• 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.

Background: Although haematopoietic stem cell transplantation (HSCT) is known to cause substantial declines in muscle strength, changes in skeletal muscle quantity and quality remain poorly characterized. The clinical utility of non‐invasive muscle assessment tools, such as bioelectrical impedance analysis (BIA) and ultrasound (US) imaging, has not been systematically compared with computed tomography (CT), which is regarded as the gold standard for skeletal muscle assessment. Methods: This study included 31 patients who underwent HSCT (23 allogeneic, 8 autologous; 42% female; median age 47 years). Skeletal muscle mass and quality were assessed using CT, BIA, and US imaging. CT was performed before transplantation, while BIA, US imaging, and physical performance assessments (handgrip strength, knee extension strength, and 6‐min walk test) were conducted both before transplantation and at discharge. Correlations between CT and non‐invasive assessments were analysed, and longitudinal changes in muscle parameters were evaluated. Results: BIA‐derived skeletal muscle index and lower‐limb muscle mass showed strong correlations with CT‐based psoas muscle volume ( ρ > 0.75, p < 0.001). CT‐based psoas muscle density demonstrated moderate correlations with phase angle and muscle echo intensity ( ρ = −0.47 to 0.41, p < 0.05). In patients undergoing allogeneic HSCT, significant declines were observed in hydration‐adjusted lean body mass (mean change −2.1 kg, p = 0.024), lower‐limb muscle mass (−0.5 kg, p = 0.005) and rectus femoris + vastus intermedius thickness (−3.5 mm, p = 0.004), phase angle (−0.6°, p < 0.001), handgrip strength (−4.4 kg, p < 0.001), knee extension strength (−72.7 N, p < 0.001), and 6‐min walk distance (−93.7 m, p < 0.001). In contrast, patients undergoing autologous HSCT largely preserved muscle strength and mass ( p > 0.200), despite similar reductions in phase angle (−0.6°, p = 0.001). Conclusions: BIA provides a clinically feasible and reliable alternative to CT for assessing skeletal muscle quantity in patients undergoing HSCT. Loss of skeletal muscle mass was strongly associated with functional decline in recipients of allogeneic HSCT, while changes in muscle quality, such as reductions in phase angle, appeared to have limited functional impact. These findings highlight the usefulness of non‐invasive monitoring and suggest that interventions focusing on muscle mass preservation may improve physical function after HSCT.

Background: Locomotive syndrome (LS) is a clinical condition used to describe reduced mobility caused by musculoskeletal dysfunction and is highly prevalent among patients with cancer. The fat-free mass index (FFMI) is an indicator of nutritional status and muscle mass, and has been associated with malnutrition and prognosis in this population. This study investigated the relationship between FFMI and LS in patients with cancer and determined sex-specific FFMI cutoff values associated with severe LS. Methods: This study included patients hospitalized for cancer treatment who were referred for rehabilitation therapy. Patient characteristics, laboratory data, body composition, and grip strength were collected. LS was assessed using the stand-up test, two-step test, and 25-Geriatric Locomotive Function Scale. FFMI was measured using bioelectrical impedance analysis. Results: Overall, 144 patients (102 men and 42 women; mean age, 63.9 ± 15.8 years) were analyzed. Ordinal logistic regression analysis demonstrated that FFMI was independently associated with LS severity (odds ratio [OR], 0.597; 95% confidence interval [CI], 0.434–0.821). The optimal FFMI cutoff values associated with severe LS (grade ≥ 2) were 16.99 kg/m² in men and 15.25 kg/m² in women, with areas under the curves of 0.806 (95% CI, 0.720–0.890) and 0.760 (95% CI, 0.596–0.925), respectively. Conclusions: FFMI was associated with mobility function in patients with cancer. The proposed sex-specific cutoff values may help identify patients with impaired mobility who could be considered for referral to rehabilitation therapy.

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.