Abstract
Background: Chemotherapy-related musculoskeletal adverse effects, such as muscle wasting, reduced muscle mass, muscle and joint pain, decreased bone density, joint stiffness, and inflammation, can impair physical activity and impact overall survival (Sutton et al., 2019; Sturgeon et al., 2019; Pin et al., 2018; Jang et al., 2020; Lee et al., 2019). However, limited research exists on the changes in musculoskeletal health and physical performance among women with gynecological cancer throughout chemotherapy.
Purpose: This study aimed to examine changes in musculoskeletal health and physical performance across chemotherapy cycles and identify factors influencing these changes.
Methods: A prospective longitudinal design was employed. Adult women with gynecologic cancer scheduled for their first chemotherapy cycle (every 3–4 weeks) were recruited from a medical center in Taiwan. Musculoskeletal health was assessed through hand grip, lower limb muscle strength, skeletal muscle mass, and 4-meter walking speed. Physical performance was evaluated using the Karnofsky Performance Status (KPS), the SARC-F for sarcopenia screening, and the International Physical Activity Questionnaire Short Form (IPAQ-T-SS). Data collection occurred at three points: before chemotherapy (T0), 3–4 weeks post-first cycle (T1) and post-third cycle (T2). Generalized Estimating Equations (GEE) analyzed changes across chemotherapy cycles.
Results: Thirty-four participants were included, with an average age of 56.3 years (Range: 38–74, SD=9.93). The primary cancer type was ovarian (n=17, 50%), with most participants (44.12%, n=15) at FIGO stage III. Significant declines were observed in KPS scores (B=-6.454, p<.001; B=-6.092, p<.001) and borderline declined changes in 4-meter walking speed (B =-1.12, p=.06) over the chemotherapy cycles. Age was a significant factor affecting KPS and walking speed. However, skeletal muscle mass, hand grip strength, lower limb strength, sarcopenia risk, and physical activity levels remained unchanged across the chemotherapy cycles.
Conclusion: Increased chemotherapy cycles were significantly associated with reduced physical performance, especially among older patients. These findings align with prior research (Fukushima et al., 2020), underscoring the importance of monitoring musculoskeletal health and physical performance in patients undergoing chemotherapy, with particular attention to older patients.
Notes
References:
1. Sutton, K., Sanft, T. B., Knobf, T. M., & Ibe, I. K. (2019). Musculoskeletal effects of antineoplastic agents. Journal of the American Academy of Orthopaedic Surgeons, 27(22), 834-839.
2. Sturgeon, K. M., Mathis, K. M., Rogers, C. J., Schmitz, K. H., & Waning, D. L. (2019). Cancer- and chemotherapy-induced musculoskeletal degradation. Journal of Bone and Mineral Research, 3(3), e10187.
3. Pin, F., Couch, M. E., & Bonetto, A. (2018). Preservation of muscle mass as a strategy to reduce the toxic effects of cancer chemotherapy on body composition. Current Opinion in Supportive and Palliative Care, 12(4), 420-426.
4. Jang, M. K., Park, C., Hong, S., Li, H., Rhee, E., & Doorenbos, A. Z. (2020). Skeletal muscle mass change during chemotherapy: A systematic review and meta-analysis. Anticancer Research, 40(5), 2409-2418.
5. Lee, J., Lin, J.-B., Wu, M.-H., et al. (2019). Muscle radiodensity loss during cancer therapy is predictive for poor survival in advanced endometrial cancer. Journal of Cachexia, Sarcopenia and Muscle, 10(4), 814-826.
6. Fukushima, T., Nakano, J., Ishii, S., et al. (2020). Factors associated with muscle function in patients with hematologic malignancies undergoing chemotherapy. Supportive Care in Cancer, 28(3), 1433-1439.
Sigma Membership
Lambda Beta at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Acute Care, Musculoskeletal Health, Chemotherapy Adverse Effects, Gynecologic Cancer
Recommended Citation
Hsu, Yu-Yun; Hsu, Keng-Fu; and Lin, Cheng-Feng, "Musculoskeletal Health and Physical Performance in Gynecological Cancer Women During Chemotherapy" (2025). International Nursing Research Congress (INRC). 144.
https://www.sigmarepository.org/inrc/2025/presentations_2025/144
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Musculoskeletal Health and Physical Performance in Gynecological Cancer Women During Chemotherapy
Seattle, Washington, USA
Background: Chemotherapy-related musculoskeletal adverse effects, such as muscle wasting, reduced muscle mass, muscle and joint pain, decreased bone density, joint stiffness, and inflammation, can impair physical activity and impact overall survival (Sutton et al., 2019; Sturgeon et al., 2019; Pin et al., 2018; Jang et al., 2020; Lee et al., 2019). However, limited research exists on the changes in musculoskeletal health and physical performance among women with gynecological cancer throughout chemotherapy.
Purpose: This study aimed to examine changes in musculoskeletal health and physical performance across chemotherapy cycles and identify factors influencing these changes.
Methods: A prospective longitudinal design was employed. Adult women with gynecologic cancer scheduled for their first chemotherapy cycle (every 3–4 weeks) were recruited from a medical center in Taiwan. Musculoskeletal health was assessed through hand grip, lower limb muscle strength, skeletal muscle mass, and 4-meter walking speed. Physical performance was evaluated using the Karnofsky Performance Status (KPS), the SARC-F for sarcopenia screening, and the International Physical Activity Questionnaire Short Form (IPAQ-T-SS). Data collection occurred at three points: before chemotherapy (T0), 3–4 weeks post-first cycle (T1) and post-third cycle (T2). Generalized Estimating Equations (GEE) analyzed changes across chemotherapy cycles.
Results: Thirty-four participants were included, with an average age of 56.3 years (Range: 38–74, SD=9.93). The primary cancer type was ovarian (n=17, 50%), with most participants (44.12%, n=15) at FIGO stage III. Significant declines were observed in KPS scores (B=-6.454, p<.001; B=-6.092, p<.001) and borderline declined changes in 4-meter walking speed (B =-1.12, p=.06) over the chemotherapy cycles. Age was a significant factor affecting KPS and walking speed. However, skeletal muscle mass, hand grip strength, lower limb strength, sarcopenia risk, and physical activity levels remained unchanged across the chemotherapy cycles.
Conclusion: Increased chemotherapy cycles were significantly associated with reduced physical performance, especially among older patients. These findings align with prior research (Fukushima et al., 2020), underscoring the importance of monitoring musculoskeletal health and physical performance in patients undergoing chemotherapy, with particular attention to older patients.
Description
Increasing chemotherapy cycles is linked to notable declines in physical performance among women with gynecological cancer, particularly in older patients.