title: Physical activity monitoring: a responsive and meaningful patient-centered outcome for surgery, chemotherapy, or radiotherapy?
abstract: BACKGROUND
  In surgical and clinical oncology, there is a growing need for patient-centered outcomes that are responsive, meaningful, and fit for purpose.
  
  
  OBJECTIVE
  The aim of this study was to validate physical activity (PA) monitoring as a responsive outcome measure at different stages of disease and treatment, by verifying correlations between PA, performance score, and quality of life (QoL).
  
  
  METHODS
  Daily life PA of 162 cancer patients, monitored by a device that records time sitting/lying, time standing, time walking, number of steps taken, and walking cadence, was compared with 20 healthy volunteers. In a subgroup of patients, functional status and QoL were assessed using the World Health Organization/Eastern Cooperative Oncology Group and the Karnofsky Performance Status scores and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) questionnaire.
  
  
  RESULTS
  The PA of patients with resectable gastrointestinal cancer did not differ significantly from controls. In contrast, patients with advanced cancer took 45% fewer steps and spent an extra 2.8 hours/day lying/sitting (P=0.001). Patients undergoing neoadjuvant chemotherapy and surgery (5-6 weeks after operation) experienced a similar reduction in PA. There were significant correlations between PA and the physical and role domains as well as fatigue subscale of the EORTC QLQ-C30 scale.
  
  
  CONCLUSIONS
  Objective PA scores correlate significantly with disease stage, functional status, and QoL of patients with cancer. Therefore, activity monitoring can make meaningful objective estimates of patient function in response to cancer and its treatment and may provide surrogate outcomes of QoL.
authors.affiliation: Clinical and Surgical Sciences, University of Edinburgh, Royal Infirmary Edinburgh, Edinburgh, Scotland, UK. eferriol@fmrp.usp.br
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ferriolli
authors.forename: Richard J E
authors.initials: RJ
authors.lastname: Skipworth
authors.forename: Paul
authors.initials: P
authors.lastname: Hendry
authors.forename: Angela
authors.initials: A
authors.lastname: Scott
authors.forename: Jacob
authors.initials: J
authors.lastname: Stensteth
authors.forename: Max
authors.initials: M
authors.lastname: Dahele
authors.forename: Lucy
authors.initials: L
authors.lastname: Wall
authors.forename: Carolyn
authors.initials: C
authors.lastname: Greig
authors.forename: Marie
authors.initials: M
authors.lastname: Fallon
authors.forename: Florian
authors.initials: F
authors.lastname: Strasser
authors.forename: Tom
authors.initials: T
authors.lastname: Preston
authors.forename: Kenneth C H
authors.initials: KC
authors.lastname: Fearon
mesh_terms: D056044:Actigraphy / Q000379:methods*; D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009369:Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D018802:Patient-Centered Care / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome