Gait Speed and Grip Strength: Predictors of Outcome in Hematologic Malignancies?
Posted: Tuesday, September 10, 2019
Characterizing gait speed as an “easily obtainable ‘vital sign,’” a Boston research team published the results of their trial in Blood, demonstrating that this measurement can independently predict survival and hospital utilization among older patients with blood cancers, including chronic lymphocytic lymphoma. Every 0.1 meter-per-second decrease in gait speed in their patient population, all 75 years or older, was associated with higher mortality (hazard ratio = 1.22), odds of unplanned hospitalizations (odds ratio = 1.33), and emergency department visits (odds ratio = 1.34).
Jane A. Driver, MD, MPH, of the Older Adult Hematologic Malignancy Program at Dana-Farber Cancer Center, and colleagues explained that the test helps identify those who are in better—as well as worse-than-expected—shape based on age, Eastern Cooperative Oncology Group performance status, and other factors. The team’s patient cohort began with 448 patients with myelodysplastic syndrome, leukemia, myeloma, or lymphoma. Of these patients, 314 were followed for at least 6 months for unplanned hospital or emergency department use.
In the gait speed test, a patient simply walks at a normal pace for 4 meters, timed with a stopwatch for a meters-per-second rate. Dr. Driver and her co-investigators also evaluated grip strength as a useful predictor of clinical outcome. They found that every 5-kg decrease was associated with worse survival (adjusted hazard ratio = 1.24)—but not hospital or emergency department use—deeming the measure possibly useful as a survival marker in patients for whom a gait speed test is not possible or practical.
In addition, the team emphasized that assessing gait speed in oncology clinics could substantially improve individualization of care. “Brief screening tests for frailty that can easily fit into clinic workflow and predict important clinical outcomes” are an unmet need, declared Dr. Driver in an institutional press release. Gait speed “is as good as other commonly used methods, which take considerably more time and resources and may not be practical for many oncology clinics.”
Disclosure: The study authors reported no conflicts of interest.