Use of a Cybex NORM dynamometer to assess muscle function in patients with thoracic cancer

Bisharat El Khoury,Cathann Manderson,Simon Mockett,Paul Howard,Helen Evans,Andrew Wilcock,Matthew Maddocks,Jacky Frisby,Mary Lewis,Sarah Bell

doi:10.1186/1472-684x-7-3

Bisharat El Khoury, Cathann Manderson + Show 8 more

Open Access

https://doi.org/10.1186/1472-684x-7-3

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Abstract

BackgroundThe cachexia-anorexia syndrome impacts on patients' physical independence and quality of life. New treatments are required and need to be evaluated using acceptable and reliable outcome measures, e.g. the assessment of muscle function. The aims of this study were to: (i) examine the acceptability and reliability of the Cybex NORM dynamometer to assess muscle function in people with non-small cell lung cancer or mesothelioma; (ii) compare muscle function in this group with healthy volunteers and; (iii) explore changes in muscle function over one month.MethodsThe test consisted of 25 repetitions of isokinetic knee flexion and extension at maximal effort while seated on a Cybex NORM dynamometer. Strength and endurance for the quadriceps and hamstrings were assessed as peak torque and total work and an endurance ratio respectively. Thirteen patients and 26 volunteers completed the test on three separate visits. Acceptability was assessed by questionnaire, reliability by intraclass correlation coefficients (ICC) and tests of difference compared outcomes between and within groups.ResultsAll subjects found the test acceptable. Peak torque and work done were reliable measures (ICC >0.80), but the endurance ratio was not. Muscle function did not differ significantly between the patient and a matched volunteer group or in either group when repeated after one month.ConclusionFor patients with non-small cell lung cancer or mesothelioma, the Cybex NORM dynamometer provides an acceptable and reliable method of assessing muscle strength and work done. Muscle function appears to be relatively well preserved in this group and it appears feasible to explore interventions which aim to maintain or even improve this.

Highlights

The cachexia-anorexia syndrome impacts on patients' physical independence and quality of life
The Cybex NORM dynamometer (Cybex, division of Lumex, Inc., Ronkonkoma, New York, USA) has been used to assess leg muscle function in healthy volunteers and various patient groups, but it has not been widely used in people with cancer, thoracic cancer [7,8,9]
To examine for any early evidence of muscle function impairment in patients despite a reasonable performance status, we studied a group of healthy volunteers, matched for sex, age and physical activity behaviour

Summary

Introduction

The cachexia-anorexia syndrome impacts on patients' physical independence and quality of life. The aims of this study were to: (i) examine the acceptability and reliability of the Cybex NORM dynamometer to assess muscle function in people with non-small cell lung cancer or mesothelioma; (ii) compare muscle function in this group with healthy volunteers and; (iii) explore changes in muscle function over one month. Our group is working to develop proactive interventions such as exercise therapies which could be offered to patients soon after diagnosis, when they are most likely to have a reasonable performance status and limited weight loss, with the aim of preserving physical independence for as long as possible These interventions would have a particular focus on maintaining the performance of the main muscles of ambulation, i.e. the quadriceps and hamstrings. We have examined the acceptability and reliability of the Cybex NORM dynamometer to assess aspects of muscle function in people with non-small cell lung cancer or mesothelioma, a good performance status and limited weight loss. To begin to explore the rate of decline in muscle function we repeated the test after one month

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