Background
Objectives
Method
Protocol
Search 1: outcome measures
Eligibility criteria
Studies
Participants
Outcomes
Information sources, search and study selection
Data collection process
Search 2: measurement properties
Eligibility criteria
Studies
Participants
Outcomes
Information sources, search and data extraction
Risk of bias of studies
Results
Search 1: outcome measures
Outcome measure | Reliability, measurement error and responsiveness | Criterion concurrent validity (gold standard) | Criterion predictive validity | Construct validity (hypothesis testing) |
---|---|---|---|---|
Functional capacity
| ||||
6-minute walk test
| x | x | ||
12-minute walk test
| x | x | x | x |
Incremental-shuttle walk test
| x | 1 study [30], strongly correlated with CPET | ||
Endurance-shuttle walk test
| x | x | x | x |
Stair-climb test
| x | 1 study [29], strongly correlated with CPET | ||
Physical activity
| ||||
Accelerometer
| x | x | x | |
Pedometer
| x | x | x | 1 study [53], moderately correlated with CPET |
Muscle strength
| ||||
Hand-held dynamometry
| x | x | x | x |
Hand-held dynamometry with pulley force sensor
| 1 study [52], very good intra-rater reliability; large SEM | x | x | x |
Hand-grip dynamometry
| 1 study [28], moderate intra-rater reliability | x | x | x |
Manual-muscle test
| x | x | x | x |
One-repetition maximum
| x | x | x | x |
Chair-stand test
| x | x | x | 1 study [53], moderately correlated with PS and fatigue |
Search 2: measurement properties
Study selection
Study characteristics
Author, yr location | n | Gender M/F | Age mean (SD) yrs | OM | Setting (n)% / method of pt selection | Cancer type (n)% | Cancer stage (n)% | Cancer treatment at baseline time-point (n)% |
---|---|---|---|---|---|---|---|---|
Functional capacity
| ||||||||
Jones 2012 USA [40] | 118 | 71/47 | 61 ± 10 | 6MWT | Health system / consecutive | NSCLC | IIIB, IV, recurrent IV | Chemo (70) 59%; RT (10) 8%; post-op (27) 23%; post-chemo (55) 47%; post-RT (54) 46% |
Pancieri 2010 Brazil [22] | 40 | 22/18 | 48 ± 16 | 6MWT; SCT | Hospital / consecutive | NSCLC (33) 82.5%; other LC (2) 5%; benign (5) 12.5% | NR | Pre-op LR |
Kasymjanova 2009 Canada [25] | 64 | 29/35 | 62.0 ± 10.8 | 6MWT | Outpt clinic / consecutive | NSCLC | III (8) 12%; IV (56) 87% | Pre-chemo |
53 | 28/25 | 64 (range 45–81) | 6MWT | Hospital/ sample part of larger prospective trial | NSCLC (39) 74%; SCLC (12) 23%; meso (1) 2%; lung met (1) 2% | NSCLC only: I – II (4) 8%; III-IV (41) 77%; recurrent (8) 15% | Pre- RT (17) 32%; pre-chemo-RT (36) 68%; prior chemo (33) 62%; | |
Saad 2007 Brazil [24] | 36 | 20/16 | Median 55.5 ± 13.4 | 6MWT | Hospital / consecutive | NSCLC (26) 72%; lung met (8) 22%; sarcoma (2) 6% | NR | Pre-op LR |
Parsons 2003 Canada [39] | 70 | 40/30 | 65 (range 29–83) | 6MWT SCT | Hospital / convenience | NSCLC (55) 79%; pulmonary met (11) 16%; meso (2) 3%; benign (2) 3% | NR | Pre-op LR |
Pierce 1994 Australia [23] | 54 | 54/0 | 67 ± 7 | 6MWT | Hospital / consecutive | LC (including NSCLC) | NR | Pre-op LR |
Holden 1992 USA [41] | 16 | 13/3 | 68 ± 9.3 | 6MWT; SCT | Hospital | NSCLC (15) 94%; SCLC (1) 6% | I (10) 62%; II (3) 19%; III (2) 12%; IV (1) 6% | Pre-op LR |
England 2012 UK [44] | 41 | 21/20 | 64 ± 8 | ISWT | Outpt clinic | NSCLC (26) 63%; meso (11) 27%; SCLC (4) 10% | Local (21) 51%; advanced (20); 49% | Post pall-chemo (26) 63%; post pall-RT (10) 24%; post-RT (1) 2% |
Win 2006 UK [30] | 125 | 81/44 | 68.8 ± 7.7 | ISWT | Consecutive | NSCLC | NR | Pre-op LR |
Win 2004 UK [64] | 111 | 71/40 | 69 (range 42–85) | ISWT | Outpt clinic | NSCLC (107) 96%; miscellaneous (4) 4% | I-IIIA | Pre-op LR |
Brunelli 2012 Italy [43] | 282 | 218/64 | 68.0 ± 9.8 | SCT | Tertiary referral centre / consecutive | NSCLC | I (118) 42%; other (164) 58% | Pre-op LR |
Brunelli 2010 Italy [31] | 109 | 83/26 | 66.6 ± 11.1 | SCT | Tertiary referral centre / consecutive | NSCLC | NR | Pre-op LR |
Brunelli 2008a Italy [34] | 536 | 426/110 | 67 ± 9 | SCT | Tertiary referral centre / consecutive | NSCLC | I (206) 38% ; > I (330) 62% | Pre-op LR (536) 100%; chemo (56) 10% |
Brunelli 2008b Italy [33] | 640 | NR | 66.7 ± 9.3 | SCT | Tertiary referral centre / consecutive | NSCLC | NR | Pre-op LR (640) 100%; neoadjuvant chemo (100) 16% |
Koegelenberg 2008 South Africa [29] | 44 | 31/13 | 47.6 ± 12.5 | SCT | Tertiary referral centre / consecutive | NSCLC (13) 29%; benign (31) 70% | NR | Pre-op LR |
Nikolic 2008 Croatia [36] | 101 | 82/19 | 61.1 ± 8.4 | SCT | Hospital / consecutive | NSCLC | NR | Pre-op LR |
Brunelli 2007 Italy [20] | 200 | NR | 66.8 ± 9.1 | SCT | Tertiary referral centre / consecutive | NSCLC | NR | Pre-op LR (200) 100%; neoadjuvant chemo (19) 9.5% |
Toker 2007 Turkey [37] | 150 | 127/23 | 59.3 ± 10.3 (gp 1) 60.7 ± 10.9 (gp 2) | SCT | University hospital / consecutive | NSCLC | NR | Pre-op LR |
Brunelli 2005 Italy [42] | 391 | 309/82 | 69.1 ± 8.3 (gp 1) 67.0 ± 9.0 (gp 2) | SCT | Tertiary referral centre / consecutive | NSCLC | NR | Pre-op LR |
Brunelli 2004 Italy [35] | 109 | NR | 75.2 ± 3.0 | SCT | Tertiary referral centre / consecutive | NSCLC | I (23) 21% ; > I (86) 79% | Pre-op lobectomy |
Brunelli 2003 Italy [21] | 227 | NR | 66.4 ± 9.1 (gp 1) 66.8 ± 8.1 (gp 2) | SCT | Tertiary referral centre / consecutive | NSCLC | NR | Pre-op LR |
Brunelli 2002 Italy [32] | 160 | 128/32 | 66.2 ± 9.6 | SCT | Tertiary referral centre / consecutive | NSCLC | NR | Pre-op LR |
Pate 1996 USA [38] | 12 | 10/2 | 63.6 ± 4.9 | SCT | Three university hospitals / consecutive | NSCLC (7) 58%; NR (5) 42% | I (5) 42%; III (2) 17%; NR (5) 42% | Pre-op LR |
Physical activity
| ||||||||
Maddocks 2012 UK [47] | 84 | 54/30 | 66 ± 9 | Acc | Outpt clinic | NSCLC (71) 84%; SCLC (8) 9%; meso (5) 6% | IIIB (43) 51%; IV (41) 49% | Palliative Rx |
84 | 65/19 | 62 (range 40–94) | Acc | Hospital inpt (42) 50%; home (42) 50% | NSCLC | II (1) 1%; III (18) 21%; IV (65) 77% | Pre-chemo (84) 100%; prior Rx (31) 37% | |
Maddocks 2010 UK [46] | 60 | 40/20 | 68 ± 9 | Acc | Outpt clinic | NSCLC (53) 88%: meso (5) 8%; GI (2) 3% | Local (35) 58%; advanced (25) 42% | NR |
Novoa 2011 Spain [51] | 38 | 30/8 | 62.8 ± 10.1 | Pedom | Output clinic / consecutive | NSCLC | NR | Pre-op LR |
Muscle strength
| ||||||||
Trutschnigg 2008 Canada [28] | 74 | 48/26 | 61.5 ± 13.1 | HGD | Hospital and laboratory | NSCLC; GI | Advanced | NR |
Brown 2005 UK [53] | 53 | 30/23 | Median 64 (range 43–81) | HGD CST | Palliative care centre x 2 and hospital | Gp1: healthy controls (15) 100% Gp2: cancer: NSCLC (29) 76%; SCLC (6) 16%; no histology LC (3) 8% | Locally advanced (20) 53%; IV (18) 47% | NR |
Knols 2002 Switzerland [52] | 40 | 27/13 | 49.4 ± 14.8 | HHD+ pulley | Hospital inpt / convenience | NSCLC (7) 17.5%; other LC (3) 7.5%; haem (20) 50%; sarcoma (5) 12.5%; seminoma (3) 7.5%; other (2) 5% | I-IV | Chemo |
Author, yr
6MWT
| OM procedure referenced | Encouragement standardised | Number of repeat Ax in testing session | ||||
---|---|---|---|---|---|---|---|
Jones 2012 [40] | Yes [50] | NR | NR | ||||
Pancieri 2010 [22] | No | ‘encouraged walking’ | NR | ||||
Kasymjanova 2009 [25] | NR | 1 x practice 1 x actual (on different days) | |||||
Yes [20] | NR | NR | |||||
Saad 2007 [24] | Yes [50] | NR | NR | ||||
Parsons 2003 [39] | Yes | 1 x practice, 1 x actual | |||||
Pierce 1994 [23] | Yes [73] | NR | 3 (best value used) | ||||
Holden 1992 [41] | No | NR | 2 (15-30 min interval) | ||||
ISWT
|
OM procedure referenced
|
Encouragement standardised
|
No of repeat Ax in testing session
|
Additional description
| |||
England 2012 [44] | Yes [59] | NR | 1 x practice, 1 x actual | Participants wore COSMED K4 b2 system (COSMED, Italy) to measure HR, VE and VO2 throughout test | |||
Yes [59] | NR | 1 | HR and SpO2 monitored and recorded at 30 second intervals throughout test | ||||
SCT
|
Equipment
|
Monitoring during test
|
Intensity
|
Outcome
|
Number of repeat Ax in testing session
|
Experience of assessors
|
Additional description
|
Brunelli 2012, 2010, 2008a, 2008b, 2007, 2005, 2004, 2003, 2002 [20–21, 31, 32–35, 42–43,] | 16 flights x 11 steps (0.155 m height) | Continuous verbal interaction to Ax SOB/ symptoms; HR; SpO2
| Pace of pt choice, asked to climb max no steps and stop for exhaustion, limiting SOB, leg fatigue or chest pain | No steps and time taken, minimum value SpO2, exercise oxygen desaturation (= fall SpO2 < 90% or fall >4%) | 1 | Physician | Calculations from test: |
• Work = (step height in meters x steps per min x body weight in kg x 0.1635)[74] | |||||||
• VO2max (ml/min) = 5.8 x weight in kg + 151 + 10.1 x work) [74] | |||||||
• VO2max corrected for body surface area (ml/min2) = VO2max / max HR | |||||||
Pancieri 2010 [22] | 6 flights x 12 steps (16.9 cm height), 30° incline | HR, SpO2
| Climb all steps in the shortest possible time with verbal encouragement between flights. Testing stopped for fatigue, limiting SOB, thoracic pain or exhaustion | Time taken | 1 | ||
Koegelenberg 2008 [29] | 12 flights x 10 steps (3.48 m b/t floors) | HR, SpO2
| Pt asked to climb ‘as fast and as high’ as they possibly could to a max elevation of 20 m | Altitude, time taken, speed of ascent | NR | NR | Stair climb considered completed if pt rested or more than 3 seconds or reached 20 m height Allowed to use rail only for balance |
Nikolic 2008 [36] | 92 steps (0.15 m height) | HR, SpO2 (measured every 20 steps) | Pace of pt choice, asked to climb max no steps and stop for exhaustion, limiting SOB, leg fatigue or chest pain | No steps, time taken | 1 | Physician | Pt instructed not to use hand-rail |
Toker 2007 [37] | 20 steps per flight (15 cm height) | HR, SpO2
| Pt motivated to do their best and motivation | SpO2 (pre, post, change), HR (pre, post, change), time taken | 2 | Resident doctor | |
Pate 1996 [38] | 21 steps per flight (17.5 cm height) | HR, SpO2
| Moderate pace of pts choice, encouraged to exercise to a symptom-limited max and complete the flight of stairs they were on if possible | No steps, time taken, altitude (m), reason for stopping | 1 | NR | Test considered completed as soon as patient stopped for any reason Pt instructed not to use hand-rail |
Holden 1992 [41] | 11 steps per flight (0.17 m height) | SpO2
| Own pace | Altitude, time taken | 1 | Therapist | Calculations from test: |
• Work = step height x steps per min x weight in kg x 0.1635 | |||||||
• VO2 ml/min = 5.8 x weight in kg + 151 + (10.1 x work) | |||||||
Physical activity
|
Equipment
|
Location of monitoring
|
Outcome
|
Duration of Ax
|
Position of sensor
| ||
Maddocks 2012 [47] | Uni-axial accelerometer ActivPALTM monitor (PAL Technologies Ltd., UK) | Home environment | Mean daily step count, number of sit-to-stand transitions, time in hrs spent sitting/lying, upright standing and upright stepping | 7 days (6 full days of data) | Mid-third of anterior thigh of pts chosen leg | ||
Actigraph Piezoelectric Accelerometer (Ambulatory Monitoring Inc., AMI, USA) | Group 1 (inpt) and group 2 (home environment) | Mean duration daytime activity (no of vertical/horizontal accelerations per min) | 3-7 days | Non-dominant wrist | |||
Novoa 2011 [51] | OMROM Walking Style Pro® pedometer | Home environment | Mean daily no total and aerobic steps; mean daily distance walked (km); mean daily time of aerobic activity (min) | Daytime only, daily Ax while waiting for surgery | Pedometer attached to waist band or belt | ||
Maddocks 2010 [46] | Uni-axial accelerometer ActivPALTM monitor (PAL Technologies Ltd., UK) | Home environment | Mean daily step count and estimate energy expenditure (METh); acceptability (non-compliance in hours); optimal duration of monitoring | 7 days (6 full days of data) | Mid-third of anterior thigh of dominant leg | ||
Physical activity
|
Equipment
|
Location of monitoring
|
Outcome
|
Duration of Ax
|
Position of sensor
| ||
Maddocks 2012 [47] | Uni-axial accelerometer ActivPALTM monitor (PAL Technologies Ltd., UK) | Home environment | Mean daily step count, number of sit-to-stand transitions, time in hrs spent sitting/lying, upright standing and upright stepping | 7 days (6 full days of data) | Mid-third of anterior thigh of pts chosen leg | ||
Actigraph Piezoelectric Accelerometer (Ambulatory Monitoring Inc., AMI, USA) | Group 1 (inpt) and group 2 (home environment) | Mean duration daytime activity (no of vertical/horizontal accelerations per min) | 3-7 days | Non-dominant wrist | |||
Novoa 2011 [51] | OMROM Walking Style Pro® pedometer | Home environment | Mean daily no total and aerobic steps; mean daily distance walked (km); mean daily time of aerobic activity (min) | Daytime only, daily Ax while waiting for surgery | Pedometer attached to waist band or belt | ||
Maddocks 2010 [46] | Uni-axial accelerometer ActivPALTM monitor (PAL Technologies Ltd., UK) | Home environment | Mean daily step count and estimate energy expenditure (METh); acceptability (non-compliance in hours); optimal duration of monitoring | 7 days (6 full days of data) | Mid-third of anterior thigh of dominant leg | ||
Muscle strength
|
Equipment
|
Muscle group movement
|
Participant position
|
No of assessors
|
Number of repeat Ax in testing session
|
Experience of assessors
|
Additional description
|
Trutschnigg 2008 [28] | Jamar HGD (Sammons Preston, Bolingbrook), position 3 on handle | Grip | Sitting, feet on ground shoulder width apart, Elb 90 ° F, wrist 0°, arm on arm rest [75] | NR | 1-2 x practice 2 x 3reps actual (mean value used) | NR | Dominant hand Patient instructed when to start and stop contraction with a 3 second contraction time No encouragement |
Brown 2005 [53] | Square design chair with firm seat 43 cm height and arm rests | Sit to stand | Seated | NR | NR | NR | Pt asked to rise from seated position to fully upright position as fast as they could, if possible without using arm rests |
Knols 2002 [52] | Mecmesin FB50K pull-gauge HHD, Mecmesin, England | Elb E, Knee E | 1. Supine, Elb 90 °F, upper edge pull- attachment perpendicular to ulnar side of forearm distal to caput ulnae, non-elastic belt over ASIS stabilised pt on table | 2 (random order) 30 min interval | 6 x practice 3 x actual (60 second interval) | Physiotherapist | Dominant UL and LL Ax – identified by asking participant to throw a ball and kick a ball (preferred stance leg chosen) Figures also provided for both testing positions ‘Make’ test used Pt asked to increase force over 2 seconds and maintain for another 5 seconds |
2. sitting edge of table upright no back support, knee 90 °F, stabilise trunk by grasping table, lower edge pull-attachment perpendicular to ant surface tibia, distal to end med mall |
Outcome measures
Author, yr | Type of validity and OM | Missing values | Comparator OM or predicted outcome | Validation results |
---|---|---|---|---|
Functional capacity
| ||||
Jones 2012 [40] | Crit-pred 6MWT | Nil | All-cause mortality | Unadjusted HR p = 0.003; Compared to 6MWT <358.5 m adjusted HR = 0.61 (95% CI 0.34-1.07) if 6MWT 358.5-450 m; Compared to 6MWT <385.5 m adjusted HR = 0.48 (95% CI 0.24-0.93) if 6MWT >450 m |
Pancieri 2010 [22] | Crit-pred 6MWT | NR | Predicted post-op 6MWT = pre-op 6MWT x (FS – resected FS) ÷ FS | r = 0.40, p<0.01 |
Kasymjanova 2009 [25] | Crit-pred 6MWT | 19pts dropped out | Survival | Compared to 6MWT ≥ 400 m mortality HR = 0.44 (95% CI 0.23-0.83) if 6MWT <400 m, p = 0.001 |
Crit-pred; construct 6MWT | 3pts not complete Ax | 1. Development of RP | 1. ROC area under curve = 0.41, p = 0.4 | |
2. FEV1
| 2. r = 0.53, p<0.001 | |||
3. FVC | 3. r = 0.44, p = 0.001 | |||
4. DLCO | 4. r = 0.48, p<0.001 | |||
Saad 2007 [24] | Crit-pred 6MWT | 9pts died; 30pts not complete Ax (rural) | Predictors of improvement in pre-op to 180 days-post-op: | 1. GEE = 0.001, SE = 0.000, p = 0.003 |
1. SF-36 PF | 2. GEE = 0.001, SE = 0.000, p = 0.000 | |||
2. SF-36 PR | 3. GEE = 0.001, SE = 0.000, p = 0.031 | |||
3. SF-36 GH | ||||
Parsons 2003 [39] | Crit-pred 6MWT | 29pts | LOS out of hospital < 30 days post-op | Not significant |
Pierce 1994 [23] | Crit-pred 6MWT | NR | Post-op: | 1. p<0.05 |
1. respiratory failure | 2. p>0.05 | |||
2. surgical POC | 3. p>0.05 | |||
3. respiratory POC | 4. p>0.05 | |||
4. cardiac POC | 5. p>0.05 | |||
5. all POC | ||||
Holden 1992 [41] | Crit-pred 6MWT | 3pts not complete Ax | Survival > 90 days post-op | 6MWT diff b/t groups with/without survival p<0.05; |
6MWT > 1000feet (305 m) pre-op sensitivity 100%, positive predictive value 85%, negative predictive value 100% for survival | ||||
England 2012 [44] | Construct ISWT | Nil | 1. P max monitor (insp mm strength) | 1. r = 0.42, p = 0.01 |
2. dynamometry (peripheral mm power) | 2. r = 0.39, p = 0.01 | |||
3. spirometry (% predicted FEV1) | 3. r = 0.22, p = 0.17 | |||
4. spirometry (% predicted FVC) | 4. r = 0.21, p = 0.2 | |||
5. CRDQ (mastery) | 5. r = 0.21, p = 0.18 | |||
Win 2006 [30] | Crit-pred; crit-concurrent; construct ISWT | Nil | 1. CPET (VO2peak) | 1. r = 0.67, p<0.001 |
2. CPET (VO2peak% predicted) | 2. r = 0.30 | |||
3. spirometry (FEV1) | 3. r = 0.5 | |||
4. 12 month survival | 4. ROC area = 0.7, p = 0.003 | |||
Win 2004 [64] | Crit-pred, construct ISWT | 8pts | 1. poor surgical outcome (post-op death, MI, heart failure, resp failure, septicaemia, pneumonia, cardiac arrthymia) | 1. p = 0.6 between poor and sufficient outcome groups |
2. FEV1
| 2. r = 0.46, not significant | |||
Brunelli 2012 [43] | Crit-pred SCT | 14 | Median survival and 5-year survival | Altitude >18 m independent predictor: HR = 0.5, p = 0.003 |
Brunelli 2010 [31] | Construct SCT | Nil | SCT (VO2max) | Altitude: correlation coefficient = 0.7, p<0.0001 |
Speed of ascent: correlation coefficient = 0.47, p = 0.005 | ||||
Pancieri 2010 [22] | Crit-pred SCT | NR | Predicted post-op SCT = pre-op SCT x (FS – resected FS) ÷ FS | r = 0.66, p<0.001 |
Brunelli 2008a [34] | Crit-pred SCT | Nil | POC < 30 days post-op | Pre-op altitude: coefficient = −0.05, OR = 0.95 (95% CI 0.91-0.99), SE = 0.02, p = 0.045 |
O2desat >4%: coefficient = 0.56, OR = 1.8 (95% CI 1–3), SE = 0.3, p = 0.05 | ||||
Brunelli 2008b [33] | Crit-pred SCT | Nil | 1. POC < 30 days post-op | 1. altitude: coefficient = 0.34, SE = 0.2, OR = 1.4 (95% CI 1.02-1.95), p = 0.04 |
2. Death < 30 days post-op | 2. altitude: coefficient = 0.91, SE = 0.4, OR = 2.5 (95% CI 1.1-5.5), p = 0.02 | |||
3. Post-op hospital costs | 3. altitude: coefficient = 2160.2, SE = 573, p<0.001 | |||
Koegelenberg 2008 [29] | Crit-concurrent SCT | Nil | CPET (VO2max) | Altitude r2 = 0.06, Speed of ascent r2 = 0.77 (lung cancer only) |
Nikolic 2008 [36] | Crit-pred SCT | Nil | POC < 30 days post-op | Best independent predictor = SpO2 after 40 steps and SCT duration for lobectomy group (60% sensitivity, 75% specificity cut off value 1.09) positive LR = 2.4 (95% CI 1.71-3.38), negative LR = 0.53 (95% CI 0.38-0.76) |
Brunelli 2007 [20] | Constuct SCT | 53pts at 3 months | Post-op SCT (VO2peak) | Pre-op SCT VO2peak directly associated with post-op SCT: regression analysis lobectomy F = 3.58, p<0.01; pneumonectomy F = 3.53, p<0.01 |
Toker 2007 [37] | Crit-pred SCT | Nil | POC (cardiac or pulmonary) | SpO2 pre-SCT: OR = 0.74 (95% CI 0.58-1.00), p = 0.001 |
Change SpO2 pre to post-SCT: OR = 1.59 (95% CI 1.21-2.10), p = 0.018 | ||||
Brunelli 2005 [42] | Crit-pred SCT | 13pts | 1. POC < 30 days post-op | Inability to perform pre-op SCT: |
1. p = 0.7 | ||||
2. Death < 30 days post-op | 2. OR = 0.20 (95% CI 0.06-0.62), p = 0.005 | |||
Brunelli 2004 [35] | Crit-pred SCT | 18pts | POC < 30 days post-op | Lower altitude pre-op independent predictor: coefficient = −0.18, p = 0.0015 |
Brunelli 2003 [21] | Crit-pred SCT | Nil | O2 desat during post-op SCT | O2 desat during pre-op SCT independent variable: regression coefficient = 0.22, p = 0.0004 |
Parsons 2003 [39] | Crit-pred SCT | 29pts | LOS out of hospital < 30 days post-op | 1. longer LOS correlated with speed of ascent r = 0.34, p≤0.02 |
2. workload achieved predicted LOS out of hospital r2 = 0.130 | ||||
Brunelli 2002 [32] | Crit-pred SCT | Nil | POC < 30 days post-op | Altitude independent variable: p = 0.003 |
Pate 1996 [38] | Crit-pred SCT | Nil | POC < 30 days post-op | Significant difference in pre-op SCT between pt who did and did not develop POC |
Holden 1982 [41] | Crit-pred SCT | 3pts | Survival > 90 days post-op | SCT diff b/t groups with/without survival p<0.05 |
SCT > 44steps pre-op positive predictive value 91%, negative predictive value 80% for survival | ||||
Physical activity
| ||||
Maddocks 2012 [47] | Construct Acc | Nil | ECOG PS | Statistically significant difference in mean daily step count, time spent sitting/lying, upright, standing or stepping between PS 0, 1 and 2 p<0.05 but not mean daily sit-to-stand transitions |
Construct Acc | 16pts Acc, 16pts questionnaires | 1. HADS | 1. Outpt: depression and activity r = −0.41, p = 0.04 | |
2. Ferrans and Power QLI Cancer Version III | 2. Daytime activity and QLI domains of health/functioning r = 0.51, p<0.01; social/economic r = 0.38, p = 0.048; psychological/spiritual r = 0.45, p = 0.02; family r = 0.45, p = 0.02; overall QLI r = 0.57, p<0.01 | |||
3. EORTC | 3. Inpt: daytime activity and loss of appetite r = −0.41, p = 0.005 | |||
4. PSQI | 4. Outpt: lower sleep medication use and activity r = −0.58, p<0.01 | |||
Novoa 2011 [51] | Construct Pedom | 13 pts – unable to perform exercise test | CPET (VO2max) | Mean daily total steps r = 0.4 |
Mean daily aerobic steps r = 0.16 | ||||
Mean daily time of aerobic capacity r = 0.11 | ||||
Mean daily distance walked r = 0.44 | ||||
Maddocks 2010 [46] | Construct Acc | 2 pts withdrawn | Estimated EE (stepping and non-stepping) measured from acc | Non-stepping EE and daily step count r = −0.91, p<0.01 |
Muscle strength
| ||||
Brown 2005 [53] | Construct CST | Nil | 1. KPS | 1. r2 = 0.565, p < 0.001 (ca group) |
2. FACIT-fatigue | 2. with incr fatigue, lower CST p<0.01 (ca group) |
Risk of bias of studies
Author, yr | Reliability | Measurement error | Hypothesis testing | Criterion validity | Responsiveness |
---|---|---|---|---|---|
Functional capacity
| |||||
Brunelli 2012 [43] | x | x | x | Fair | x |
England 2012 [44] | x | x | Fair | x | x |
Jones 2012 [40] | x | x | x | Excellent | x |
Brunelli 2010 [31] | x | x | Excellent | x | x |
Pancieri 2010 [22] | x | x | x | Fair | x |
Kasymjanova 2009 [25] | x | x | x | Fair | x |
Brunelli 2008a [34] | x | x | x | Excellent | x |
Brunelli 2008b [33] | x | x | x | Excellent | x |
Koegelenberg 2008 [29] | x | x | x | Fair | x |
Nikolic 2008 [36] | x | x | x | Poor | x |
Brunelli 2007 [20] | x | x | Fair | x | x |
Mao 2007 [26] | x | x | Fair | Good | x |
Saad 2007 [24] | x | x | x | Poor | x |
Toker 2007 [37] | x | x | x | Excellent | x |
Win 2006 [30] | x | x | Fair | Good | x |
Brunelli 2005 [42] | x | x | x | Excellent | x |
Brunelli 2004 [35] | x | x | x | Good | x |
Win 2004 [64] | x | x | Poor | Poor | x |
Brunelli 2003 [21] | x | x | x | Excellent | x |
Parsons 2003 [39] | x | x | x | Good | x |
Brunelli 2002 [32] | x | x | x | Excellent | x |
Pate 1996 [38] | x | x | x | Poor | x |
Pierce 1994 [23] | x | x | x | Poor | x |
Holden 1992 [41] | x | x | x | Poor | x |
Physical activity
| |||||
Maddocks 2012 [47] | x | x | Poor | x | x |
Novoa 2011 [51] | x | x | Poor | x | x |
x | x | Fair | x | x | |
Maddocks 2010 [46] | x | x | Fair | x | x |
Muscle strength
| x | x | |||
Trutschnigg 2008 [28] | Poor (intra-r) | x | x | x | x |
Brown 2005 [53] | x | x | Fair | x | x |
Knols 2002 [52] | Fair (inter-r) | Fair | x | x | x |