Background and Objectives: Changes in activities of daily living (ADL) and quality of life (QOL) of patients with bone metastasis who underwent surgical treatment through Bone Metastasis Cancer Boards (BMCBs), a recent multidisciplinary approach for managing bone metastases, have been reported; however, no reports exist on patients who undergo conservative treatment. In this study, we aimed to evaluate these patients’ ADL and QOL and examine the factors influencing changes in these parameters. Materials and Methods: We retrospectively reviewed 200 patients with bone metastases who underwent conservative therapy through BMCBs between 2013 and 2021. A reassessment was conducted within 2–8 weeks after the initial assessment. Patients’ background and changes in performance status (PS), Barthel Index (BI), EuroQol five-dimension (EQ-5D) scores, and Numerical Rating Scale (NRS) scores were initially assessed. Furthermore, we categorized patients into two groups based on improvements or deteriorations in ADL and QOL and performed comparative analyses. Results: Significant improvements in EQ-5D (0.57 ± 0.02 versus [vs.] 0.64 ± 0.02), NRS max (5.21 ± 0.24 vs. 3.56 ± 0.21), and NRS average (2.98 ± 0.18 vs. 1.85 ± 0.13) scores were observed between the initial assessment and reassessment (all p < 0.001). PS (1.84 ± 0.08 vs. 1.72 ± 0.08) and BI (83.15 ± 1.68 vs. 84.42 ± 1.73) also showed improvements (p = 0.06, and 0.054, respectively). In addition, spinal cord paralysis (odds ratio [OR]: 3.69, p = 0.049; OR: 8.42, p < 0.001), chemotherapy (OR: 0.43, p = 0.02; OR: 0.25, p = 0.007), and NRS average scores (OR: 0.38, p = 0.02; OR: 0.14, p < 0.001) were independent factors associated with ADL and QOL. Conclusions: Patients with bone metastases who underwent conservative treatment through BMCBs exhibited an increase in QOL without a decline in ADL. The presence of spinal cord paralysis, absence of chemotherapy, and poor pain control were associated with a higher risk of deterioration in ADL and QOL.

• ADL and QOL were compared between bone metastasis patients with and without rehabilitation using propensity score matching. • Rehabilitation improved ADL and QOL in patients with nonsurgically treated bone metastasis. • Chemotherapy was associated with greater improvement in ADL and QOL.

Background: Locomotive syndrome (LS), a condition characterized by impaired mobility due to locomotive organ dysfunction, is highly prevalent among patients with cancer. The phase angle (PhA), measured via bioelectrical impedance analysis (BIA), reflects cellular health and nutritional status. This study aimed to investigate the association between LS and the PhA in patients with cancer. Methods: This cross-sectional study included hospitalized patients who underwent cancer treatment. The assessed variables included age, sex, body mass index (BMI), gait speed, grip strength, PhA, and the outcomes of LS risk assessment using the stand-up test, two-step test, and the 25-Geriatric Locomotive Function Scale (GLFS25). Results: A total of 190 patients (57 females, 133 males; mean age, 62.6 ± 17.2 years) were analyzed. The PhA was significantly negatively correlated with the LS stage (rs = −0.507, p < 0.001). Similarly, a significant negative correlation was observed between the PhA and each LS risk test, namely, the stand-up test, two-step test, and GLFS25. Furthermore, the PhA was identified as an independent and significant factor associated with LS progression (odds ratio, 0.361; 95% confidence interval, 0.221–0.588; p < 0.001). More effective and rapid than completing the full range of LS risk tests, measuring the PhA represents a convenient and practical tool for the early screening of mobility decline. Conclusions: The PhA is a simple and effective parameter for assessing mobility decline in patients with cancer. It is a potential clinical indicator for initiating rehabilitation interventions aimed at preventing the onset and progression of LS.

PurposeExercise capacity in patients with non-small cell lung cancer (NSCLC) has been reported to be a prognostic factor. This study aimed to clarify the associations of preoperative and postoperative exercise capacity with cancer recurrence and survival.MethodsThis single-center retrospective cohort study included 133 patients with NSCLC who underwent pulmonary resection and completed a six-minute walk test either preoperatively or at discharge. Patients were stratified into long- and short-distance groups using cohort-specific six-minute walk distance (6MWD) cutoffs derived from receiver operating characteristic analyses. Outcomes were relapse-free survival (RFS), overall survival (OS), and time to recurrence (TTR).ResultsThe preoperative cohort included 75 patients, and the postoperative cohort included 123 patients. Shorter 6MWD (≤485 m preoperatively and ≤432 m postoperatively) was associated with significantly worse 5-year RFS, OS, and TTR. These associations remained significant after multivariable adjustment.ConclusionsPerioperative exercise capacity assessed by the 6MWD was associated with postoperative recurrence and survival in patients with NSCLC. Assessment of exercise capacity may provide valuable prognostic information in lung cancer management.

Rationale: Hereditary spastic paraplegia (HSP), a rare neurodegenerative disorder in Japan, is characterized by insidiously progressive lower extremity spasticity and muscle weakness. Current management is primarily symptomatic, including physical therapy and spasticity modulation with botulinum toxin or intrathecal baclofen. Recent studies have suggested that extracorporeal shock wave therapy (ESWT) may be effective for treating spasticity in patients recovering from stroke. We report a case exploring the use of radial ESWT (rESWT) combined with physiotherapy in a patient with HSP. Patient concerns: A 31-year-old man diagnosed with HSP in his 20s had been receiving physical therapy and orthotics but experienced progressive bilateral lower extremity spasticity, leading to deterioration in gait function and mobility. Diagnoses: Progressive HSP with exacerbated bilateral lower extremity spasticity manifesting as impaired gait efficiency and reduced functional mobility. Interventions: The patient was treated with rESWT focusing bilaterally on the calf muscles. Outcomes: Posttreatment, the patient’s visual analog scale score for ease of walking improved significantly from 40 to 85, reflecting enhanced walking ability. The timed up and go test results improved from 15.08 to 12.59 seconds and 11.51 to 10.43 seconds at comfortable and maximum speeds, respectively. The 10-meter walk test time decreased from 10.48 to 7.24 seconds, and the step count improved from 20 to 14. Despite the modified Ashworth scale scores and dorsiflexion measurements showing minimal changes, no adverse effects were observed. Lessons: This case report provides preliminary evidence that rESWT combined with physical therapy may improve gait disturbances, as well as the ease of walking and ambulatory ability, associated with spasticity in HSP. However, due to the limitations of a single-case study and the potential influence of confounding factors, further research – including randomized, placebo-controlled trials – is necessary to confirm its efficacy and determine optimal treatment parameters.