Relationship Between Cachexia and the Functional Progress of Patients With Cancer in Inpatient Rehabilitation.
Ishan Roy, Kevin Huang, Akash Bhakta and 3 others
PMID 35383593WHAT IT FOUND
Most cancer patients in inpatient rehab had cachexia, yet those with moderate weight loss recovered function as well as those without.
Only the most severe cases gained less function and had poorer survival, suggesting standard rehab remains effective for many.
Key findings
01Cachexia was highly prevalent, affecting 59% of the cohort by weight-based criteria and 77% by the Weight Loss Grading Scale (WLGS).
02Patients with cachexia defined by standard weight-loss criteria made similar motor and cognitive functional gains during rehabilitation as those without cachexia.
03Patients with the most severe cachexia (WLGS grade 4) had significantly lower motor function gains and decreased six-month survival compared to lower grades.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is retrospective, so it cannot prove that rehabilitation caused the functional changes or that cachexia prevented them. Cachexia was defined by weight loss and BMI, not by imaging or muscle mass measurements, so fluid retention or fat loss could confound the diagnosis. The Functional Independence Measure (FIM) has a ceiling effect, meaning it may not capture subtle functional declines in higher-functioning patients. The cohort lacked racial and ethnic diversity and was limited to patients admitted to a specific inpatient rehabilitation facility, which may affect generalizability. Data on pre-cancer treatment weight were not available, so the Weight Loss Grading Scale could only be calculated at a single time point rather than longitudinally.
Declared interests
All authors declared no conflicts of interest. The study was supported by the National Institutes of Health (N.I.H., Extramural).
The easy way to misread this
Do not assume that all patients with cachexia have poor rehabilitation potential. The study showed that patients with moderate cachexia recovered function as well as those without; only the most severely affected group (WLGS grade 4) had significantly reduced gains and survival.