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Article

Physical Function Tests Are Potential Tools to Identify Low Physical Resilience in Women after Breast Cancer Treatment

by
Fernanda Maria Martins
1,
Anselmo Alves de Oliveira
1,
Gersiel Oliveira-Júnior
1,
Marcelo A. S. Carneiro
1,2,
Luís Ronan Marquez Ferreira de Souza
1,3,
Vitor Carvalho Lara
3,
Rosekeila Simões Nomelini
1,4,
Cláudio Oliveira Assumpção
1,5,
Markus Vinícius Campos Souza
1,5 and
Fábio Lera Orsatti
1,5,*
1
Applied Physiology, Nutrition and Exercise Research Group (PhyNEr), Exercise Biology Research Lab (BioEx), Federal University of Triangulo Mineiro, Uberaba 38025-180, Brazil
2
Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina 86057-970, Brazil
3
Department of Radiology and Diagnostic Imaging, Federal University of Triangulo Mineiro, Uberaba 38025-180, Brazil
4
Department of Gynecology and Obstetrics, Federal University of Triangulo Mineiro, Uberaba 38025-180, Brazil
5
Department of Sport Sciences, Health Science Institute, Federal University of Triangulo Mineiro, Uberaba 38025-180, Brazil
*
Author to whom correspondence should be addressed.
Muscles 2023, 2(1), 97-108; https://doi.org/10.3390/muscles2010009
Submission received: 27 November 2022 / Revised: 8 February 2023 / Accepted: 20 February 2023 / Published: 9 March 2023
(This article belongs to the Special Issue Recent Perspectives Regarding Muscle and Exercise Training)
Review Reports Versions Notes

Abstract

:
Background: This study sought to investigate whether different physical function tests (objective measures of physical performance) may identify a low physical resilience in breast cancer survivors (BCS). Methods: This analytical cross-sectional study evaluated 146 BCS and 69 age-matched women without breast cancer history. The different times after the end of treatment were used as criteria for group division. Participants were divided into four groups: control (CT: n = 69–women without breast cancer history); <1.0 years after the end of treatment (<1 YAT: n = 60); 1–3.9 years after the end of treatment (1–3.9 YAT: n = 45); and ≥4 years after the end of treatment (>4 YAT: n = 41). Physical function was evaluated by 4 m walk test (4-MWT), five-times-sit-to-stand test (FTSST), timed up and go test (TUG), and short physical performance battery (SPPB). Age, menopausal status, smoking, number of medications, level of physical activity, body mass index, and muscle strength were used as confounding variables in ANCOVA. Results: All groups that underwent cancer treatment (<1 YAT, 1–3.9 YAT and ≥4 YAT) had lower physical performance (p < 0.001) identified by 4 MWT, TUG, and FTSST when compared to the CT group. For the SPPB, the <1 YAT and ≥4 YAT groups had lower performance (p = 0.005) when compared to the CT. Conclusions: The different physical function tests can be used to identify a low physical resilience in BCS.

1. Introduction

Breast cancer accounts for 29.5% of all new cancer cases in Brazil [1]. More women are surviving breast cancer as a result of medical advances and early detection [2,3]. These women, however, continue to experience adverse effects after being cured, negatively affecting their quality of life and survival time [4,5]. One of the most concerning findings is that cancer survivors have a lower physical function (or physical performance), which is linked to higher mortality rates [5].
Breast cancer treatment (i.e., chemotherapy, radiotherapy, and hormone therapy) has been associated with the impairment of several homeostatic systems, such as multihormonal dysregulation [6], an increased inflammatory profile [7], changes in the central and peripheral nervous systems [8], a decline in energy reserve capacity [9], and fatigue [9]. As a result of multiple physiological systems being compromised, patients are more likely to exhibit impairments in muscle strength and physical function [10], increasing their mortality risk [5].
Physical resilience is defined as the ability of an individual to resist or recover from a decline in physical function following exposure to a health stressor. (e.g., breast cancer treatment) [11,12]. Physical resilience has been understood as a dynamic process of interaction between physiological systems in an attempt to re-establish the original balance, maintain the initial phenotypic identity of the system, and preserve the system’s functionality after the action of a stressor [11,12,13,14,15]. Based on the proposal of a physical resilience model, physiological reserve and homeostatic systems are associated with the physical resilience capacity [11,14]. In this regard, low physical resilience is the result of wear (i.e., deregulation) and tear of the physiological reserve and homeostatic systems that are not able to restore the original balance and maintain the functionality of the organic system [15]. Consequently, low physical resilience is associated with comorbidities [13], lower quality of life [16], and higher risk of death when exposed to agent stressors [14]. Thus, consecutive evaluations of physical function following cancer treatment can provide health professionals with information regarding survivors’ physical resilience, health, and prognosis.
Most studies have used self-reported measures of physical function, such as the Short-Form 36 or the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire [17,18]. Self-reported measurement tools include benefits such as the ability to test a large number of people as well as being inexpensive and practical. However, because of the influence of interfering factors such as educational level, memory impairment, dishonest answers, omitted questions, and survey weariness, self-reported measurement tools may provide less reliable information about physical function [19,20,21]. In this regard, more appropriate measures to assess low physical resilience are required [11].
Objective measures of physical function (e.g., walking speed, timed up and go, and sit-to-stand tests) might be promising tools to identify cancer survivors with low physical resilience. Physical function tests can be used as indicators of changes in homeostatic systems and physiological reserve [10,22,23] and as a tool to distinguish functional age from chronological age [11,24]. Moreover, the physical function test has been shown to be a prognostic biomarker of mortality, low quality of life, and treatment-related complications among cancer survivors [5,25,26]. Furthermore, from a hierarchical standpoint, changes in muscle function (i.e., muscle strength) influence changes in physical performance [27]. Therefore, muscle strength tests may help determine the reason for changes in physical capacity following cancer treatment (i.e., a decline in muscle strength). Furthermore, physical function tests are quick, inexpensive, and easy-to-perform tools that do not require special equipment or training when compared to clinical tests [28,29]. In addition, they are applicable in the clinical environment [28] and have high reliability between evaluators and test/retest [30,31]. However, the effectiveness of different physical function tests to identify cancer survivors at risk of low physical resilience remains unclear. Therefore, this study aimed to investigate whether different physical function tests may identify a lower physical resilience in BCS.

2. Results

There were no statistical differences (p > 0.05) between four groups (CT, <1 YAT, 1–3.9 YAT, and ≥4 YAT) for general characteristics, marital status, education attainment, physical activity status and use of medicine. Moreover, there were no statistical differences (p > 0.05) between the BCS groups (<1 YAT, 1–3.9 YAT, and ≥4 YAT) for cancer treatment characteristics, except for end-of-treatment (years) (Table 1).
The parameters of physical function tests are shown in Table 2. After adjusting for confounding variables, YAT groups that underwent cancer treatment (<1 YAT, 1–3.9 YAT, and ≥4 YAT) showed lower physical performance in 4 MWT, TUG, and FTSST when compared to CT. The <1 YAT group and ≥4 YAT groups showed lower performance in SPPB when compared to CT. Only the 1–3.9 YAT group showed a lower MS value when compared to CT.

3. Discussion

We found that physical function assessments are promising techniques for detecting low physical resilience in BSC. As longitudinal and long-term studies are difficult and expensive to conduct, this cross-sectional study adds to the field by offering new findings about prospective techniques for measuring physical resilience in BCS (i.e., oncology hospitals). Furthermore, these simple and low-cost techniques could be utilized by health professionals (e.g., doctors or nurses) to swiftly screen for low physical resilience in clinical settings. Early detection of inadequate physical resilience may lead to preventative strategies aimed at individuals and populations. This is a significant discovery because inadequate physical resilience is associated with poor quality of life [16] and an increased risk of death [14] in cancer patients.
In the current study, physical function measured by 4 MWT, FTSST, TUG, and SPPB was lower in the BCS (i.e., the <1 YAT, 1–3.9 YAT, and ≥4 YAT groups) when compared to the age-matched women with no history of cancer (i.e., the CT group) (Table 2). These findings indicate that there is a reduction in physical function in the BCS and that this impairment does not recover even after a long period of time (4 years) after treatment ends. Physical function tests are widely used to assess physical health in different contexts [27,32]. For instance, physical function tests have been used to assess lower limb function [33], aerobic capacity [34], mobility risk [35], fall risk [36,37], disabilities [38], and balance dysfunction [39] in older adults, as well as being used as a prognostic biomarker of mortality and low quality of life among cancer survivors [5,25,26]. It has also been shown that physical function tests can be used as indicators of changes in physiological reserve and homeostatic systems in older adults [10,22,23]. In this regard, physiological reserve and homeostatic systems are related with a system’s resilience capacity; that is, physical resilience is limited in part by the underlying physiological reserve in organ systems, according to the idea of a physical resilience model [10,11,14]. Thus, physical function tests may provide a measure of an individual’s physiological reserve and, as a result, an indication of physical resilience in BSC in this construct.
We found that all physical performance tests were sensitive to identifying low physical resilience in BCS, regardless of the number of medications, muscle strength, menopause, smoking, BMI, and physical activity level (Table 2). Indeed, physical performance tests have been associated with a series of critical conditions and may reflect the decline in function of different physiological and homeostatic systems, such as body composition, homeostatic dysregulation, the energy system, and nervous system [10]. In terms of body composition, a decrease in muscle mass and, consequently, strength, as well as an increase in fat mass, result in a higher mechanical load that the patient must carry. As a result, skeletal muscles are always working at or near their maximum capacity (i.e., critical limit). When muscle strength decreases below the critical threshold, this is reflected as reduced physical capacity (i.e., reduced walking speed) [10]. Although we did not assess the change in body composition, BCS have higher body fat [40] and lower muscle strength [41] than age-matched women with no cancer treatment history. Another relevant point is that the impairment of various homeostatic systems, such as multihormonal dysregulation (i.e., levels of androgens, estrogens, estradiol, IGF-1, and insulin) and increased inflammatory profile related to cancer treatment [6,7], has been associated with the decline in mobility [10]. In addition, it has been shown that cancer treatment-associated changes in the nervous system [8], such as loss of myelinated and unmyelinated nerve fibers, demyelination partially compensated by remyelination, axonal atrophy, muscle fiber denervation, and altered autonomic responses, are associated with reduced performance in physical tests [10]. Additionally, several studies have shown that physical performance tests may mirror the energy reserve capacity [10,22,23,42,43]. In this regard, cancer treatment has been associated with changes in energy reserve capacity and fatigue [9]. Hence, changes in physical performance tests may be an indicator of a decline in the function of different physiological systems (e.g., energetic, hormonal, neural, and homeostatic) in BSC and, therefore, an expression of the capacity for physical resilience. Moreover, physical performance tests are an excellent predictor of declining physical function [44] and adverse health outcomes, such as cancer [5], cardiovascular disease [45], dementia [46], postoperative complications [47], and mortality in older adults and older BCS [48,49]. Therefore, our findings indicate that physical performance tests are potential tools capable of identifying low physical function and, consequently, physical resilience in BCS.
The physical performance tests are rarely incorporated as a standard assessment protocol in routine clinical practice. In that regard, the application of physical performance tests in the clinical setting can provide a rich resource for oncological medicine. In this perspective, our study indicates that physical performance tests can provide a sensitive and objective measure of the capacity for physical resilience and, consequently, allow physicians to establish priorities in the care plan and avoid future complications to patients’ health. Recently, it has been shown that identifying the dynamic process of physical resilience requires multiple repeated measurements of physical function (physical function recovery trajectories) after a stressor [50]. Thus, physical performance tests are quick application tools and result in different physical function responses [28]. It can be suggested that physical performance tests can be used as practical tools to quantify the dynamic process of physical resilience. In addition, physical performance tests can be used as markers of complications related to cancer treatment [47] and as a marker of early death to adapt oncologic therapeutics [51]. Moreover, the objective identification of low physical resilience by physical performance tests can contribute to therapeutic decision-making (e.g., about medication options) and/or to the development of acute care management strategies that reduce complications or complications of treatment, and/or to the development of preventive strategies to decrease the risk of adverse events, such as falls and disabilities in BCS. Furthermore, the objective screening of low physical resilience using the physical performance tests can contribute to the development of early intervention methods capable of improving physical resilience capacity, such as practicing regular physical exercise. For example, it has been shown that physical exercise is a method capable of promoting the increase in physical fitness necessary for improved resilience [52]. In that regard, high resilience is associated with positive outcomes, including successful aging, lower depression, and increased longevity in older adults [53]. Although physical exercise is a promising intervention method for increasing physical function, it is still unclear what magnitude of increase in gait speed would represent a clinical improvement in physical resilience, and thus, further research is needed to investigate this relationship.
In our study, muscle strength measured by the handgrip strength test was lower in the 1–3.9 YAT group when compared to the age-matched women with no history of cancer (i.e., the CT group) (Table 2). Moreover, we observed that the ≥4 YAT group has greater muscle strength when compared to the 1–3.9 YAT group (Table 2). These results, when compared to the results of other physical function tests, suggest that changes in handgrip strength related to the time from the end of cancer treatment do not follow the same pattern as changes in functional tests. One possible explanation is that handgrip strength alone may not be as sensitive as other tests to capture changes in various physiological systems. Reduction in muscle strength is mainly dependent on changes in muscle mass and/or the nervous system [54,55]. Indeed, no reduction in muscle mass has been reported after breast cancer treatments [56]. Furthermore, another important point is that handgrip measures the muscle strength of the upper limbs, which involves a small, specific muscle mass (hands and forearm). In the present study, we did not observe a significant difference in the levels of physical activity between the groups. Maintaining a high level of daily living activities that utilize the upper limbs, such as showering, laundry, and housework, can help to preserve (or restore) upper limb strength after cancer treatment. In this regard, as physical resilience has been understood as a dynamic process of interaction between various physiological systems [11,12,13,14,15], other physical performance tests (e.g., TUG test) can provide more comprehensive information on changes in physiological systems. Therefore, it seems reasonable to assume that physical performance tests, rather than handgrip strength, may be more sensitive to changes in physiological systems and a better tool for assessing physical resilience.
The present study has some limitations. The cross-sectional design limits temporal and causal inferences. Thus, longitudinal studies are still needed to confirm the effectiveness of the physical function tests as a tool to identify the low physical resilience in BCS women. Another limitation is related to the relatively small number of participants given the nature of the study, which may have weakened the statistical analysis. However, physical function was assessed by objective tests, all measurements were carried out by the same experienced evaluator, and the physical function tests evaluated, except for the SPPB test, showed high reproducibility and reliability reported in the scientific literature [35,57,58], therefore reducing the bias. Finally, this study did not assess any biological marker associated with the level of physiological reserve; however, it is well established in the scientific literature that physical function tests are indicators of physiological reserve [23,42,43].

4. Methods

4.1. Design

An analytical cross-sectional study was conducted to determine whether objective physical performance tests are effective tools for identifying physical resilience capacity in BCS. To develop the present study, we recruited patients who had completed breast cancer treatment (BCS; n = 146) and who were followed up at a cancer center as well as women with the same characteristics (control women; n = 69) from a neighborhood association, both from the city of Uberaba-MG (Brazil). BCS were invited to participate in the study during routine visits to the cancer treatment center. All data were collected between June 2017 and June 2018.
After verbal acceptance and signing an informed consent form, patients were directed to a reserved room and questioned about their physical activity level, menopause time, diseases, and medications. Clinical data (staging and treatment performed) were self-reported and then checked by hospital staff based on analyzing the patient’s medical records. After that, physical function and anthropometric evaluations were conducted. The assessments were carried out in this order: physical activity level questionnaire, anthropometric assessments, balance test, handgrip strength, 4 m walk test, timed up and go test and five-times-sit-to-stand test. After all the evaluations, the BSC groups were divided according to the time after the end of breast cancer treatment: (Recent: <1 year; Intermediate: from 1 to 3.9 years; Late: ≥4 years). Therefore, based on the division criteria, the patients were divided and allocated into four groups: control [(CT: n = 69; Age: 58.5 (56.6–60.4)]; <1 year after the end of treatment [(<1 YAT: n = 60; Age: 57.1 (54.9–59.3)]; 1–3.9 years after the end of treatment [(1–3.9 YAT: n = 45; Age: 55.9 (53.2–58.6)]; and ≥4 years after the end of treatment (≥4 YAT: n = 41; Age: 59.4 (56.9–61.9)]. All data were collected in a reserved room at the cancer treatment center (BCS).

4.2. Participants

BCS, who were patients at a cancer treatment center in the city, were invited to participate in this study. Patients of all treatment modalities (surgery, radiotherapy, chemotherapy, or combinations) were included in the research. The inclusion criteria included the following: the patients must have completed breast cancer treatment for breast cancer staging between I and III (early breast cancer) and have no functional limitations to perform the physical tests. Patients who had previously undergone another type of cancer treatment were excluded from the study. The CT consisted of women who had no functional limitations to perform the physical tests and who had not undergone any type of cancer treatment. Then, the University Ethics Committee on the Use of Human Subjects approved the study (number CAAE: 82691818.0.0000.5154).

4.3. Level of Physical Activity

The evaluation of the level of physical activity was assessed by the International Physical Activity Questionnaire short form (IPAQ-SF) [59]. Volunteers were considered active if they reported ≥150 min·wk−1 moderate-intensity physical activity (3–5.9 METs), ≥75 min·wk−1 of vigorous-intensity physical activity (≥6 METs), or a combination of moderate- and vigorous-intensity physical activity to achieve a total energy expenditure of ≥500–1000 MET·min·wk−1 [60].
The results of the physical activity levels are presented in Table 1. The “active (%)” shows the percentage of people who meet the physical activity cut-off (more than 150 min of mild physical activity per week and/or more than 75 min of vigorous physical activity per week). The “moderate physical activity (%)” represents the percentage of people who engaged in moderate physical activity, regardless of the total amount of physical activity they performed. The "vigorous physical activity (%)" indicates the percentage of people who participated in vigorous physical activity, regardless of the overall amount of physical activity they performed.

4.4. Anthropometric Measurements

Body mass was measured using a 100 g precision digital scale (G-life®, São Paulo, SP, Brazil). Height was measured using an inextensible tape measure (10 mm accuracy) attached to the wall. Body mass index (BMI) was calculated as the ratio between body mass (kg) and height squared (m2) [59].

4.4.1. Grip Strength

Muscle strength is defined as “the amount of force a muscle can produce with a single maximal effort”. As a measure of overall muscle strength, grip strength is commonly used in clinical settings [27]. The handgrip strength test was measured using a manual dynamometer (Jamar®, Bolingbrook, IL, USA) to detect muscle strength in the right and left hands. Three measurements were taken on both hands, and the highest value was recorded and used for statistical analysis. In cancer patients, handgrip strength has high reproducibility and reliability [27,61].

4.4.2. Physical Performance

Physical performance is defined as “an objectively measured whole-body function related to mobility” [27]. Physical performance can be evaluated through the walking speed test, chair stand test, short physical performance battery (SPPB) test, and timed up and go test (TUG) [27].

4.5. Meter Walk Test (4-MWT)

The usual walking test was evaluated by the time spent walking at a distance of 4 m. To avoid the influence of acceleration and deceleration, 1 m indentation and extension areas were considered in the test area (6 m total). Two measurements were taken, and the shorter time was considered the valid measurement. The 4-MWT has high reproducibility and reliability in clinical populations [(ICC: ≥0.90)] [27,62].

4.6. Five-Times-Sit-To-Stand Test (FTSST)

The participants were instructed to perform repeated standing and sitting movements from an armless chair (0.45 m height) as fast as possible. The time to complete 5 full repetitions was recoded. The FTSST has excellent reliability and reproducibility in adults with pathologies [(ICC: ≥0.90)] [24,63].

4.7. Timed up and Go Test (TUG)

The participants were asked to rise from a chair without using their upper limbs, walk three meters, turn around an obstacle, walk back, and sit down on the chair. They received verbal instructions to begin the test. The timing was computed from the voice command to the time they sat back. The TUG is a reliable and valid test for quantifying functional mobility that may also be useful in following clinical change over time [(ICC: ≥0.90)] [27,35].

4.8. Short Physical Performance Battery (SPPB)

The SPPB consisted of three tests to detect mobility, and the tests were performed in the following order: balance test, 4-MWT, and FTSST. Each test score varied from 0 to 4 points, and the SPPB total score varied from 0 to 12 points (sum of the scores of the three tests) [37].
The balance test consisted of three positions: side-by-side stand, semi-tandem stand, and tandem stand. The score was based on the time spend in each position (10 s maximum).
The 4-MWT test was evaluated by the time walked over a distance of four meters, which the volunteer self-selected the velocity. Two measurements were taken, and the shorter time was considered as the valid measurement.
The FTSST test was evaluated by the time spent in five maximum velocity squats in a chair with the arms folded across the chest. The technique consisted of full sit and stand position, and the volunteer started in the sit position. The SPPB has good reliability and reproducibility [(ICC: ≥0.89)] [27,57].

4.9. Statistical Analysis

Data distribution was determined using the Kolmogorov–Smirnov test. Levene’s test was used to verify the homogeneity. One-way ANOVA and ANCOVA (GLM) were used to compare the parameters between the groups. The confounding variables used in the ANCOVA were age, menopause, smoking, number of medications, BMI, muscle strength, and physical activity level. When a p < 0.05 was observed in ANOVA/ANCOVA, a post hoc test (Bonferroni) was performed. The categorical variables were compared using binary logistic regression. Data were presented as mean, confidence interval of 95% (95% CI), or percentage. The significance level was set at 5%.

5. Conclusions

Our findings indicate that physical function tests could be used to detect low physical resilience in middle-aged BCS women. From a clinical standpoint, this study could provide a quick, low-cost, and simple technique for assessing low physical resilience in BCS women.

Author Contributions

All authors conceived the experiments; F.M.M., G.O.-J., V.C.L., A.A.d.O., M.A.S.C., L.R.M.F.d.S., R.S.N. and F.L.O. were responsible for the interpreting results and for writing the first draft of the manuscript. F.M.M., M.A.S.C., C.O.A., M.V.C.S. and F.L.O. were responsible for editing the manuscript. All authors have read and agreed to the published version of the manuscript.

Funding

The Minas Gerais Research Funding Foundation (FAPEMIG- APQ-00957-22), Coordination for the Improvement of Higher Education Personnel (CAPES-001), and National Council for Scientific and Technological Development (CNPq–302560/2021-1).

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the University Ethics Committee on the Use of Human Subjects approved the study (Number CAAE: 82691818.0.0000.5154).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

http://bdtd.uftm.edu.br/handle/123456789/1316, accessed on 27 November 2022.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. (INCA) BNCI. Estimativa 2020: Incidência de Câncer no Brasil; Instituto Nacional de Cáncer: Rio de Janeiro, Brazil, 2020. [Google Scholar]
  2. American Cancer Society. Cancer Facts & Figures 2022; American Cancer Society: Atlanta, GA, USA, 2022. [Google Scholar]
  3. Hewitt, M.; Rowland, J.H.; Yancik, R. Cancer survivors in the United States: Age, health, and disability. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 2003, 58, 82–91. [Google Scholar]
  4. Brown, J.; Harhay, M.; Harhay, M. Physical function as a prognostic biomarker among cancer survivors. Br. J. Cancer 2015, 112, 194. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  5. Mehta, R.R.; Beattie, C.W.; Gupta, T.K.D. Endocrine profile in breast cancer patients receiving chemotherapy. Breast Cancer Res. Treat. 1991, 20, 125–132. [Google Scholar] [CrossRef] [PubMed]
  6. Dieli-Conwright, C.; Wong, L.; Waliany, S.; Bernstein, L.; Salehian, B.; Mortimer, J. An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy. Cancer 2016, 122, 2646–2653. [Google Scholar] [PubMed]
  7. Taillibert, S.; Le Rhun, E.; Chamberlain, M.C. Chemotherapy-related neurotoxicity. Curr. Neurol. Neurosci. Rep. 2016, 16, 81. [Google Scholar] [CrossRef]
  8. Lacourt, T.E.; Heijnen, C.J. Mechanisms of neurotoxic symptoms as a result of breast cancer and its treatment: Considerations on the contribution of stress, inflammation, and cellular bioenergetics. Curr. Breast Cancer Rep. 2017, 9, 70–81. [Google Scholar] [CrossRef] [Green Version]
  9. Ferrucci, L.; Cooper, R.; Shardell, M.; Simonsick, E.; Schrack, J.; Kuh, D. Age-Related Change in Mobility: Perspectives From Life Course Epidemiology and Geroscience. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 2016, 71, 1184–1194. [Google Scholar] [CrossRef] [Green Version]
  10. Whitson, H.E.; Duan-Porter, W.; Schmader, K.E.; Morey, M.C.; Cohen, H.J.; Colón-Emeric, C.S. Physical resilience in older adults: Systematic review and development of an emerging construct. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 2016, 71, 489–495. [Google Scholar] [CrossRef] [Green Version]
  11. Hadley, E.C.; Kuchel, G.A.; Newman, A.B. Report: NIA workshop on measures of physiologic resiliencies in human aging. J. Gerontol. Ser. A 2017, 72, 980–990. [Google Scholar] [CrossRef] [Green Version]
  12. LeBrasseur, N.K. Physical resilience: Opportunities and challenges in translation. J. Gerontol. Ser. A 2017, 72, 978–979. [Google Scholar]
  13. Chhetri, J.K.; Xue, Q.-L.; Ma, L.; Chan, P.; Varadhan, R. Intrinsic capacity as a determinant of physical resilience in older adults. J. Nutr. Health Aging 2021, 25, 1006–1011. [Google Scholar] [CrossRef] [PubMed]
  14. Varadhan, R.; Walston, J.D.; Bandeen-Roche, K. Can physical resilience and frailty in older adults be linked by the study of dynamical systems? J. Am. Geriatr. Soc. 2018, 66, 1455. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  15. Ristevska-Dimitrovska, G.; Filov, I.; Rajchanovska, D.; Stefanovski, P.; Dejanova, B. Resilience and quality of life in breast cancer patients. Open Access Maced. J. Med. Sci. 2015, 3, 727. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  16. Duan-Porter, W.; Cohen, H.J.; Demark-Wahnefried, W.; Sloane, R.; Pendergast, J.F.; Snyder, D.C.; Morey, M.C. Physical resilience of older cancer survivors: An emerging concept. J. Geriatr. Oncol. 2016, 7, 471–478. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  17. Hurria, A.; Soto-Perez-de-Celis, E.; Allred, J.B.; Cohen, H.J.; Arsenyan, A.; Ballman, K.; Le-Rademacher, J.; Jatoi, A.; Filo, J.; Mandelblatt, J.; et al. Functional decline and resilience in older women receiving adjuvant chemotherapy for breast cancer. J. Am. Geriatr. Soc. 2019, 67, 920–927. [Google Scholar] [CrossRef] [Green Version]
  18. Reuben, D.B.; Valle, L.A.; Hays, R.D.; Siu, A.L. Measuring physical function in community-dwelling older persons: A comparison of self-administered, interviewer-administered, and performance-based measures. J. Am. Geriatr. Soc. 1995, 43, 17–23. [Google Scholar] [CrossRef]
  19. Seymour, D.G.; Ball, A.E.; Russell, E.M.; Primrose, W.R.; Garratt, A.M.; Crawford, J.R. Problems in using health survey questionnaires in older patients with physical disabilities. The reliability and validity of the SF-36 and the effect of cognitive impairment. J. Eval. Clin. Pract. 2001, 7, 411–418. [Google Scholar] [CrossRef] [Green Version]
  20. Jones, T.L.; Baxter, M.A.; Khanduja, V. A quick guide to survey research. Ann. R. Coll. Surg. Engl. 2013, 95, 5–7. [Google Scholar] [CrossRef]
  21. Schrack, J.A.; Simonsick, E.M.; Ferrucci, L. The relationship of the energetic cost of slow walking and peak energy expenditure to gait speed in mid-to-late life. Am. J. Phys. Med. Rehabil. 2013, 92, 28–35. [Google Scholar] [CrossRef] [Green Version]
  22. Soares, W.; Lima, C.; Ferrioli, E.; Dias, R.C.; Perracini, M.R. The relationship between gait speed, functional reserve and frailty in community dwelling older adults. Physiotherapy 2015, 101, e1416. [Google Scholar] [CrossRef] [Green Version]
  23. Belsky, D.W.; Caspi, A.; Houts, R.; Cohen, H.J.; Corcoran, D.L.; Danese, A.; Harrington, H.; Israel, S.; Levine, M.E.; Schaefer, J.D.; et al. Quantification of biological aging in young adults. Proc. Natl. Acad. Sci. USA 2015, 112, E4104–E4110. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  24. Verweij, N.M.; Schiphorst, A.H.W.; Pronk, A.; van den Bos, F.; Hamaker, M.E. Physical performance measures for predicting outcome in cancer patients: A systematic review. Acta Oncol. 2016, 55, 1386–1391. [Google Scholar] [CrossRef] [PubMed]
  25. Sehl, M.; Lu, X.; Silliman, R.; Ganz, P.A. Decline in physical functioning in first 2 years after breast cancer diagnosis predicts 10-year survival in older women. J. Cancer Surviv. Res. Pract. 2013, 7, 20–31. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  26. Beaudart, C.; Rolland, Y.; Cruz-Jentoft, A.J.; Bauer, J.M.; Sieber, C.; Cooper, C.; Al-Daghri, N.; de Carvalho, I.A.; Bautmans, I.; Bernabei, R.; et al. Assessment of muscle function and physical performance in daily clinical practice: A position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Calcif. Tissue Int. 2019, 105, 1–14. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  27. Studenski, S.; Perera, S.; Wallace, D.; Chandler, J.M.; Duncan, P.W.; Rooney, E.; Fox, M.; Guralnik, J.M. Physical performance measures in the clinical setting. J. Am. Geriatr. Soc. 2003, 51, 314–322. [Google Scholar] [CrossRef] [Green Version]
  28. Forte, R.; Macaluso, A. Relationship between performance-based and laboratory tests for lower-limb muscle strength and power assessment in healthy older women. J. Sport. Sci. 2008, 26, 1431–1436. [Google Scholar] [CrossRef]
  29. Steffen, T.M.; Hacker, T.A.; Mollinger, L. Age-and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys. Ther. 2002, 82, 128–137. [Google Scholar]
  30. Bohannon, R.W.; Shove, M.E.; Barreca, S.; Masters, L.M.; Sigouin, C. Five-repetition sit-to-stand test performance by community-dwelling adults: A preliminary investigation of times, determinants, and relationship with self-reported physical performance. Isokinet. Exerc. Sci. 2007, 15, 77–81. [Google Scholar] [CrossRef]
  31. Kim, H.-J.; Park, I.; Lee, H.J.; Lee, O. The reliability and validity of gait speed with different walking pace and distances against general health, physical function, and chronic disease in aged adults. J. Exerc. Nutr. Biochem. 2016, 20, 46. [Google Scholar] [CrossRef]
  32. Schurr, K.; Sherrington, C.; Wallbank, G.; Pamphlett, P.; Olivetti, L. The minimum sit-to-stand height test: Reliability, responsiveness and relationship to leg muscle strength. Clin. Rehabil. 2012, 26, 656–663. [Google Scholar] [CrossRef]
  33. Fiser, W.M.; Hays, N.P.; Rogers, S.C.; Kajkenova, O.; Williams, A.E.; Evans, C.M.; Evans, W.J. Energetics of walking in elderly people: Factors related to gait speed. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 2010, 65, 1332–1337. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  34. Podsiadlo, D.; Richardson, S. The timed “Up & Go”: A test of basic functional mobility for frail elderly persons. J. Am. Geriatr. Soc. 1991, 39, 142–148. [Google Scholar] [PubMed]
  35. Trommelen, R.D.; Buttone, L.F.; Dicharry, D.Z.; Jacobs, R.M.; Karpinski, A. The use of five repetition sit to stand test (FRSTST) to assess fall risk in the assisted living population. Phys. Occup. Ther. Geriatr. 2015, 33, 152–162. [Google Scholar] [CrossRef]
  36. Shumway-Cook, A.; Brauer, S.; Woollacott, M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys. Ther. 2000, 80, 896–903. [Google Scholar]
  37. Guralnik, J.M.; Simonsick, E.M.; Ferrucci, L.; Glynn, R.J.; Berkman, L.F.; Blazer, D.G.; Scherr, P.A.; Wallace, R.B. A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. J. Gerontol. 1994, 49, M85–M94. [Google Scholar] [CrossRef]
  38. Whitney, S.L.; Wrisley, D.M.; Marchetti, G.F.; Gee, M.A.; Redfern, M.S.; Furman, J.M. Clinical measurement of sit-to-stand performance in people with balance disorders: Validity of data for the Five-Times-Sit-to-Stand Test. Phys. Ther. 2005, 85, 1034–1045. [Google Scholar] [CrossRef] [Green Version]
  39. Sullard, C.B. An Assessment of Body Composition, Balance, and Muscular Strength and Endurance in Breast Cancer Survivors. Bachelor’s Thesis, Wichita State University, Wichita, KS, USA, 2011. [Google Scholar]
  40. Santagnello, S.B.; Martins, F.M.; de Oliveira, G.N., Jr.; de Sousa, J.d.F.R.; Nomelini, R.S.; Murta, E.F.C.; Orsatti, F.L. Resistance Training–Induced Gains in Muscle Strength and Power Mediate the Improvement in Walking Speed in Middle-Aged Women Who Are Breast Cancer Survivors. J. Strength Cond. Res. 2021. Available online: https://journals.lww.com/nsca-jscr/Abstract/9000/Resistance_Training_Induced_Gains_in_Muscle.94023.aspx (accessed on 27 November 2022). [CrossRef]
  41. González, P.M.; Cofré, R.M.; Cabello, M.E. Functional reserve in functionally independent elderly persons: A calculation of gait speed and physiological cost. Rev. Bras. Geriatr. Gerontol. 2016, 19, 577–589. [Google Scholar] [CrossRef] [Green Version]
  42. Fitzpatrick, A.L.; Buchanan, C.K.; Nahin, R.L.; Dekosky, S.T.; Atkinson, H.H.; Carlson, M.C.; Williamson, J.D.; Ginkgo Evaluation of Memory (GEM) Study Investigators. Associations of gait speed and other measures of physical function with cognition in a healthy cohort of elderly persons. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 2007, 62, 1244–1251. [Google Scholar] [CrossRef] [Green Version]
  43. Owusu, C.; Margevicius, S.; Schluchter, M.; Koroukian, S.M.; Berger, N.A. Short Physical Performance Battery, usual gait speed, grip strength and Vulnerable Elders Survey each predict functional decline among older women with breast cancer. J. Geriatr. Oncol. 2017, 8, 356–362. [Google Scholar] [CrossRef]
  44. Afilalo, J. Frailty in patients with cardiovascular disease: Why, when, and how to measure. Curr. Cardiovasc. Risk Rep. 2011, 5, 467. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  45. Waite, L.M.; Grayson, D.A.; Piguet, O.; Creasey, H.; Bennett, H.P.; Broe, G.A. Gait slowing as a predictor of incident dementia: 6-year longitudinal data from the Sydney Older Persons Study. J. Neurol. Sci. 2005, 229, 89–93. [Google Scholar] [CrossRef] [PubMed]
  46. Robinson, T.N.; Wu, D.S.; Sauaia, A.; Dunn, C.L.; Stevens-Lapsley, J.E.; Moss, M.; Stiegmann, G.V.; Gajdos, C.; Cleveland, J.C., Jr.; Inouye, S.K. Slower walking speed forecasts increased postoperative morbidity and one-year mortality across surgical specialties. Ann. Surg. 2013, 258, 582. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  47. Veronese, N.; Stubbs, B.; Volpato, S.; Zuliani, G.; Maggi, S.; Cesari, M.; Lipnicki, D.M.; Smith, L.; Schofield, P.; Firth, J.; et al. Association between gait speed with mortality, cardiovascular disease and cancer: A systematic review and meta-analysis of prospective cohort studies. J. Am. Med. Dir. Assoc. 2018, 19, 981–988.e7. [Google Scholar] [CrossRef] [PubMed]
  48. Studenski, S.; Perera, S.; Patel, K.; Rosano, C.; Faulkner, K.; Inzitari, M.; Brach, J.; Chandler, J.; Cawthon, P.; Connor, E.B.; et al. Gait speed and survival in older adults. JAMA 2011, 305, 50–58. [Google Scholar] [CrossRef] [Green Version]
  49. Gijzel, S.M.W.; Whitson, H.E.; van de Leemput, I.A.; Scheffer, M.; van Asselt, D.; Rector, J.L.; Rikkert, M.G.M.O.; Melis, R.J.F. Resilience in clinical care: Getting a grip on the recovery potential of older adults. J. Am. Geriatr. Soc. 2019, 67, 2650–2657. [Google Scholar] [CrossRef] [Green Version]
  50. Pamoukdjian, F.; Lévy, V.; Sebbane, G.; Boubaya, M.; Landre, T.; Bloch-Queyrat, C.; Paillaud, E.; Zelek, L. Slow gait speed is an independent predictor of early death in older cancer outpatients: Results from a prospective cohort study. J. Nutr. Health Aging 2017, 21, 202–206. [Google Scholar] [CrossRef]
  51. Deuster, P.A.; Silverman, M.N. Physical fitness: A pathway to health and resilience. US Army Med. Dep. J. 2013. Available online: https://pubmed.ncbi.nlm.nih.gov/24146240/ (accessed on 27 November 2022).
  52. MacLeod, S.; Musich, S.; Hawkins, K.; Alsgaard, K.; Wicker, E.R. The impact of resilience among older adults. Geriatr. Nurs. 2016, 37, 266–272. [Google Scholar] [CrossRef] [Green Version]
  53. Vandervoort, A.A.; McComas, A.J. Contractile changes in opposing muscles of the human ankle joint with aging. J. Appl. Physiol. (Bethesda Md. 1985) 1986, 61, 361–367. [Google Scholar] [CrossRef]
  54. Clark, B.C.; Taylor, J.L. Age-related changes in motor cortical properties and voluntary activation of skeletal muscle. Curr. Aging Sci. 2011, 4, 192–199. [Google Scholar] [CrossRef] [PubMed]
  55. Rier, H.N.; Jager, A.; Sleijfer, S.; van Rosmalen, J.; Kock, M.C.J.M.; Levin, M.-D. Changes in body composition and muscle attenuation during taxane-based chemotherapy in patients with metastatic breast cancer. Breast Cancer Res. Treat. 2018, 168, 95–105. [Google Scholar] [CrossRef]
  56. Freire, A.N.; Guerra, R.O.; Alvarado, B.; Guralnik, J.M.; Zunzunegui, M.V. Validity and reliability of the short physical performance battery in two diverse older adult populations in Quebec and Brazil. J. Aging Health 2012, 24, 863–878. [Google Scholar] [CrossRef] [PubMed]
  57. Goldberg, A.; Chavis, M.; Watkins, J.; Wilson, T. The five-times-sit-to-stand test: Validity, reliability and detectable change in older females. Aging Clin. Exp. Res. 2012, 24, 339–344. [Google Scholar] [CrossRef] [PubMed]
  58. Rosenberg, D.E.; Bull, F.C.; Marshall, A.L.; Sallis, J.F.; Bauman, A.E. Assessment of sedentary behavior with the International Physical Activity Questionnaire. J. Phys. Act. Health 2008, 5, S30–S44. [Google Scholar] [CrossRef] [PubMed]
  59. Garber, C.E.; Blissmer, B.; Deschenes, M.R.; Franklin, B.A.; Lamonte, M.J.; Lee, I.-M.; Nieman, D.C.; Swain, D.P.; American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Med. Sci. Sport. Exerc. 2011, 43, 1334–1359. [Google Scholar] [CrossRef]
  60. World Health Organization. Obesity: Preventing and Managing the Global Epidemic; World Health Organization: Geneva, Switzerland, 2000.
  61. De Almeida Marques, R.; de Souza, V.F.; Rosario, T.C.; da Silva Garcia, M.R.P.; Pereira, T.S.S.; Marques-Rocha, J.L.; Guandalini, V.R. Agreement between maximum and mean handgrip strength measurements in cancer patients. PLoS ONE 2022, 17, e0270631. [Google Scholar] [CrossRef]
  62. Kon, S.S.C.; Patel, M.S.; Canavan, J.L.; Clark, A.L.; Jones, S.E.; Nolan, C.M.; Cullinan, P.; Polkey, M.I.; Man, W.D.-C. Reliability and validity of 4-metre gait speed in COPD. Eur. Respir. J. 2013, 42, 333–340. [Google Scholar] [CrossRef]
  63. Muñoz-Bermejo, L.; Adsuar, J.C.; Mendoza-Muñoz, M.; Barrios-Fernández, S.; Garcia-Gordillo, M.A.; Pérez-Gómez, J.; Carlos-Vivas, J. Test-retest reliability of five times sit to stand test (FTSST) in adults: A systematic review and meta-analysis. Biology 2021, 10, 510. [Google Scholar] [CrossRef]
Table
Table 1. Comparison of general characteristics, marital status, education attainment, physical activity status, cancer treatment and medical treatment between groups.
Table 1. Comparison of general characteristics, marital status, education attainment, physical activity status, cancer treatment and medical treatment between groups.
CT
(n = 69)		<1 YAT
(n = 60)		1–3.9 YAT
(n = 45)		≥4 YAT
(n = 41)		p
General characteristics
Age (years)58.5 (56.6; 60.4)57.1 (54.9; 59.3)55.9 (53.2; 58.6)59.4 (56.9; 61.9)0.216
BMI (kg/m2)27.9 (26.6; 29.2)28.5 (27.2; 29.9)26.9 (24.9; 29.0)27.2 (26.1; 28.3)0.406
Menopause (%)94.2 (n = 65)83.3 (n = 50)86.6 (n = 39)100.0 (n = 41)0.302
Smoker (%)13.0 (n = 9)11.6 (n = 7)17.7 (n = 8)2.4 (n = 1)0.263
Marital status
Single (%)17.3 (n = 12)18.3 (n = 11)17.7 (n = 13)9.7 (n = 4)0.933
Married (%)42.0 (n = 29)48.3 (n = 29)44.4 (n = 20)53.6 (n = 22)0.321
Divorced (%)15.9 (n = 11)20.0 (n = 12)11.1 (n = 5)17.0 (n = 7)0.977
Widow (%)24.6 (n = 17)13.3 (n = 8)15.5 (n = 7)19.5 (n = 8)0.373
Education attainment
Complete elementary school (%)53.6 (n = 37)51.6 (n = 31)53.3 (n = 24)60.9 (n = 25)0.751
Complete high school (%)34.7 (n = 24)25.0 (n = 15)28.8 (n = 13)19.5 (n = 8)0.337
College graduated (%)11.5 (n = 8)23.3 (n = 14)17.7 (n = 8)19.5 (n = 8)0.329
Physical activity status
Physical activity level (min/Week)808.8 (609.4; 1008.2)699.1 (504.6; 893.6)649.5 (487.8; 811.8)663.4 (467.6; 859.2)0.648
Active (%)69.5 (n = 48)66.6 (n = 40)68.8 (n = 31)65.8 (n = 27)0.155
Walking (min/Week)43.9 (17.4; 37.0)27.2 (17.4; 37.0)32.5 (19.8; 45.1)43.9 (29.2; 58.6)0.266
Walking (%)75.3 (n = 52)65.0 (n = 39)71.1 (n = 32)73.1 (n = 30)0.862
Moderate physical activity (min/Week)104.8 (77.4; 132.2)84.2 (60.9; 107.5)122.2 (74.5; 149.8)91.2 (64.5; 117.9)0.533
Moderate physical activity (%)78.2 (n = 54)76.6 (n = 46)82.2 (n = 37)85.3 (n = 35)0.310
Vigorous physical activity (%)17.3 (n = 12)15.0 (n = 9)13.3 (n = 6)17.0 (n = 7)0.843
Treatment of cancer ¥
Surgery (%)******100.0 (n = 60)100.0 (n = 45)100.0 (n = 41)1.000
Quadrantectomy surgical (%)******50.0 (n = 30)62.2 (n = 28)48.7 (n = 20)0.440
Mastectomy surgical (%)******1.6 (n = 1)0.0 (n = 0)2.4 (n = 1)0.822
Quadrantectomy and axillary dissection (%)******8.3 (n = 5)8.8 (n = 4)7.3 (n = 3)0.914
Mastectomy and axillary dissection (%)******3.3 (n = 2)2.2 (n = 1)4.8 (n = 2)0.247
Chemotherapy (session)******31.4 (30.3; 32.6)31.8 (29.2; 34.4)29.6 (27.3; 32.0)0.434
Radiotherapy (session)******8.8 (7.5; 10.0)8.3 (7.2; 9.3)7.6 (6.3; 8.9)0.348
Chemotherapy (n)******10.0 (n = 6)4.4 (n = 2)19.5 (n = 8)0.193
Radiotherapy (n)******28.3 (n = 17)35.5 (n = 16)34.1 (n = 14)0.502
Radiotherapy and Chemotherapy (n)******61.6 (n = 37)60.0 (n = 27)46.3 (n = 19)0.145
End-of-treatment (years)******0.7 (0.6; 0.9)2.75 (2.5; 2.9) #7.02 (6.1; 7.8) # †<0.001
Medical treatment
Depression drug (%)17.3 (n = 12)28.3 (n = 17)26.6 (n = 12)29.2 (n = 12)0.166
Hypertension drug (%)33.3 (n = 23)35.0 (n = 21)33.3 (n = 15)39.0 (n = 16)0.626
Diabetes drug (%)8.6 (n = 6)6.6 (n = 4)15.5 (n = 7)7.3 (n = 3)0.773
Thyroid drug (%)11.5 (n = 8)8.3 (n = 5)6.6 (n = 3)12.1 (n = 5)0.890
Hypercholesterolemia drug (%)21.7 (n = 15)21.6(n = 13)15.5 (n = 7)26.8 (n = 11)0.643
Tamoxifen drug ¥ (%)******41.6 (n = 25)51.1 (n = 23)60.9 (n = 25)0.057
Anastrazole drug ¥ (%)******16.6 (n = 10)26.6 (n = 12)17.0 (n = 7)0.394
Number of medications (n)1.8 (1.3; 2.2)1.8 (1.3; 2.3)1.9 (1.3; 2.4)2.0 (1.5; 2.6)0.845
CT = control group; <1 YAT = <1 year after the end of treatment group; 1–3.9 YAT = 1–3.9 years after the end of treatment group; ≥4 YAT = ≥4 years after the end of treatment group; BMI = body mass index; # = significantly different from <1 YAT; † = significantly different from 1–3.9 YAT; ¥ = the control group was excluded from the statistical analysis. Active (%) = the percentage of people who meet physical activity guideline/cut-off (at least 150 min of mild physical activity per week and/or at least 75 min of strenuous physical activity per week). Moderate physical activity (%) = the percentage of people who have engaged in moderate physical activity, regardless of the overall amount of physical activity they performed. Vigorous physical activity (%) = the percentage of people who have engaged in vigorous physical activity, regardless of the overall amount of physical activity they performed.
Table
Table 2. Comparison of physical function between groups.
Table 2. Comparison of physical function between groups.
CT
(n = 69)		<1 YAT
(n = 60)		1–3.9 YAT
(n = 45)		≥4 YAT
(n = 41)		pη2pOP
Unadjusted Values
4-MWT (m.s)1.2 (1.1; 1.3)1.1 (1.0; 1.1) *1.1 (1.0; 1.1) *1.0 (1.0; 1.1) *0.0010.080.96
FTSST (s)8.7 (7.9; 9.5)12.1 (11.4; 12.9) *11.4 (10.5; 12.4) *11.2 (10.3; 12.0) *<0.0010.171.00
SPPB (score)11.4 (11.2; 11.7)10.9 (10.5; 11.2) *11.1 (10.8; 11.4)10.7 (10.2; 11.2) *0.0230.040.75
TUG (s)6.9 (6.5; 7.4)8.6 (8.2; 9.1) *8.4 (7.9; 9.0) *8.2 (7.6; 8.8) *<0.0010.130.99
MS (kg)25.5 (24.1; 26.9)24.1 (22.6; 25.6)22.7 (21.1; 24.4) *25.8 (24.0; 27.5)0.0350.030.67
Adjusted Values
4-MWT (m.s)1.2 (1.2; 1.3)1.1 (1.0; 1.2) *1.1 (1.0; 1.2) *1.0 (0.9; 1.1) *<0.0010.130.99
FTSST (s)8.6 (7.9; 9.3)11.9 (11.1; 12.7) *11.1 (10.2; 12.0) *11.8 (10.8; 12.7) *<0.0010.211.00
SPPB (score)11.5 (11.2; 11.8)10.9 (10.6; 11.2) *11.2 (10.8; 11.5)10.8 (10.5; 11.2) *0.0050.070.87
TUG (s)6.9 (6.6; 7.3)8.4 (8.0; 8.9) *8.2 (7.7; 8.7) *8.3 (7.8; 8.8) *<0.0010.160.99
MS (kg)25.8 (24. 4; 27.1)23.7 (22.2; 25.2)22.6 (20.9; 24.3) *26.7 (25.0; 28.5) †0.0030.070.89
CT = control group; <1 YAT = <1 year after the end of treatment group; 1–3.9 YAT = 1–3.9 years after the end of treatment group; ≥4 YAT = ≥4 years after the end of treatment group; BMI = body mass index; 4-MWT = 4 m walk test; FTSST = five-times-sit-to-stand test; TUG = timed up and go test; SPPB = short physical performance battery; MS = muscle strength; * = significantly different from CT; † = significantly different from 1–3.9 YAT; ANCOVA adjusted for age, menopause, smoking, number of medications, BMI and level of physical activity, and MS (except for MS analysis); η2p = partial eta-squared; OP = observed power.
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Martins, F.M.; de Oliveira, A.A.; Oliveira-Júnior, G.; Carneiro, M.A.S.; de Souza, L.R.M.F.; Lara, V.C.; Nomelini, R.S.; Assumpção, C.O.; Souza, M.V.C.; Orsatti, F.L. Physical Function Tests Are Potential Tools to Identify Low Physical Resilience in Women after Breast Cancer Treatment. Muscles 2023, 2, 97-108. https://doi.org/10.3390/muscles2010009

AMA Style

Martins FM, de Oliveira AA, Oliveira-Júnior G, Carneiro MAS, de Souza LRMF, Lara VC, Nomelini RS, Assumpção CO, Souza MVC, Orsatti FL. Physical Function Tests Are Potential Tools to Identify Low Physical Resilience in Women after Breast Cancer Treatment. Muscles. 2023; 2(1):97-108. https://doi.org/10.3390/muscles2010009

Chicago/Turabian Style

Martins, Fernanda Maria, Anselmo Alves de Oliveira, Gersiel Oliveira-Júnior, Marcelo A. S. Carneiro, Luís Ronan Marquez Ferreira de Souza, Vitor Carvalho Lara, Rosekeila Simões Nomelini, Cláudio Oliveira Assumpção, Markus Vinícius Campos Souza, and Fábio Lera Orsatti. 2023. "Physical Function Tests Are Potential Tools to Identify Low Physical Resilience in Women after Breast Cancer Treatment" Muscles 2, no. 1: 97-108. https://doi.org/10.3390/muscles2010009

APA Style

Martins, F. M., de Oliveira, A. A., Oliveira-Júnior, G., Carneiro, M. A. S., de Souza, L. R. M. F., Lara, V. C., Nomelini, R. S., Assumpção, C. O., Souza, M. V. C., & Orsatti, F. L. (2023). Physical Function Tests Are Potential Tools to Identify Low Physical Resilience in Women after Breast Cancer Treatment. Muscles, 2(1), 97-108. https://doi.org/10.3390/muscles2010009

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