Identifying A Practical Measurement Of Physical Function To Implement Within An Outpatient Geriatric Oncology Clinic

A comprehensive geriatric assessment (CGA) is recommended for older adults with cancer to inform their survivorship care plan. Physical function (PF) is a critical component of CGA; however, incorporating an objective measure of PF into clinical practice is difficult. Objective measures of PF can identify older cancer survivors in need of rehabilitation and/or exercise services to reduce fall risk, a prevalent challenge in this population. PURPOSE: To determine the practicality of implementing an objective PF assessment in an outpatient geriatric oncology clinic. METHODS: Ambulatory older cancer survivors (≥ 60 years) completed the timed up and go (TUG) and short physical performance battery (SPPB) at a standard of care clinic visit. Shorter TUG time and higher SPPB scores indicate higher levels of PF. Established cut-points were used to identify individuals at increased fall risk: ≥12.6 seconds for TUG; a score of ≤6 and ≤ 9 for SPPB. Time to administer TUG and SPPB were recorded to evaluate practicality of implementation. Spearman correlation coefficients were used to evaluate the relationship between TUG and SPPB. A paired samples t-test was used to ascertain differences in time to administer assessments. RESULTS: Cancer survivors (n = 22) were 77.0 ± 5.5 (Mean ± SD) years old (range: 66-85). The majority of survivors were female (n = 16; 72.7%), and had stage IV cancer (n = 8; 38.1%). The most common cancer sites were breast (n = 8) and prostate (n = 4). Five survivors used an assistive device (cane: n = 3; walker: n = 2). One survivor was unable to complete the assessments and was excluded from analysis. Average TUG time was 14.7 ± 7.2 seconds with 47.6% (n = 10) survivors identified as being at high fall risk. Average SPPB score was 7.7 ± 2.9, with 38.1% (n = 8) and 72.7% (n = 16) of scores indicating high fall risk using the ≤6 and ≤ 9 cut-points, respectively. TUG scores across SPPB score ranges of ≤6, 7-9, and ≥ 10 were 22.1 ± 5.5 seconds, 12.0 ± 2.7, and 7.2 ± 1.6, respectively. TUG and SPPB scores were significantly correlated (r = -0.94; p < 0.001). Time to administer TUG (n = 18; 0.8 ± 0.3 minutes) was significantly shorter than SPPB (n = 20; 4.1 ± 1.5 minutes, p < 0.001). CONCLUSIONS: TUG and SPPB scores are well correlated, and both are feasible PF assessments to implement within a CGA; TUG may be more practical due to the shorter time requirement.