Laboratoire Motricité, Interactions, Performance, MIP - EA4334, Le Mans Université, Avenue Olivier Messiaen, 72085, Le Mans Cedex 9, France.
Inter-regional Institute of Cancerology Jean Bernard, Le Mans, France.
Support Care Cancer. 2019 Jan;27(1):229-238. doi: 10.1007/s00520-018-4320-0. Epub 2018 Jun 24.
As a subjective symptom, cancer-related fatigue is assessed via patient-reported outcomes. Due to the inherent bias of such evaluation, screening and treatment for cancer-related fatigue remains suboptimal. The purpose is to evaluate whether objective cancer patients' hand muscle mechanical parameters (maximal force, critical force, force variability) extracted from a fatiguing handgrip exercise may be correlated to the different dimensions (physical, emotional, and cognitive) of cancer-related fatigue.
Fourteen women with advanced breast cancer, still under or having previously received chemotherapy within the preceding 3 months, and 11 healthy women participated to the present study. Cancer-related fatigue was first assessed through the EORTC QLQ-30 and its fatigue module. Fatigability was then measured during 60 maximal repeated handgrip contractions. The maximum force, critical force (asymptote of the force-time evolution), and force variability (root mean square of the successive differences) were extracted. Multiple regression models were performed to investigate the influence of the force parameters on cancer-related fatigue's dimensions.
The multiple linear regression analysis evidenced that physical fatigue was best explained by maximum force and critical force (r = 0.81; p = 0.029). The emotional fatigue was best explained by maximum force, critical force, and force variability (r = 0.83; p = 0.008). The cognitive fatigue was best explained by critical force and force variability (r = 0.62; p = 0.035).
The handgrip maximal force, critical force, and force variability may offer objective measures of the different dimensions of cancer-related fatigue and could provide a complementary approach to the patient reported outcomes.
作为一种主观症状，癌因性疲乏是通过患者报告的结果来评估的。由于这种评估存在固有偏见，因此对癌因性疲乏的筛查和治疗仍不尽如人意。本研究旨在评估从疲劳性握力运动中提取的客观癌症患者手部肌肉机械参数（最大力、临界力、力变异性）是否与癌因性疲劳的不同维度（身体、情绪和认知）相关。
本研究纳入了 14 名患有晚期乳腺癌的女性，她们仍在接受或在过去 3 个月内接受过化疗，同时纳入了 11 名健康女性。首先通过 EORTC QLQ-30 及其疲劳模块评估癌因性疲劳。然后在 60 次最大重复握力收缩期间测量疲劳度。提取最大力、临界力（力-时间演化的渐近线）和力变异性（连续差异的均方根）。进行多元回归模型分析，以研究力参数对癌因性疲劳各维度的影响。
多元线性回归分析表明，最大力和临界力可以很好地解释身体疲劳（r=0.81；p=0.029）。最大力、临界力和力变异性可以很好地解释情绪疲劳（r=0.83；p=0.008）。临界力和力变异性可以很好地解释认知疲劳（r=0.62；p=0.035）。
握力的最大力、临界力和力变异性可以提供癌因性疲劳不同维度的客观测量指标，为患者报告的结果提供了一种补充方法。
