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Supportive Care in Cancer

, Volume 18, Issue 12, pp 1539–1544 | Cite as

Physical activity level as an outcome measure for use in cancer cachexia trials: a feasibility study

  • Matthew Maddocks
  • Anthony Byrne
  • Colin D. Johnson
  • Richard H. Wilson
  • Kenneth C. H. Fearon
  • Andrew Wilcock
Original Article

Abstract

Purpose

Cancer cachexia impacts on treatment options, quality of life and survival. New treatments are emerging but need to be assessed using outcomes which patients find meaningful. One approach is the measurement of physical activity levels by small lightweight monitors, but experience is limited in cancer patients.

Materials and methods

This study formally assessed the acceptability of wearing an ActivPAL™ monitor for 1 week using compliance based on analysis of movement data. The optimal period of monitoring was explored by comparing mean values of daily step count and energy expenditure (EE) for 2 or 4 and 6 days of monitoring. The relationships between step count, stepping EE and non-stepping EE were also explored.

Results

Sixty patients (mean age 68 years; Eastern Cooperative Oncology Group performance status 0–2) with lung or upper gastrointestinal cancer took part. All but one found that the monitor acceptable and mean [95% CI] compliance was 98% [94–100%]. Median daily step counts and EE scores over 2 or 4 days were significantly higher than those from 6 days (p ≤ 0.01). Step count was strongly related to stepping and non-stepping EE (r = −0.911, p < 0.01).

Conclusions

The ActivPAL™ is acceptable to patients with outcomes obtained over 6 days recommended for use in future studies.

Keywords

Accelerometry Cachexia Function Physical activity Outcomes 

Notes

Acknowledgements

We thank Cancer Research UK (C18598/A8211) for funding this work, Paul Silcocks for statistical advice, National Cancer Research Network staff for help with recruitment and all patients who took part in this study.

Conflicts of interest

None declared.

References

  1. 1.
    Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res 8:135–160CrossRefPubMedGoogle Scholar
  2. 2.
    Bonnefoy M, Normand S, Pachiaudi C, Lacour JR, Laville M, Kostka T (2001) Simultaneous validation of ten physical activity questionnaires in older men: a doubly labelled water study. JAGS 49:28–35CrossRefGoogle Scholar
  3. 3.
    Dahele M, Fearon K (2004) Research methodology: cancer cachexia syndrome. Palliat Med 18:409–417CrossRefPubMedGoogle Scholar
  4. 4.
    Dahele M, Skipworth R, Wall L, Voss A, Preston T, Fearon K (2007) Objective physical activity and self-reported quality of life in patients receiving palliative chemotherapy. J Pain Symptom Manage 33:676–685CrossRefPubMedGoogle Scholar
  5. 5.
    Fouladiun M, Körner U, Gunnebo L, Sixt-Ammilon P, Bosaeus I, Lundholm K (2007) Daily physical–rest activities in relation to nutritional state, metabolism, and quality of life in cancer patients with progressive cachexia. Clin Cancer Res 13:6379–6385CrossRefPubMedGoogle Scholar
  6. 6.
    Gordon JN, Green SR, Goggin PM (2005) Cancer cachexia. Q J Med 98:770–788Google Scholar
  7. 7.
    Grant PM, Ryan CG, Tigbe WW, Granat MH (2006) The validation of a novel activity monitor in the measurement of posture and motion during everyday activities. Br J Sports Med 40:992–997CrossRefPubMedGoogle Scholar
  8. 8.
    Maddocks M, Petrou A, Skipper L, Wilcock A (2009) Validity of three accelerometers during treadmill walking and motor vehicle travel. Br J Sports Med. doi: 10.1136/bjsm.2008.051128 Google Scholar
  9. 9.
    Muscaritoli M, Bossola M, Aversa Z, Bellantone R, Fanelli FR (2006) Prevention and treatment of cancer cachexia: new insights into an old problem. Eur J Cancer 42:31–41CrossRefPubMedGoogle Scholar
  10. 10.
    Maddocks M, Lewis M, Chauhan A, Manderson C, Hocknell J, Wilcock A (2009) Randomized controlled pilot study of neuromuscular electrical stimulation of the quadriceps in patients with non-small cell lung cancer. J Pain Symptom Manage. doi: 10.1016/j.jpainsymman.2009.05.001
  11. 11.
    Netz Y, Wu M-J (2005) Physical activity and psychological well-being in advanced age: a meta-analysis of intervention studies. Psychol Aging 20:272–284CrossRefPubMedGoogle Scholar
  12. 12.
    Paul DR, Kramer M, Stote KS, Spears KE, Moshfegh AJ, Baer DJ, Rumpler WV (2008) Estimates of adherence and error analysis of physical activity data collected via accelerometry in a large study of free-living adults. BMC Medical Research Methodology 8:38CrossRefPubMedGoogle Scholar
  13. 13.
    Prince SA, Adamo KB, Hamel M, Hardt J, Gorber SC, Tremblay M (2008) A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nut Phys Act 5:56CrossRefGoogle Scholar
  14. 14.
    Rejeski JW, Mihalko SL (2001) Physical activity and quality of life in older adults. J Gerontol A Biol Sci Med Sci 56:23–35PubMedGoogle Scholar
  15. 15.
    Ryan CG, Grant PM, Tigbe WW, Granat MH (2006) The validity and reliability of a novel activity monitor as a measure of walking. Br J Sports Med 40:779–784CrossRefPubMedGoogle Scholar
  16. 16.
    Steer TE (2005) Report of a Joint Cancer Research UK/Medical Research Council workshop on cancer cachexia research at the Royal College of Physicians, Tuesday, 2nd December 2003. Br J Cancer 92:1830–1833CrossRefPubMedGoogle Scholar
  17. 17.
    Trost SG, McIver KL, Pate RP (2005) Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc 37:s531–s543CrossRefPubMedGoogle Scholar
  18. 18.
    Tudor-Locke C, Washington TL, Hart TL (2009) Expected values for steps/day in special populations. Preventative Medicine 49:3–11CrossRefGoogle Scholar
  19. 19.
    Ward DS, Evenson KR, Vaughn A, Rodgers AB, Tropano RP (2005) Accelerometer use in physical activity: best practices and research recommendations. Med Sci Sport Exerc 37:582–588CrossRefGoogle Scholar
  20. 20.
    Wilson EB (1927) Probable inference, the law of succession, and statistical inference. J Am Stat Assoc 22:209–212CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Matthew Maddocks
    • 1
  • Anthony Byrne
    • 2
  • Colin D. Johnson
    • 3
  • Richard H. Wilson
    • 4
  • Kenneth C. H. Fearon
    • 5
  • Andrew Wilcock
    • 1
    • 6
  1. 1.Department of Palliative MedicineNottingham University Hospitals NHS TrustNottinghamUK
  2. 2.Marie Curie Holme TowerCardiff and Vale NHS TrustPenarthUK
  3. 3.Division of SurgerySouthampton University Hospitals NHS TrustSouthamptonUK
  4. 4.Cancer CentreBelfast Health and Social Care TrustBelfastUK
  5. 5.Surgical OncologyRoyal Infirmary of EdinburghEdinburghUK
  6. 6.Hayward House Specialist Palliative Cancer Care UnitNottingham University Hospitals NHS TrustNottinghamUK

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