Cancer Cachexia Rehabilitation in a Novel Outpatient Clinical Program

ABSTRACT: Cancer cachexia is a tumor-induced muscle wasting syndrome that has a debilitating impact on patient functional status, quality of life, and cancer prognosis. This brief report summarizes a retrospective cohort study that aims to describe the oncological histories, functional co-impairments, therapy referral patterns, and physical therapy outcomes of 163 patients who were evaluated at a novel physiatry-led outpatient cancer cachexia clinic (2021-2023). Forty-nine percent of the cohort that met Fearon consensus criteria for cachexia demonstrated increased odds of experiencing multiple impairments (OR = 7.4, P < 0.0001), specifically gluteal weakness (OR = 2.6, P = 0.0078), and 4 times the odds of receiving a walking program intervention (OR = 4.1, P = 0.0004). Physical therapy was prescribed for 71% of the cohort, with no significant difference between cachexia and noncachexia groups in physical therapy order frequency (OR = 0.9, P = 0.7307) or physical therapy initiation (OR = 0.8, P = 0.5419). However, cachexia patients trended toward lower odds of meeting physical therapy long-term goals or having these goals reassessed (OR = 0.2, P = 0.0032). This study highlights cachexia prevalence, rehabilitation challenges, and the need for standardized, evidence-based treatment protocols. Gluteal weakness assessment may improve referrals to cachexia rehabilitation.