The purpose of this study was to investigate the association between physical activity and the progression of muscle atrophy in haematologic cancer patients undergoing chemotherapy and to identify factors associated with muscle atrophy.
Forty hematologic cancer patients aged 65 years or older admitted for chemotherapy, excluding those who met the exclusion criteria, were evaluated for muscle atrophy on admission and at discharge according to the GLIM (Global Leadership Initiative on Malnutrition) criteria of muscle atrophy, and based on the assessment of muscle atrophy, the subjects were divided into two groups: muscle atrophy group and non-muscle atrophy group. Subjects were fitted with a physical activity meter during hospitalization to measure the number of steps taken and the amount of energy expended during the activity. Multivariate analysis was performed using the stepwise method and comparisons between the two groups were performed using the Mann-Whitney U test, Fisher's exact test, and Spearman's correlation coefficient, with the significance level set at less than 5%.
There were no significant differences in age, gender, length of hospital stay, or cancer type between patients in the muscle atrophy (n=10) and non-muscle atrophy (n=30) groups. Compared to the non-muscle atrophy group, significantly more subjects in the muscle atrophy group had an average of less than 1,000 steps per day, significantly fewer steps per activity meter (steps/day) and less energy expended in activity (kcal/day). There was also a correlation between physical activity and skeletal muscle index (SMI) (r = 0.74). Other significant differences were also found in FIM, SMI, grip strength, lower leg circumference, skeletal muscle mass and LBM (Lean Body Mass). Further factors associated with skeletal muscle atrophy in multivariate analysis were average daily activity expenditure and average daily number of steps. A significant association was found between the amount of physical activity during hospitalization and the occurrence of muscle atrophy at discharge.
These results indicate that increased physical activity during inpatient chemotherapy has an important role in preventing the progression of muscle atrophy in haematological cancer patients.
The results of this study indicate that increased daily physical activity and routine exercise, such as walking, are associated with muscle atrophy in patients with haematologic cancers. Patients with hematologic cancers often have difficulty sustaining high-intensity exercise due to bone marrow suppression and fatigue. It has been reported that low-intensity exercise was more useful than high-intensity exercise in reducing muscle atrophy in patients with cancer cachexia, and it is possible that the amount of physical activity also prevented muscle atrophy in the results of this study.The results of this study suggest that efforts to increase walking and daily physical activity (e.g., low-impact exercise to reduce fatigue and training specifically for muscular endurance) as well as conventional resistance training exercise, etc. may prevent skeletal muscle atrophy in patients with haematologic cancers.
Sarcopenia
Physical activity
