A physiotherapists perspective of a geriatric clinic in a tertiary oncology centre.

Abstract

Aims and objectives: To analyse various domains amongst the geriatric population such as age, gender, body mass index (BMI), comorbidities, type of cancer and use of assistive devices, and find a correlation between the outcome measures such as short physical performance battery (SPPB) and performance-oriented mobility assessment (POMA).

Methodology: Patients above 60 years were screened and further referred to the physiotherapy department. A brief history was recorded to retrieve the demographic data such as name, age, gender, height, weight, BMI, hand dominance, diagnosis, previous investigations are done, comorbidities if any present, use of assistive devices if required and in case any previous oncological treatment has been delivered. Various outcome measures were administered such as POMA, SPPB, 6 minutes walk test (6 MWT) and numerical rating for fatigue. The interpretations were noted on a case report sheet and the appropriate interventions for the deficits were delivered to the patient. Also, the patients were asked to carry on the necessary investigation (if required) and get back to the physiotherapy OPD. No follow-up is required by the patients as this was a retrospective single-endpoint study.

Results and analysis: The descriptive analysis was done by using R software (version 4.2.3). The main objective was to analyse the variables descriptively using numbers and percentages. The correlation between 2 outcome measures: SPPB and POMA was assessed using Spearman's rank correlation.All the 100 patients had solid tumour malignancies, commonly GI (37%), thoracic (18%), breast (17%), H and N (13%), uro-oncology (11%) and gynecology (4%). The median age was 70 years (range, 60-88). The median BMI was 22.10 (IQR, 19.40-24.77). Among 100 patients, comorbidities were found in most of the patients, most commonly hypertension (35%), diabetes mellitus (20%), heart disease (9%) and other diseases (8%). Out of 100 patients, 15% of them used assistive devices but the remaining 85% of patients did not require any assistive devices. Different outcome measures were also assessed for understanding the patients' risk in different categories. On assessing POMA, most of the patients had a medium risk of fall (49%), followed by high risk (31%) and low risk (14%). On assessing SPPB, most of the patients had low risk (41%), followed by medium risk (31%) and high risk (28%). The aerobic capacity of patients was assessed using 6 MWT (walking capacity) which showed that most of them had a severe reduction in aerobic capacity (37%) followed by moderation reduction (28%), good aerobic capacity (25%) and mild reduction (10%). The treatment required by the patients involved most commonly LL strengthening (71; 30.6%) and aerobic conditioning (67; 28.9%) and the least was brisk walking (4; 1.72%) and UL strengthening (2; 0.86%).

Conclusion: Commonly deranged domains included fatigue (97%), risk of fall (80%), reduced aerobic capacity (75%) and comorbidities (73%). The correlation between SPPB and POMA was assessed using Spearman's rank correlation method which obtained a correlation coefficient of 0.79 which implies that there is a strong positive association between SPPB and POMA.