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Strength of skeletal muscle and self-reported physical performance in Austrian glioblastoma-patients

Muskelkraft und selbsteingeschätzte körperliche Leistungsfähigkeit bei österreichischen Glioblastom-Patienten

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Summary

Background

Aim of this study was to describe longitudinal assessments of handgrip strength, strength of thigh muscles, and self-reported physical performance in patients with glioblastoma after neurosurgical intervention undergoing chemoradiation.

Methods

Strength testing was performed in 24 Austrian glioblastoma patients (m:f = 19:5, 52 ± 14a, BMI = 26 ± 3 kg/m²) at baseline and follow up after chemoradiation (interval between baseline and follow up = 14 ± 9 weeks). Isokinetic testing of knee extension/flexion was performed by using a Biodex 3 dynamometer. Handgrip strength was measured by using a Jamar hand-dynamometer. Physical performance was assessed by using the subscales “physical functioning” and “role physical” of the SF-36 Health Survey.

Results

Peak torque of knee extensors (peak torque) were clearly lower than expected for age- and sex-related values (p < 0.0001). In comparison with age- and sex-related reference values, deficits of “role physical” (p < 0.0001) and “physical functioning” (p = 0.010) were found.

Effects of measurements of muscle strength on “physical functioning” were significant (peak torque:p < 0.001; handgrip strength:p < 0.001).

No significant change could be detected after follow up for peak torque (p = 0.337), handgrip strength (p = 0.995), “physical functioning” (p = 0.824), and “role physical” (0.594).

Conclusions

In this study, notable deficits especially in muscular strength of thigh muscles and general physical performance of patients with glioblastoma have been found before and after chemoradiation. Reduced muscle strength and impaired self-reported physical performance seem to be clinically relevant functional deficits in (Austrian) glioblastoma patients. Therefore, rehabilitation and supportive care should also include options to increase muscle strength.

Zusammenfassung

Grundlagen

Die vorliegende Untersuchung hatte die Beschreibung der motorischen Grundeigenschaft „Kraft“ (vor und nach Chemoradiatio) und deren Auswirkung auf die Leistungs- und Funktionsfähigkeit von Glioblastom (GBM)-Patienten zum Ziel.

Methodik

24 Patienten (m:f = 19:5, 52 ± 14a, BMI = 26 ± 3 kg/m²) wurden in die vorliegende Pilot-Untersuchung eingeschlossen. Es wurden bei jedem Patienten eine „Handdynamometrie“ mit Ermittlung der Faustschlusskraft (Jamar®) sowie eine isokinetische Dynamometrie der Extensoren und Flexoren der Kniegelenke (Biodex®-3) vor und nach Chemoradiatio (Abstand zwischen den Messungen = 14 ± 9 Wochen) durchgeführt. Die körperliche Leistungs- und Funktionsfähigkeit der Studienteilnehmer wurde mittels der Subskalen „Körperliche Funktionsfähigkeit“ und „Körperliche Rollenfunktion“ des SF-36 Health Survey erfragt.

Ergebnisse

Das maximale Drehmoment der Knieextensoren (maximales Drehmoment) lag deutlich unter den alters- und geschlechtsspezifischen Erwartungswerten (p < 0,0001). Verglichen mit alters- und geschlechtsspezifischen Referenzwerten konnten signifikante Defizite der selbsterfassten Leistungs- und Funktionsfähigkeit der Patienten („Körperliche Rollenfunktion“:p < 0,0001; „Körperliche Funktionsfähigkeit“:p = 0,010) gefunden werden. Sowohl Faustschlusskraft als auch maximales Drehmoment zeigten signifikante (negative) Korrelationen mit der Subskala „Körperliche Funktionsfähigkeit“ (maximales Drehmoment:p < 0,001; Faustschlusskraft:p < 0,001). Maximales Drehmoment (p = 0,337), Faustschlusskraft (p = 0,995), „Körperliche Funktionsfähigkeit“ (p = 0,824), und „Körperliche Rollenfunktion“ (0,594) änderten sich im Zeitverlauf (vor und nach Chemoradiatio) nicht signifikant.

Schlussfolgerungen

Im Rahmen der vorliegenden Studie an GBM-Patienten (vor und nach Chemoradiatio) konnten deutliche Defizite der Kraft der Knieextensoren und der selbsterfassten körperlichen Leistungs- und Funktionsfähigkeit gefunden werden. Da diese Defizite funktionell relevant für den Alltag der Patienten zu sein scheinen, sollte die Rehabilitation dieser Patienten Optionen zur Verbesserung der motorischen Grundeigenschaft Kraft inkludieren.

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Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Mohammad Keilani MD, MSc & Richard Crevenna MBA, MSc

  2. Section of Medical Statistics, Core Unit for Medical Statistics and Informatics, Medical University of Vienna, Vienna, Austria

    Christoph Krall PhD

  3. Department of Internal Medicine I/Division of Oncology, Medical University of Vienna, Vienna, Austria

    Christine Marosi MD, Birgit Flechl MD & Maximilian Marhold

  4. Department of Radiotherapy, Medical University of Vienna, Vienna, Austria

    Karin Dieckmann MD

  5. Department of Neurosurgery, Medical University of Vienna, Vienna, Austria

    Georg Widhalm MD

Authors
  1. Mohammad Keilani MD, MSc
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  2. Christoph Krall PhD
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  3. Christine Marosi MD
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  4. Birgit Flechl MD
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  5. Karin Dieckmann MD
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  6. Georg Widhalm MD
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  7. Maximilian Marhold
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  8. Richard Crevenna MBA, MSc
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Correspondence to Richard Crevenna MBA, MSc.

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Keilani, M., Krall, C., Marosi, C. et al. Strength of skeletal muscle and self-reported physical performance in Austrian glioblastoma-patients. Wien Klin Wochenschr 124, 377–383 (2012). https://doi.org/10.1007/s00508-012-0186-1

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  • DOI: https://doi.org/10.1007/s00508-012-0186-1

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