Therapeutic validity and effectiveness of exercise interventions after lower limb-salvage surgery for sarcoma: a systematic review

van Kouswijk, H. W.; van Keeken, H. G.; Ploegmakers, J. J. W.; Seeber, G. H.; van den Akker-Scheek, I.

doi:10.1186/s12891-023-06315-y

Table 3 Summary of the included studies (n = 7)

From: Therapeutic validity and effectiveness of exercise interventions after lower limb-salvage surgery for sarcoma: a systematic review

Study, Year Country Design	N	Sex (% F)	Age (y)	BMI (kg/m²)	Tumour description (n)^a	Surgery type (n)^b; Resection amplitude (cm)	Complications (% of N)	Outcome measures^c
Study, Year Country Design	N	Sex (% F)	Age (y)	BMI (kg/m²)	Tumour description (n)^a	Surgery type (n)^b; Resection amplitude (cm)	Complications (% of N)	Joint and muscle function	Functional performance	Other
Morri 2018 [31] Italy Cross-sectional	IG: 30	33	19 (9–60)	NR	Primary OS (25) or ES (55) in DF (19) and PT (11)	MKP (30); 14.5 (11–30)	30	• Knee ROM^e • Quadriceps strength (MRC scale)^e	• TESS^e • TUG^f • 6mWT^e
Morri 2018 [32] Italy Cross-sectional	IG: 27	33	19 (9–60)	22 (14–34)	Primary OS/SCS (22) or ES (5) in DF (19) or PT (8)	MKP (27); NR	30		• MSTS^e	• Compliance^e • NRS satisfaction^e
Morri 2019 [33] Italy CCT	IG: 22 CG: 15	IG: 23 CG: 33	IG: 21 (30) CG: 21 (15)	NR	Primary OS (31) or CS/ES (6) in DF (27) or PT (10)	MKP (37); IG: 15 (9) CG: 15 (7)	IG: 14 CG: 27	• Knee ROM^e • Quadriceps strength (MRC scale)^e	• MSTS^e • TESS^e • TUG^f • 6mWT^e • 10mWT^e	• CoM speed^f
Pitera 2017 [34] Poland Cross-sectional	IG: 42	55	63 ± 11	NR	Primary or metastatic GCT (1), LS (1), or NR (40) in PF (13) or NR (29)	C-MPFP (36), UC-MPFP (8); NR (8–26)	14		• MSTS^e • HHS^e • Custom system^e	• VAS-pain^f
Shehadeh 2013 [35] Jordan Cross-sectional	IG: 59	46	24 (5–60)	NR	Primary or metastatic OS (28), ES (13), CS (5), or other (13) in PF (6), DF (21), PF and DF (2), TF (2), or other (14)	Endoprosthesis (49), bone graft (5), or no replacement (5); NR	12		• MSTS-ISOLS^e
Tsauo 2006 [36] Taiwan Cross-sectional	IG: 20 CG: 20^d	NR	IG: 22 ± 7 CG: 22 ± 7	NR	IG: In DF (13) or PT (7) CG: NA	MKP (20); DF: 16 ± 4 PT: 16 ± 2	NR	• Knee ROM^e • Isokinetic knee muscle strength^e	• MSTS^e • Gait evaluation
Zhang 2016 [37] China RCT	IG: 30 CG: 30	IG: 40 CG: 27	IG: 25 ± 6 CG: 24 ± 8	NR	Primary OS (42), GCT (14) or ES (2), in DF (26), PT (16), or NR (18), Enneking grade I or II	MKP (60); NR	NR	• Knee ROM^e	• First time off bed^f • HSS^e	• Compliance^e • Grade-A wound recovery^e

‘Age’ and ‘Resection amplitude’ are shown as median (range or IQR), or mean ± SD
CG control group, IG intervention group, NA not applicable, NR not reported, CCT clinical controlled trial, RCT randomised controlled trial
^aOS, osteosarcoma; ES, Ewing sarcoma; SCS, spindle cell sarcoma; CS, chondrosarcoma; GCT, giant cell tumour; LS, leiomyosarcoma; DF, distal femur; PF, proximal femur; PT, proximal tibia; TF, total femur
^bMKP, modular knee prosthesis; C-MPFP, cemented modular proximal femur prosthesis; UC-MPFP, uncemented modular proximal femur prosthesis
^cROM, range of motion; MRC, medical research council; MSTS, musculoskeletal tumour society; TESS, Toronto extremity salvage score; TUG, timed up-and-go; 6mWT, 6-min walk test; 10mWT, 10-m walk test; HHS, Harris hip score; ISOLS, International Society of Limb Salvage; HSS, hospital for special surgery knee score; NRS, numeric rating scale; CoM, centre of mass; VAS, visual analogue scale
^dControl group consisted of healthy controls
^eHigher scores indicate better performance
^fLower scores indicate better performance

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ISSN: 1471-2474

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