Use of the SFMA as a measure of overall functionality in patients undergoing hematopoietic stem cell transplantation (HSCT).

Abstract

7119 Background: The 6 minute walk test (6MW) has been used in research as a measure of overall functionality and has been related to prognosis and quality of life (QOL) in cancer patients. For some clinics, the use of other functional tests may be a timely and space saving option. The selective functional movement assessment (SFMA) is a short, systematic evaluation of 7 fundamental movement patterns which can be conducted in patient rooms. The SFMA can make clinicians aware of deficient, painful movement patterns that may indicate impairment and motor control deficits. The SFMA may help identify functional impairments for pre- and peri-transplant interventions in patients undergoing HSCT. Methods: Patients were assessed prior to HSCT. A composite score (range: 19-38) was given to patients based SFMA performance. A lower score represented improved movement profiles. 6MW was tested by standardized protocol on an established route. Pearson correlations were calculated to evaluate the relationship between 6MW and SFMA. Results: We evaluated 32 patients (10 autologous, 11 myeloablative allogeneic, 11 reduced intensity allogeneic). One patient was unable to complete all portions of the SFMA due to physical limitations; all patients completed the 6MW. The mean SFMA composite score was 24.9± 3. ≥50% of patients exhibited deficient movement patterns during forward flexion and deep squat. Other patterns that showed a high level of deficiency (> 30% of all patients) were back extension, single leg stance, shoulder mobility, and cervical rotation. The mean 6MW was 477± 94 m. There was a moderate negative correlation between 6MW and SFMA composite score (r =-0.46, p<0.001), implying that a shorter 6MW was associated with more deficient movements. Conclusions: The SFMA could be useful for quantifying overall functionality in settings where the 6MW is not ideal. The SFMA may also be useful for identification of functional issues that may be addressed before or during HSCT by interventions to limit disability and maintain QOL. Further research should evaluate the SFMA results pre to post transplant to assess changes in fundamental movement deficits. The use of the SFMA’s prognostic ability should also be evaluated.