Assessing Physical Function and Fatigue in Patients Selected to Undergo Bone Marrow Transplant.

Introduction The assessment of baseline physical function should be an important and integral component in the selection of patients to undergo a bone marrow transplant. This assessment can establish a baseline level of function that can be tracked as the person undergoes cancer treatment as well as during the survivorship period. It can also be used to identify physical impairments early that can subsequently be treated rehabilitative interventions to minimize activity limitations and participation restrictions. Simple tests are available and can be useful in clinical settings. Objectives The aim of this work is to share one center's experience in the collection and analysis of data pertinent to physical function in patients referred for pre-bone marrow transplant evaluation. Methods Retrospective chart review of patients referred for an initial consultation in a cancer rehabilitation clinic in a cancer institute. The medical charts of 29 patients selected to undergo bone marrow transplant (AML/ALL-4, Lymphoma-11 and myeloma 14) were reviewed. Mean age was 55. Gender: 12 female and 17 male. The following information was reviewed: a) Patient Reported Outcome Measure Information System (PROMIS) Physical Function Short form and Fatigue short form b) Timed up and Go (TUG) test c) Sit to stand in 30 seconds test (STS-30) d) Grip Strength (in Kg)using a hand held dynamometer and e) 4 stage balance test. Values obtained during clinic visits were compared to available normative data for factors such as age and gender. These tools were selected because they are validated instruments that are easily collected in a physician's clinic. Results Based on the PROMIS Physical Function score results, 9/28 pre-BMT (32%) had an impaired physical function. Based on the PROMIS-Fatigue score results, 6/28 pre-BMT patients (21%) complained of significant fatigue. STS-30 results: 13/28 (46.4%) patients had normal scores for age and gender; 15/28 (53.6%) participants had abnormal scores for age and gender. Score for 1 participant was not available. Grip strength results: 17/27 (63%) patients had normal values for age and gender, 10/27 (37%) patients had normal values for age and gender. Scores for 2 participants were not available. 4 stage balance test: 28/29 (96.6%) participants had a normal balance and 1/29 (3.4%) participants had an impaired balance. Conclusion Assessment of physical function should be an integral part of the evaluation of patients prior to bone marrow transplant. Several instruments can be easily incorporated into a clinical setting and the information gathered can be very useful in directing need for additional interventions and can also serve as a baseline. Grip strength and sit to stand tests are easy to perform and can be very useful in assessment of physical function.