Objective: This study investigated the impact of rehabilitation modalities on the maintenance of walking ability in terminally ill cancer patients admitted to a palliative care unit (PCU). Methods: We retrospectively analyzed patients who died in our PCU between April 2020 and March 2024. Eligible patients were those who remained ambulatory during admission and received physical or occupational therapy. Based on the content of rehabilitation, patients were categorized into an Exercise group (Ex group), who engaged in dynamic tasks such as walking and stair climbing, and a Bedside group (BS group), who primarily underwent bed-based training with little or no dynamic activity. The primary outcome was the duration until loss of toileting ambulation, defined as the ability to walk independently to the in-room toilet. Group differences were evaluated using Kaplan–Meier analysis, log-rank tests, and Cox proportional hazards models. Results: Patients in the Ex group demonstrated a significantly longer duration of preserved ambulation compared with those in the BS group (median 30.0 days vs 20.5 days, log-rank p=0.002). Multivariate Cox regression further indicated that the Ex group had a substantially reduced risk of ambulation loss (hazard ratio 0.50, 95% confidence interval 0.33–0.77, p=0.001). Conclusion: Active rehabilitation that incorporates dynamic movement practice was associated with prolonged preservation of walking ability in terminally ill cancer patients. These findings underscore the potential role of structured rehabilitation in sustaining mobility, autonomy, and quality of life during the final stage of illness.

OBJECTIVESMetabolic rate is affected not solely by diet but also by environmental characteristics such as climate and seasonal changes in day length. In the present study, we conducted a controlled study in which we observed metabolic response to short-term energy restriction (ER).

MATERIALS AND METHODSThirty-two subjects were divided randomly into a slight ER group and a moderate ER group. The energy intake per day for slight ER vs moderate ER was 1462 kcal vs 1114 kcal. During the 4-day study periods, the same daily timetable, which consists of nutrition, exercise, sleeping and others, was imposed on both groups. The same environment was also provided to both groups.

RESULTSAfter the 4-day ER, significant decreases in body weight and basal metabolic rate (BMR) were shown in both groups. The decrease in body weight was 2% of the baseline level in both groups, and the decreases in the BMR were 6% of baseline levels in the slight ER group and 13% in the moderate ER group. The decrease in BMR in the moderate ER group was significantly larger than that in the slight ER group.

CONCLUSIONSIn a controlled study of short-term ER, we observed a significant decrease in BMR. There was a positive association between the degree of ER and the reduction in BMR. Reductions in BMR were greater than those in body weight. It, thus, appears that the minimization of weight loss is due to dramatic decreases in BMR. This suggests the existence of metabolic resistance against ER.