scholarly journals Feasibility of Fitness Tracker Usage to Assess Activity Level and Toxicities in Patients With Colorectal Cancer

2021 ◽  
pp. 125-133
Author(s):  
William H. Ward ◽  
Caitlin R. Meeker ◽  
Elizabeth Handorf ◽  
Maureen V. Hill ◽  
Margret Einarson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Colorectal Cancer ◽  
Performance Status ◽  
Objective Measure ◽  
Standardize Patient ◽  
Subjective Assessment ◽  
Activity Level ◽  
Initial Assessment ◽  
End Point ◽  
Fitness Tracker

PURPOSE Performance status (PS) is a subjective assessment of patients' overall health. Quantification of physical activity using a wearable tracker (Fitbit Charge [FC]) may provide an objective measure of patient's overall PS and treatment tolerance. MATERIALS AND METHODS Patients with colorectal cancer were prospectively enrolled into two cohorts (medical and surgical) and asked to wear FC for 4 days at baseline (start of new chemotherapy [± 4 weeks] or prior to curative resection) and follow-up (4 weeks [± 2 weeks] after initial assessment in medical and postoperative discharge in surgical cohort). Primary end point was feasibility, defined as 75% of patients wearing FC for at least 12 hours/d, 3 of 4 assigned days. Mean steps per day (SPD) were correlated with toxicities of interest (postoperative complication or ≥ grade 3 toxicity). A cutoff of 5,000 SPD was selected to compare outcomes. RESULTS Eighty patients were accrued over 3 years with 55% males and a median age of 59.5 years. Feasibility end point was met with 68 patients (85%) wearing FC more than predefined duration and majority (91%) finding its use acceptable. The mean SPD count for patients with PS 0 was 6,313, and for those with PS 1, it was 2,925 (122 and 54 active minutes, respectively) ( P = .0003). Occurrence of toxicity of interest was lower among patients with SPD > 5,000 (7 of 33, 21%) compared with those with SPD < 5,000 (14 of 43, 32%), although not significant ( P = .31). CONCLUSION Assessment of physical activity with FC is feasible in patients with colorectal cancer and well-accepted. SPD may serve as an adjunct to PS assessment and a possible tool to help predict toxicities, regardless of type of therapy. Future studies incorporating FC can standardize patient assessment and help identify vulnerable population.

Feasibility of using a fitness tracker to assess activity level and toxicity in colorectal cancer patients.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 684-684
Author(s):  
William Harrell Ward ◽  
Caitlin R. Meeker ◽  
Maureen Hill ◽  
Elizabeth A. Handorf ◽  
Michael J. Hall ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Performance Status ◽  
Risk Groups ◽  
Accurate Estimate ◽  
Activity Level ◽  
Steps Per Day ◽  
Grade 3 ◽  
Fitness Tracker ◽  
Colorectal Cancer Patients ◽  
Ecog Ps

684 Background: Performance status (PS) is traditionally used to predict tolerance and morbidity associated with colorectal cancer (CRC) treatment. Monitoring activity level at the start of therapy using a wearable fitness tracker (Fitbit) may provide a more accurate estimate of overall patient (pt) PS and help predict treatment-related toxicity. Methods: With IRB approval, we prospectively enrolled CRC pts undergoing therapy into two cohorts: medical (M) and surgical (S). Our primary aim was to assess the feasibility of using Fitbit to assess activity level and toxicity. After documenting baseline ECOG PS, M and S pts wore Fitbit for four days while receiving chemotherapy or prior to surgery, respectively. Pts’ mean steps per day (SPD) were calculated, excluding days Fitbit was worn < 12 hours. To stratify the prediction of toxicity risk, a cutoff of 5,000 SPD was selected and any post-operative complication (S pts) or ≥ grade 3 toxicity (M pts) was counted as toxicity. The study is ongoing to accrue 80 pts. Results: On interim analysis, 43 pts were evaluated for the primary aim. Seventy nine percent (34/43) of pts had at least 3 days with ≥ 12 hours of Fitbit usage, meeting the 75% feasibility endpoint. Forty pts (25 M, 15 S) had at least 1 day with ≥ 12 hours of Fitbit usage and had data available for analysis. Mean SPD for PS 0 and PS 1 pts was 7,183 and 3,214, respectively (p=0.01), and overall was 6,290 (SD 4,416). Eight M pts and 2 S pts experienced toxicity (Table). The rate of toxicity was 23% (7/30) in pts with PS 0 and 33% (3/10) in pts with PS 1. With SPD as cutoff, the toxicity rate was 11% (2/19) in pts with > 5000, compared to 38% (8/21) in pts with < 5000. Conclusions: We observed high rates of compliance with a fitness tracker in CRC pts. SPD serves as a useful identifier for toxicity and may be a better predictor than traditional PS. These findings provide rationale to study SPD in lieu of PS for risk stratification of patients undergoing therapy and possibly incorporate pre-habilitation programs in high-risk groups, though validation in larger studies is needed. [Table: see text]

Physical Activity Level and Colorectal Cancer Mortality

2016 ◽  
Vol 28 (7) ◽  
pp. 638-647 ◽  
Author(s):  
Yejin Mok ◽  
Christina Jeon ◽  
Gyu Jang Lee ◽  
Sun Ha Jee
Keyword(s):  
Physical Activity ◽  
Colorectal Cancer ◽  
Cancer Mortality ◽  
Physical Activity Level ◽  
Activity Level ◽  
Colorectal Cancer Mortality

Actigraphy as an objective measure of performance status in patients with advanced cancer.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 62-62 ◽  
Author(s):  
William F. Pirl ◽  
Daisuke Fujisawa ◽  
Jamie Stagl ◽  
Justin Eusebio ◽  
Lara Traeger ◽  
...  
Keyword(s):  
Physical Activity ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Objective Measure ◽  
Stage Iv ◽  
Self Report ◽  
Subjective Rating ◽  
Metabolic Equivalents ◽  
Patient Reported ◽  
Ecog Ps

62 Background: Treatment decisions are often based on performance status (PS), a subjective rating of patient functioning derived from observation and patient-report. Devices that monitor physical activity, such as wrist actigraphs, can accurately measure the percent of time a person is immobile while awake (awake immobile). Thus, actigraphy may have potential to better estimate true PS. We compared actigraphy to both Eastern Cooperative Oncology Group PS (ECOG PS) and patient-reported physical activity as predictors of survival in patients with stage IV non-small cell lung cancer (NSCLC). Methods: Participants (n = 41) were ambulatory patients with stage IV NSCLC receiving care at MGH. Participants wore a watch-sized accelerometer device (ACTIWATCH 2) for three consecutive 24-hour periods (72 hours) and completed a self-report questionnaire about physical activity, scored as METS (metabolic equivalents) per week. Patients’ oncologists rated their ECOG PS (0-5) at the end of the 72-hour actigraphy period. Relationships among ECOG PS, awake immobile, and METs per week were tested with Pearson correlations. A ROC curve for 6-month survival was used to determine a meaningful cut-off for awake immobile. Unadjusted Cox regression models tested associations with survival from assessment times. Results: Participants’ ECOG PS ratings were: 0 (22%), 1 (63%), 2 (12%), and 3 (2%). ECOG PS and awake immobile were correlated (r = .42, p < .01). METS per week was correlated only with ECOG PS (r = -.35, p = .03). At time of analysis, 15 patients had died with a minimum follow up of 9 months. Among all patients, survival was predicted by ECOG PS, HR = 3.77 (95% CI 1.70-8.35), p < .01; awake immobile as both as a continuous (percentage points) and categorical ( > 23%) variable, HR = 1.04 (95% CI 1.00-1.09), p = .05 and HR = 4.12 (95% CI 1.37-12.39), p = .01, respectively; but not METS per week. Among patients with good EGOC PS (0-1), only awake immobile ( > 23%) predicted survival, HR = 5.80 (95% CI 1.39-24.12), p = .02. Moreover, within the largest ECOG group (PS1), awake immobile ( > 23%) still predicted survival, HR = 5.53 (95% CI 1.18-25.94), p = .03. Conclusions: Actigraphy, an objective measure of patient activity, may have utility in determining patient PS.

Feasibility of using fitness tracker to assess activity level and toxicities in colorectal cancer (CRC) patients (Pts).

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 91-91
Author(s):  
Thomas Holden ◽  
Maureen Hill ◽  
William Harrell Ward ◽  
Caitlin R. Meeker ◽  
Elizabeth A. Handorf ◽  
...  
Keyword(s):  
Performance Status ◽  
Final Analysis ◽  
Risk Groups ◽  
Accurate Estimate ◽  
Small Sample ◽  
Activity Level ◽  
Steps Per Day ◽  
Definitive Surgery ◽  
Fitness Tracker ◽  
Ecog Ps

91 Background: Performance status (PS) is used to predict tolerance and morbidity associated with CRC treatment. Monitoring activity level at the start of therapy using a wearable fitness tracker Fitbit (Fb) may provide a more accurate estimate of a pt’s overall PS and help predict treatment related toxicity (T). Methods: With IRB approval, we prospectively enrolled CRC pts undergoing therapy into 2 cohorts, medical undergoing chemotherapy (M) and surgical undergoing definitive surgery (S). Our objective was to assess feasibility of using Fb to track pt activity level and secondarily correlate with T. After documenting baseline ECOG PS, M and S pts wore Fb for 4 days while receiving chemotherapy or prior to surgery, respectively. Pts’ mean steps per day (SPD) were calculated excluding days Fb was worn <12 hours. To stratify prediction of toxicity risk, a cutoff of 5000 SPD was selected and any post-operative complication (S pts) or ≥grade 3 toxicity (M pts) was counted as T. The study met accrual of 80 pts. Results: On final analysis, 80 pts were evaluated for the primary aim. 68 pts had at least 3 days with ≥12 hours of Fb usage, meeting the 75% feasibility endpoint. 76 pts had at least 1 day with ≥12 hours of Fb usage with data for analysis. SPD correlated with PS and the SPD and active minutes (read by device) for PS 0 and PS 1 pts was 6313 steps and 122 min and 2925 steps and 55 min, respectively (p=0.0003). Rate of T was 25% in pts with PS 0 and 33% in pts with PS 1. With SPD, rate of T was numerically lower in pts with >5000 SPD compared to pts with <5000 SPD (21% vs 32%, p = NS). Conclusions: We observed high rates of compliance with Fb in CRC pts. SPD cutoff of 5000 correlated with ECOG PS 0 vs 1. We observed usefulness of SPD as an identifier for toxicities and suggestion that it may be more reliable compared to PS alone in this small sample of pts. These findings provide rationale to study SPD in conjunction with PS for risk stratification of pts undergoing therapy, and can possibly be incorporated into pre-habilitation selection in high risk groups. [Table: see text]

scholarly journals The studying of physical activity indices in students of medical university

2020 ◽  
Vol 99 (8) ◽  
pp. 816-821
Author(s):  
Nikolay I. Prokhorov ◽  
Ekaterina A. Shashina ◽  
Valentina V. Makarova ◽  
Aleksandr A. Matveev
Keyword(s):  
Physical Activity ◽  
Healthy Lifestyle ◽  
Subjective Assessment ◽  
Activity Level ◽  
Age Group ◽  
Steps Per Day ◽  
Average Activity ◽  
Medical University ◽  
Separate Discipline ◽  
Activity Indices

Introduction. According to WHO experts, the lack of proper physical activity is one of the leading health risk factors for students.The purpose of this assessment was to study the physical activity of students of Sechenov University.Material and methods. Quantitative indices of the physical activity were assessed on the base of the step counts data obtained from smartphones. Analysis of the subjective assessment of the physical activity sufficiency and the awareness of students about its age-matched normal level was performed on the survey data. Data included 167 4th year students of the Sechenov University.Results. On average, students took 9703 ± 3006.2 steps per day, which is lower than the average activity level for young people. Less than half of the students (43%) were classified as show medium and high physical activity. There were no gender differences in the level of physical activity. In the weekly dynamics, a tendency to a decrease in activity on weekends was revealed. Physical activity for everyday life exceeded 10,000 steps per day and was regarded as medium and high. On weekends, activity decreased to 8,236.9 ± 4,556.1, which corresponded to “below average” activity. A relationship between the level of the physical activity and body mass index in this age group was not found. Subjective assessment of the physical activity did not correspond to the results of the pedometer. The level of awareness of medical students in matters of motor activity standards was generally quite high - 70.1%, but among young men, it was only 26.3%.Conclusions. Issues of a healthy lifestyle in general, and physical activity in particular, should be included in the curriculum for training doctors in higher education institutions either as a separate discipline or as part of a special discipline, such as hygiene.

Randomized, Phase III Trial of Panitumumab With Infusional Fluorouracil, Leucovorin, and Oxaliplatin (FOLFOX4) Versus FOLFOX4 Alone As First-Line Treatment in Patients With Previously Untreated Metastatic Colorectal Cancer: The PRIME Study

2010 ◽  
Vol 28 (31) ◽  
pp. 4697-4705 ◽  
Author(s):  
Jean-Yves Douillard ◽  
Salvatore Siena ◽  
James Cassidy ◽  
Josep Tabernero ◽  
Ronald Burkes ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Group Performance ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Growth Factor Receptor ◽  
Progression Free Survival ◽  
Phase Iii ◽  
Phase Iii Trial ◽  
End Point

Purpose Panitumumab, a fully human anti–epidermal growth factor receptor (EGFR) monoclonal antibody that improves progression-free survival (PFS), is approved as monotherapy for patients with chemotherapy-refractory metastatic colorectal cancer (mCRC). The Panitumumab Randomized Trial in Combination With Chemotherapy for Metastatic Colorectal Cancer to Determine Efficacy (PRIME) was designed to evaluate the efficacy and safety of panitumumab plus infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) versus FOLFOX4 alone as initial treatment for mCRC. Patients and Methods In this multicenter, phase III trial, patients with no prior chemotherapy for mCRC, Eastern Cooperative Oncology Group performance status of 0 to 2, and available tissue for biomarker testing were randomly assigned 1:1 to receive panitumumab-FOLFOX4 versus FOLFOX4. The primary end point was PFS; overall survival (OS) was a secondary end point. Results were prospectively analyzed on an intent-to-treat basis by tumor KRAS status. Results KRAS results were available for 93% of the 1,183 patients randomly assigned. In the wild-type (WT) KRAS stratum, panitumumab-FOLFOX4 significantly improved PFS compared with FOLFOX4 (median PFS, 9.6 v 8.0 months, respectively; hazard ratio [HR], 0.80; 95% CI, 0.66 to 0.97; P = .02). A nonsignificant increase in OS was also observed for panitumumab-FOLFOX4 versus FOLFOX4 (median OS, 23.9 v 19.7 months, respectively; HR, 0.83; 95% CI, 0.67 to 1.02; P = .072). In the mutant KRAS stratum, PFS was significantly reduced in the panitumumab-FOLFOX4 arm versus the FOLFOX4 arm (HR, 1.29; 95% CI, 1.04 to 1.62; P = .02), and median OS was 15.5 months versus 19.3 months, respectively (HR, 1.24; 95% CI, 0.98 to 1.57; P = .068). Adverse event rates were generally comparable across arms with the exception of toxicities known to be associated with anti-EGFR therapy. Conclusion This study demonstrated that panitumumab-FOLFOX4 was well tolerated and significantly improved PFS in patients with WT KRAS tumors and underscores the importance of KRAS testing for patients with mCRC.

Performance status and activity level of lung cancer patients using wearable devices as passive monitoring: A scoping review.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21141-e21141
Author(s):  
Santiago Ponce Aix ◽  
Leonardo Crama ◽  
Francisco J. Núñez-Benjumea ◽  
Sergio Sánchez ◽  
Sergio Cervera-Torres ◽  
...  
Keyword(s):  
Physical Activity ◽  
Lung Cancer ◽  
Sleep Duration ◽  
Scoping Review ◽  
Performance Status ◽  
Wearable Devices ◽  
Activity Level ◽  
Sleep Onset Latency ◽  
Step Counts ◽  
Scoping Reviews

e21141 Background: Lung Cancer (LC) and particularly non-small cell lung cancer (NSCLC) is considered one of the most lethal types of cancer to date. Suitability and toxicity of treatment, or eligibility of LC patients for clinical trials usually rely on subjective indicators of Performance Status (PS) such as the Eastern Cooperative Oncology Group (ECOG) and Karnofsky indexes. In recent years, however, the use of electronic wearable devices has increasingly come to the fore with the aim of increasing objectivity of PS assessments. These devices are capable of objectively and passively monitor health-related outcomes such as daily physical activity and sleep patterns. Consequently, a comprehensive review of the current state of the art in this matter can provide further insights for future research within oncology areas in general, and lung cancer, in particular. The main goal of this scoping review is to identify and categorize scientific publications that, over the past 10 years, used wearable devices as means of monitoring activity level of LC patients. Methods: The study follows the PRISMA-ScR framework (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Results: A total of 32 studies were identified as suitable to be included in the review where (n = 22; 68.7%) focused on physical activity and (n = 10; 31%) in sleep or circadian patterns. Approximately half of the studies used a wrist wearable. Device output included step counts, activity counts, metabolic equivalents, time active, time spent in moderate-to-vigorous activity, sedentary time, sleep duration, sleep efficiency, total sleep time/sleep duration, sleep onset latency, wake times, and wrist movement per minute. However, step counts arose as one of the most representative outcomes of physical activity (n = 17; 53%). In general, higher levels of physical activity and circadian organization (day/night activity balance) as measured by actigraphy, are associated with less fatigue, pain, and better quality of life. Conclusions: This review shows that wearable devices, and especially wrist wearables, are increasingly used in oncology settings as a reliable method to monitor physical and sleep activity and to complement PS assessment. Further research is needed, however, to determine the extent to which this methodology can be used to more directly objectivize current PS assessment itself.

scholarly journals Total energy expenditure in patients with colorectal cancer: associations with body composition, physical activity, and energy recommendations

2019 ◽  
Vol 110 (2) ◽  
pp. 367-376 ◽  
Author(s):  
Sarah A Purcell ◽  
Sarah A Elliott ◽  
Peter J Walter ◽  
Tom Preston ◽  
Hongyi Cai ◽  
...  
Keyword(s):  
Physical Activity ◽  
Colorectal Cancer ◽  
Body Composition ◽  
Body Weight ◽  
Energy Expenditure ◽  
Total Energy ◽  
Residual Activity ◽  
Total Energy Expenditure ◽  
Activity Level ◽  
Fat Free Mass

ABSTRACT Background Total energy expenditure (TEE) data in patients with early-stage cancer are scarce, precluding an understanding of energy requirements. Objective The objective was to cross-sectionally characterize TEE in patients with colorectal cancer (CRC) and to compare measured TEE with energy recommendations. It was hypothesized that TEE would differ according to body mass, body composition, and physical activity level (PAL) and current energy recommendations would have poor individual-level accuracy. Methods Patients with newly diagnosed CRC had resting energy expenditure (REE) measured by indirect calorimetry and TEE by doubly labeled water. Hypermetabolism was defined as REE &gt; 110% of that predicted from the Mifflin St.-Jeor equation. Body composition was assessed via DXA. Physical activity was determined as the ratio of TEE to REE (TEE:REE) (PAL) and residual activity energy expenditure (RAEE). TEE was compared with energy recommendations of 25–30 kcal/d and Dietary Reference Intakes (DRIs) using Bland–Altman analyses. Patients were stratified according to median BMI, PAL, and sex-specific ratio of fat mass (FM) to fat-free mass (FFM). Results Twenty-one patients (M:F 14:7; mean ± SD BMI: 28.3 ± 4.9 kg/m2, age: 57 ± 12 y) were included. Most (n = 20) had stage II–III disease; 1 had stage IV. Approximately half (n = 11) were hypermetabolic; TEE was not different in those with hypermetabolism and REE as a percentage of predicted was not correlated with TEE. Mean ± SD TEE was 2473 ± 499 kcal/d (range: 1562–3622 kcal/d), or 29.7 ± 6.3 kcal/kg body weight (range: 20.4–48.5 kcal/kg body weight). Mean ± SD PAL was 1.43 ± 0.27. The energy recommendation of 25 kcal/kg underestimated TEE (−12.6% ± 16.5%, P = 0.002); all energy recommendations had wide limits of agreement (the smallest was DRI with measured PAL: −21.2% to 29.3%). Patients with higher BMI and FM:FFM had higher bias using kilocalories per kilogram recommendations; bias from several recommendations was frequently lower (i.e. underestimation) in patients with higher PAL and RAEE. Conclusions TEE variability was not reflected in energy recommendations and error was related to body weight, body composition, and physical activity. This trial was registered at clinicaltrials.gov as NCT03131921.

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