Dear Editor,
We read with interest the article by Dilektasli et al. [1], which examined the relationship between 4-meter gait speed (4MGS) and nutritional status, frailty, and activities of daily living in hospitalized pulmonology patients. While the study provides valuable insights, we wish to highlight key methodological considerations to strengthen future research in this field.
First, regarding sample size and representativeness
This study had a relatively small sample size (only 80 patients) and was limited to a single specialized ward (pulmonary disease ward), which may restrict the generalizability of the findings. To enhance the external validity of the results, it is recommended to expand the sample size and include a more diverse hospitalized patient population (e.g., patients with other medical or surgical conditions) [2].
Second, concerning study design
The cross-sectional design precludes causal conclusions. Longitudinal assessments—measuring gait speed, nutritional status, and frailty at admission, during hospitalization, and post-discharge—could elucidate temporal relationships [3]. Mediation analyses (e.g., evaluating whether grip strength mediates the link between malnutrition and gait speed) would clarify underlying mechanisms [4]. While multivariate regression was performed, further exploration of interactions (e.g., between nutritional status and frailty) is warranted [5].
Finally, clinical implications and intervention strategies
While the findings revealed correlations between walking speed and nutritional status/frailty, they lacked specific clinical intervention guidance. It is recommended that concrete interventions (e.g., nutritional supplementation, rehabilitation training) be proposed and their effects evaluated. For example, a randomized controlled trial could be designed to assess the efficacy of nutritional interventions in improving walking speed and frailty [6].
In conclusion, while Dilektasli et al. present compelling evidence that 4MGS correlates with comorbidities, frailty, grip strength, and nutritional status in hospitalized pulmonary patients, addressing these methodological considerations would enhance the validity and clinical applicability of findings. We commend the authors for their valuable contribution to this emerging field.
Sincerely,
Qing-qing Shan.
Chengdu Integrated TCM & Western Medicine Hospital.
Author contributions
Qing-qing Shan and Yangke Li wrote the main manuscript text. All authors reviewed the manuscript.
Data availability
No datasets were generated or analysed during the current study.
Declarations
Competing interests
The authors declare no competing interests.
Footnotes
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References
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Associated Data
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Data Availability Statement
No datasets were generated or analysed during the current study.