Background-A sit to stand task following a hip fracture may be achieved through compensations (e.g. bilateral arms and uninvolved lower extremity), not restoration of movement strategies of the involved lower extremity. The primary purpose was to compare upper and lower extremity movement strategies using the vertical ground reaction force during a sit to stand task in participants recovering from a hip fracture to control participants. The secondary purpose was to evaluate the correlation between vertical ground reaction force variables and validated functional measures.

Purpose: To determine whether there were significant differences in self-report and objective measures of physical fitness and function between women post–breast cancer (BC) treatment with and without clinically significant fatigue. Methods: We performed a secondary analysis of baseline data collected from 281 postmenopausal women post–BC treatment (62 ± 10 years; time since diagnosis = 5.6 ± 3.9 years) who participated in prior exercise trials. Scores on the SF-36 (36-Item Short Form Health Survey) vitality subscale (0-100) were used to identify women with clinically significant fatigue, where a score of 45 or less represents fatigue and a score of 70 or more represents no fatigue. Objectively measured function included maximal leg press strength (kg), physical function battery, timed chair stand, Unipedal Stance Test, and gait characteristics. Self-reported outcomes included physical function, pain, mental health, sensory symptoms of chemotherapy-induced peripheral neuropathy (CIPN), habitual physical activity level, and fall history. Results: Twenty percent of women (n = 57) reported clinically significant fatigue 6 years postdiagnosis, whereas 34% (n = 100) reported no fatigue. Except for leg strength, unipedal stance, step length, and base of support while walking, fatigued women had significantly worse objectively measured function than women without fatigue. Fatigued women also reported poorer physical function, greater bodily pain, and poorer mental health and were twice as likely as nonfatigued women to report symptoms of CIPN and having fallen. Conclusions: Women with a history of BC, and in particular those with CIPN, should be routinely screened for clinically significant fatigue in the survivorship period. Clinical and survivorship care plans aimed at limiting functional decline and reducing falls in survivors of BC should include fatigue-reduction strategies.

Cancer patients treated with cytotoxic chemotherapy experience fatigue and changes in body composition that can impact physical functioning and quality of life during and after treatment. Interleukin-6 (IL-6) is associated with fatigue in cancer survivors and plays an important role in the regulation of body composition. The purpose of the present study was to determine the specific role of IL-6 in cyclophosphamide-doxorubicin-5-fluorouracil (CAF)-induced changes in fatigue, food intake, and body composition using mice lacking IL-6. Female wild-type (WT) and IL-6−/− mice were injected with four cycles of CAF or normal saline (NS) administered at 21-day intervals. Daily voluntary wheel-running activity (VWRA), used as a proxy for fatigue, and food intake were monitored daily up to 21 days after the fourth dose. Dual-energy X-ray absorptiometry (DEXA) was used to assess treatment-related changes in lean body mass (LBM), fat mass (FM), and bone mineral content (BMC). Patterns of change in fatigue and food intake did not differ between CAF-treated WT and IL-6−/− mice. However, a Genotype × Drug interaction was observed for LBM (p = 0.047) and FM (p = 0.035) but not BMC (p = .569). Whereas WT mice lost LBM and FM during CAF treatment, IL-6-deficient mice did not. Treatment-related decreases in levels of the anabolic hormone insulin-like growth factor-1 (IGF-1) may contribute to LBM and FM loss since CAF decreased IGF-1 levels in an IL-6-dependent manner. These findings implicate IL-6 and possibly IGF-1 in the regulation of body composition in breast cancer patients exposed to cytotoxic chemotherapy.

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Uninvolved side knee moments and powers were the largest contributors to asymmetrical vertical ground reaction force in participants post-hip fracture. The association of vertical ground reaction force variables and clinical measures of function suggesting reducing vertical ground reaction force asymmetry may contribute to higher levels of function post-hip fracture. Functional and strength training should target the involved knee to reduce vertical ground reaction force asymmetry.