2020

Integrative Cancer Therapies

Gait Analysis of Patients After Allogeneic Hematopoietic Cell Transplantation Reveals Impairments of Functional Performance

Sarah Kneis, Elisa Straub, Isabelle Daniela Walz, Philipp von Olshausen, Anja Wehrle, Albert Gollhofer, Hartmut Bertz

Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg

Keywords

gait analysis, fast gait speed, fear of falling, allogeneic hematopoietic cell transplantation, cancer survivors, functional impairment

Abstract

Background: After allogeneic hematopoietic cell transplantation (alloHCT), patients often report functional impairments like reduced gait speed and muscle weakness. These impairments can increase the risk of adverse health events similar to elderly populations. However, they have not been quantified in patients after alloHCT (PATs). Methods: We compared fear of falling (Falls Efficacy Scale–International) and temporal gait parameters recorded on a 10-m walkway at preferred and maximum gait speed and under dual-task walking of 16 PATs (aged 31-73 years) with 15 age-matched control participants (CONs) and 17 seniors (SENs, aged >73 years). Results: Groups’ gait parameters especially differed during the maximum speed condition: PATs walked slower and required more steps/10 m than CONs. PATs exhibited greater stride, stance, and swing times than CONs. PATs’ swing time was even longer than SENs’. The PATs’ ability to accelerate their gait speed from preferred to fast was smaller compared with CONs’. PATs reported a greater fear of falling than CONs and SENs. Conclusion: Gait analysis of alloHCT patients has revealed impairments of functional performance. Patients presented a diminished ability to accelerate gait and extending steps possibly related to a notable strength deficit that impairs power-generation abilities from lower extremities. Furthermore, patients reported a greater fear of falling than control participants and even seniors. Slowing locomotion could be a risk-preventive safety strategy. Since functional disadvantages may put alloHCT patients at a higher risk of frailty, reinforcing appropriate physical exercises already during and after alloHCT could prevent adverse health events and reduce the risk of premature functional aging.

Moticon's Summary

This study aimed at investigating and quantifying gait impairment following allogenic hematopoietic cell transplantation. In this context patients frequently report functional impairment like reduced gait speed and muscle weakness. For the assessment patients walked on a 10m walkway at preferred and maximum speed as well as under a dual-task. Furthermore, fear of falling during the trials was assessed using the falls efficacy scale. Moticon sensor insoles were used to collect gait parameters during the different walking tasks. The sample group included 16 affected patients, 15 age matched controls as well as 17 seniors. Results revealed altered gait parameters compared to the match control group. Specifically gait speed was reduced in comparison to the matched control groups. Likewise patients reported a greater fear of falling than both control groups.

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