Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan.
Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.
BMC Musculoskelet Disord. 2023 Aug 18;24(1):661. doi: 10.1186/s12891-023-06797-w.
This study aimed to examine the validity of the timed up and go test (TUGT), which is a representative, objective, and functional assessment that can evaluate walking speed, strength, and balance, and determine the significant factors associated with physical dysfunction in the early postoperative period in patients with soft tissue sarcomas (STSs).
This retrospective, single-center, observational study conducted at the National Cancer Center Hospital included 54 patients with STSs in the thigh who underwent surgery. The Musculoskeletal Tumor Society (MSTS) score, which subjectively evaluates the affected limb, was evaluated at discharge, and TUGT was performed preoperatively and at discharge. Higher scores indicated good limb function in the MSTS score and poor performance in the TUGT. Spearman's correlation analysis was performed to identify the relationship between the MSTS score and TUGT. A receiver operating characteristic curve was used to calculate the cut-off value of the change in pre- and postoperative TUGT for an MSTS score of ≥ 80%. To examine the significant factors associated with physical dysfunction, multivariate regression analysis was performed using the change in pre- and postoperative TUGT as the dependent variable.
Postoperative TUGT and the change in pre- and postoperative TUGT were significantly associated with the MSTS score. The cut-off value for the change in pre- and postoperative TUGT for acceptable affected lower-limb function was 3.7 s. Furthermore, quadriceps muscle resection was significantly associated with the change in pre- and postoperative TUGT in the early postoperative period.
TUGT could be a useful objective evaluation tool for postoperative patients with STSs. The cut-off value for the change in TUGT can be used to monitor postoperative recovery. If recovery is prolonged, a rehabilitation program can be designed according to the severity of the functional impairment in muscle strength, balance, or gait. In addition, sufficient information should be obtained regarding the presence or absence of quadriceps resection, which has a significant impact on postoperative performance.
本研究旨在检验计时起立行走测试（TUGT）的有效性，TUGT 是一种具有代表性、客观性和功能性的评估方法，可评估行走速度、力量和平衡，并确定软组织肉瘤（STS）患者术后早期与身体功能障碍相关的显著因素。
本研究为回顾性、单中心、观察性研究，在国立癌症中心医院进行，纳入了 54 例接受大腿部 STS 手术的患者。MSTS 评分（主观评估患侧）在出院时进行评估，TUGT 在术前和出院时进行。MSTS 评分中得分越高表示肢体功能越好，TUGT 中表现越差。采用 Spearman 相关分析确定 MSTS 评分与 TUGT 之间的关系。采用受试者工作特征曲线计算 TUGT 术前和术后变化的截断值，以获得 MSTS 评分≥80%的结果。为了检验与身体功能障碍相关的显著因素，采用多元回归分析，将 TUGT 术前和术后的变化作为因变量。
术后 TUGT 和 TUGT 术前和术后的变化与 MSTS 评分显著相关。TUGT 术前和术后变化的截断值为 3.7 秒，可接受的患侧下肢功能。此外，股四头肌切除术与术后早期 TUGT 术前和术后的变化显著相关。
TUGT 可作为 STS 术后患者有用的客观评估工具。TUGT 变化的截断值可用于监测术后恢复情况。如果恢复时间延长，可以根据肌肉力量、平衡或步态功能障碍的严重程度设计康复计划。此外，应充分了解股四头肌切除术的有无，这对术后表现有重大影响。
