The characteristics of physical activity and gait in patients receiving radiotherapy in cancer induced bone pain.
OBJECTIVE
An objective measure of pain relief may add important information to patients' self assessment, particularly after a treatment. The study aims were to determine whether measures of physical activity and/or gait can be used in characterizing cancer-induced bone pain (CIBP) and whether these biomarkers are sensitive to treatment response, in patients receiving radiotherapy (XRT) for CIBP.


METHODS
Patients were assessed before (baseline) and 6-8weeks after XRT (follow up). The following assessments were done: Brief Pain Inventory (BPI), activPAL™ activity meter, and GAITRite® electronic walkway (measure of gait). Wilcoxon, Mann-Whitney and Pearson statistical analyses were done.


RESULTS
Sixty patients were assessed at baseline; median worst pain was 7 and walking interference was 5. At follow up 42 patients were assessed. BPI worst pain, average pain, walking interference and total functional interference all improved (p<0.001). An improvement in functional interference correlated with aspects of physical activity (daily hours standing r=0.469, p=0.002) and gait (cadence r=0.341, p=0.03). The activPAL and GAITRite parameters did not change following XRT (p>0.05). In responder analyses there were no differences in activPAL and GAITRite parameters (p>0.05).


CONCLUSIONS
Assessment of physical activity and gait allow a characterization of the functional aspects of CIBP, but not in the evaluation of XRT.
European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Technology and Science (NTNU), Trondheim, Norway. Electronic address: tonje.laugsand@ntnu.no.
Tonje A
TA
Sande
University of Edinburgh, Edinburgh Cancer Research Centre, United Kingdom.
Angela C
AC
Scott
European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Technology and Science (NTNU), Trondheim, Norway; University of Edinburgh, Edinburgh Cancer Research Centre, United Kingdom.
Barry J A
BJ
Laird
Pfizer Biotherapeutics, Translational Medicine and Molecular Medicine Clinical Research, Collegeville, United States.
Hong I
HI
Wan
University of Edinburgh, Royal Dick Vet School, United Kingdom.
Susan M
SM
Fleetwood-Walker
European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Technology and Science (NTNU), Trondheim, Norway; Cancer Clinic, St. Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway.
Stein
S
Kaasa
European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Technology and Science (NTNU), Trondheim, Norway; St. Olavs Hospital, University Hospital of Trondheim, Department of Anaesthesiology and Emergency Medicine, Trondheim, Norway.
Pål
P
Klepstad
University of Edinburgh, Centre for Integrative Physiology,Edinburgh, United Kingdom.
Rory
R
Mitchell
University of Edinburgh, Centre for Population Health Sciences, Edinburgh, United Kingdom.
Gordon D
GD
Murray
University of Edinburgh, Department of Anaesthesia and Pain Medicine, Western General Hospital, Edinburgh, United Kingdom.
Lesley A
LA
Colvin
University of Edinburgh, Edinburgh Cancer Research Centre, United Kingdom.
Marie T
MT
Fallon
D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000503:physiopathology / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D005684:Gait / Q000528:radiation effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000528:radiation effects*; D009369:Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy; D010146:Pain / Q000209:etiology / Q000503:physiopathology* / Q000532:radiotherapy*; D010147:Pain Measurement; D016138:Walking / Q000502:physiology
Biomarker; Bone metastases; Gait; Physical activity; Radiotherapy