2012 Annual Conference

Simmonds, Maureen J.

University of Texas, Health Science Centre, San Antonio

The purpose of this study was to evaluate the reliability of patients with cancer self-measuring physical performance.  

Eighty six adults with mixed cancers and an Eastern Cooperative Oncology Group (ECOG) score between 0-3 were recruited from three urban hospitals.

All patients completed a Cancer Quality of Life Questionnaire (EORTC-QLQC30), the Brief Fatigue Inventory.  They also completed seven tasks from the Simmonds Physical Performance Battery twice and performance was measured by the patient and practitioner simultaneously.  The procedure was repeated within the same session and a week later. 

Intraclass correlation coefficients were computed to assess reliabilities (intra- inter-tester and day-to-day) on each of the measures. 

Complete data was available for 80/86 participants.  Forty three males and 37 females participated and they had a mean age of 60.64 years (SD= 13.48).  The majority of participants had a diagnosis of stage IV cancer (n=55) and 71 had solid tumors.  Test-retest reliability of self-measured performance for the seven tasks was good to excellent (ICC_1,1= 0.87-0.963)  as was inter-rater reliability  (ICC_1,2= 0.93-0.97).   However there were significant differences (p<0.05) between patient and practitioner measures on all tasks except the six minute distance walk.  Patients systematically measured their own task performance slower than did practitioners.

Patients with cancers can reliably measure their own physical performance and this paves the way for evaluating the utility of the measures as simple markers of disease of functional status, and as an aid to setting activity related goals.  Due to the systematic underestimation of patient compared to practitioners measures of performance, the two methods cannot be used interchangeably.

Measures of physical performance are complementary to self-report measures and are useful methods of measuring and monitoring the burden of cancer and its treatments. Preliminary evidence suggests that they are also useful predictors of treatment tolerance and of outcome - including survival.  It is plausible that the measures have utility as indicators of disease status (progression, recurrence, or resolution) and for helping patients set activity based goals that can be accomplished in their own environment.  Establishing the reliability of self-measurement of physical performance can enable patients to measure and monitor their own performance to better inform clinicians about the impact of the disease and its treatment.