Interplay between mobility, social participation, and symptom burden in advanced lung cancer

Advanced non-small cell lung cancer (NSCLC) is associated with a high symptom burden that negatively impacts daily functioning and quality of life. A better understanding of the time course and relationships between these constructs can help tailor rehabilitation interventions in the context of disease progression. The objectives were to describe and compare the trajectories in mobility, participation, and symptom burden and to assess associations and explore predictors of mobility change.

Secondary data analysis of a longitudinal cohort study of 110 participants with NSCLC. Mobility and participation were measured using the WHODAS 2.0 subdomains, and symptom burden was measured using the POS-S. Data at baseline, 2, 4, and 6 months were analysed using repeated measures ANOVA and regression models. Change scores were compared over time, and multiple linear regression identified predictors of mobility change.

Overall, mobility and symptom burden remained stable, whilst participation scores showed improvement at 4 and 6 months (p < 0.05). Both improvements and declines in mobility status were correlated with changes in participation (r = 0.297-0.462, p < 0.001) and symptom burden (r = 0.151-0.368, p < 0.05). Baseline symptom burden was a significant predictor of mobility change, even after adjusting for demographic and clinical variables (p = 0.003).

Improvements in participation despite stable mobility and symptom burden suggest an adaptive response and/or benefit from care. Mobility, related to both symptom burden and participation, offers a functional indicator that could be used to focus rehabilitation in advanced NSCLC.