies evaluating the prevalence of sleep disturbance and influence on functional outcomes in older adults with cancer are few. In this study, we examined the prevalence of sleep disturbance and its association with physical function and cognition in older adults with cancer. Methods Patients referred to the Specialized Oncology Care & Research in the Elderly clinics at the Universities of Rochester and Chicago from May 2011 to October 2015 who underwent a geriatric assessment (GA) and completed the sleep assessment were included. Presence of sleep disturbance was self-reported (yes/no). Physical function was assessed using Instrumental Activities of Daily Living (IADLs), physical activity (PA) survey, falls in the preceding six months, and Short Physical Performance Battery (SPPB). Bivariate and multivariable analyses were used to examine the associations between sleep disturbance with functional outcomes and cognition. Results We included 389 older patients. The prevalence of sleep disturbance was 40%. Sixty eight percent had ≥1 IADL impairment, 76% had PA limitation, 37% had ≥1 fall, 70% had impairment on SPPB, and 47% screened positive for cognitive impairment. On bivariate analyses, sleep disturbance was associated with IADL impairment (Odds ratio [OR] 1.96, 95% Confidence Interval [CI] 1.23-3.13, P=0.005) and PA limitation (OR 2.43, 95% CI 1.38-4.28, P=0.002). The associations remained significant on multivariable analyses. Sleep disturbance was not significantly associated with falls, impairment on SPPB and performance on the cognitive screen. Conclusion Sleep disturbance was associated with IADL impairment and PA limitation. It is important for oncologists to inquire about sleep problems, and these patients should also be screened for functional impairment if sleep disturbance was present.

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Research Corner Outcome Measures in Cardiopulmonary Physical Therapy: Short Physical Performance Battery

Cited by 102 publications

References 0 publications

Relationship between pre-transplant physical function and outcomes after kidney transplant

Relationship between pre-transplant physical function and outcomes after kidney transplant

A randomized trial of adjunct testosterone for cancer‐related muscle loss in men and women

Associations of sleep disturbance with physical function and cognition in older adults with cancer

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