title: Assessment of physical functioning in recurrent glioma: preliminary comparison of performance status to functional capacity testing.
abstract: BACKGROUND
  Performance status (PS) scoring systems are tools of immense clinical importance in the management of patients with malignant disease but these tools are subjective and do not provide an objective evaluation of physical functioning. We conducted a pilot study to explore the feasibility and clinical utility of functional capacity testing to assess physical functioning in recurrent primary malignant glioma patients.
  
  
  METHODS
  Using a cross-sectional design, consecutive patients with recurrent glioma performed a six minute walk (6MW) test to assess functional capacity. Performance status was assessed using Karnofsky Performance Status (KPS) scoring system. QOL was assessed by the Functional Assessment of Cancer Therapy-Brain scale. Self-reported exercise behavior was assessed using the Godin Leisure Time Exercise Questionnaire (GLTEQ).
  
  
  RESULTS
  A total of 171 patients were recruited and tested. Seventy percent were diagnosed with glioblastoma multiforme (WHO grade IV) and 85% were undergoing therapy. Median KPS was 90% (range, 70-100%). Median 6MW distance was 400 m (range, 102-630 m), equivalent to 56 +/- 13% (range, 14-87%) of that predicted for age and sex. KPS, self-reported exercise, and QOL increased across 6MW distance quartiles (P < 0.05) although there was considerable variation within each category. 6MW distance and KPS were significantly correlated with each other (r = 0.34, P < 0.01) and several QOL domains (range, r = -0.43 to 0.46, P < 0.05).
  
  
  CONCLUSIONS
  6MW distance is a clinically feasible tool that provides an objective measure of physical functioning in select patients with recurrent glioma. Further research is required to investigate the prognostic value of these tests in patients with advanced malignancy.
authors.affiliation: Department of Surgery, Duke University Medical Center, Box 3624, Durham, NC 27710, USA. lee.w.jones@duke.edu
authors.forename: Lee W
authors.initials: LW
authors.lastname: Jones
authors.forename: Rachel-Rose
authors.initials: RR
authors.lastname: Cohen
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Mabe
authors.forename: Miranda J
authors.initials: MJ
authors.lastname: West
authors.forename: Annick
authors.initials: A
authors.lastname: Desjardins
authors.forename: James J
authors.initials: JJ
authors.lastname: Vredenburgh
authors.forename: Allan H
authors.initials: AH
authors.lastname: Friedman
authors.forename: David A
authors.initials: DA
authors.lastname: Reardon
authors.forename: Emily
authors.initials: E
authors.lastname: Waner
authors.forename: Henry S
authors.initials: HS
authors.lastname: Friedman
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001932:Brain Neoplasms / Q000503:physiopathology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000379:methods; D005260:Female; D005910:Glioma / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult