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Svensson A1,2,3, Karlsson E2, Rydwik E2
1Linköping University - LiU, Institution of Medicine and Health, Linköping, Sweden, 2Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden, 3Karolinska University Hospital, Allied Health Professionals, Solna, Sweden
Background: Age, frailty and physical function can affect the postoperative course and risk of complications after surgery. Previous studies have shown correlations between respiratory and peripheral muscle strength in healthy older people, but less is known about the older people with gastrointestinal cancer.
Purpose: To investigate the relationship between respiratory muscle strength and extremity muscle strength in older people prior to surgical treatment of pancreatic-, colorectal-, and liver cancer, and if there are differences in muscle strength between the different diagnose groups.
Methods: Patients ≥70 years of age awaiting surgical treatment for pancreatic-, liver-, and colorectal cancer were recruited between 2015-2017 for a cross-sectional study at two hospitals in Stockholm. Muscle strength was assessed with the 30 second Chair Stand Test, Jamar hand dynamometer and a respiratory dynamometer (MicroRPM). Information about the participants´ comorbidity, preoperative treatment, age, gender, nutritional status and physical activity level were obtained through interview and self-assessment form. Statistical analysis included Spearman correlation, multivariable linear regression and ANOVA or Kruskall-Wallis.
Results: One hundred and ninety-two individuals were included, 61% were men. Diagnosis distribution consisted of 31.3% with colon cancer, 13% with rectal cancer, 25% liver cancer/metastasis and 30.7% with pancreatic cancer. There was a significant independent association (p 0,001 - 0,03, R² 0,34 - 0,49) between respiratory muscle strength and extremity muscle strength when controlling for age, gender, walking speed, nutritional status, lung disease, and smoking. There were significant differences in muscle strenght between men and women but no significant differences in respiratory or extremity muscle strength between the different diagnose groups.
Conclusion(s): The results indicate that there is an independent association between respiratory and extremity muscle strength in older people with pancreatic-, liver-, and colorectal cancer. The generalizability of the result may be limited due to the selection of study population. No significant difference in muscle strength was found between the different diagnostic groups, the result may be caused by insufficient power. Further studies are needed to investigate how muscle strength develops over time and whether preoperative muscle strength affects the postoperative process.
Implications: Results show different muscular function among the elderly population prior to abdominal surgery. A preoperative assessment of muscle function could potentially optimize post-operative care. The study demonstrated significant independent association between respiratory and extremity muscle strength, the assessment could be performed efficiently and comfortably for the patient by performing only one of the muscle tests.
Keywords: Respiratory Muscles, Preoperative Care, Physical Fitness
Funding acknowledgements: No funding sources.
Purpose: To investigate the relationship between respiratory muscle strength and extremity muscle strength in older people prior to surgical treatment of pancreatic-, colorectal-, and liver cancer, and if there are differences in muscle strength between the different diagnose groups.
Methods: Patients ≥70 years of age awaiting surgical treatment for pancreatic-, liver-, and colorectal cancer were recruited between 2015-2017 for a cross-sectional study at two hospitals in Stockholm. Muscle strength was assessed with the 30 second Chair Stand Test, Jamar hand dynamometer and a respiratory dynamometer (MicroRPM). Information about the participants´ comorbidity, preoperative treatment, age, gender, nutritional status and physical activity level were obtained through interview and self-assessment form. Statistical analysis included Spearman correlation, multivariable linear regression and ANOVA or Kruskall-Wallis.
Results: One hundred and ninety-two individuals were included, 61% were men. Diagnosis distribution consisted of 31.3% with colon cancer, 13% with rectal cancer, 25% liver cancer/metastasis and 30.7% with pancreatic cancer. There was a significant independent association (p 0,001 - 0,03, R² 0,34 - 0,49) between respiratory muscle strength and extremity muscle strength when controlling for age, gender, walking speed, nutritional status, lung disease, and smoking. There were significant differences in muscle strenght between men and women but no significant differences in respiratory or extremity muscle strength between the different diagnose groups.
Conclusion(s): The results indicate that there is an independent association between respiratory and extremity muscle strength in older people with pancreatic-, liver-, and colorectal cancer. The generalizability of the result may be limited due to the selection of study population. No significant difference in muscle strength was found between the different diagnostic groups, the result may be caused by insufficient power. Further studies are needed to investigate how muscle strength develops over time and whether preoperative muscle strength affects the postoperative process.
Implications: Results show different muscular function among the elderly population prior to abdominal surgery. A preoperative assessment of muscle function could potentially optimize post-operative care. The study demonstrated significant independent association between respiratory and extremity muscle strength, the assessment could be performed efficiently and comfortably for the patient by performing only one of the muscle tests.
Keywords: Respiratory Muscles, Preoperative Care, Physical Fitness
Funding acknowledgements: No funding sources.
Topic: Older people; Cardiorespiratory; Musculoskeletal
Ethics approval required: Yes
Institution: Institution of Medicine and Health, Linköping University
Ethics committee: The Regional ethical review board in Stockholm
Ethics number: 2015/1179–31
All authors, affiliations and abstracts have been published as submitted.
