title: Associations between objectively measured physical activity and quality of life in cancer patients with brain metastases.
abstract: BACKGROUND
  Physical activity has demonstrated benefits for quality of life (QoL) and cancer-related fatigue earlier in the cancer trajectory; however, less is known regarding its role in patients with end-stage cancer.
  
  
  OBJECTIVE
  The primary aim of this study was to examine the association between objectively measured physical activity and QoL in cancer patients with brain metastases.
  
  
  METHODS
  Patients diagnosed with brain metastases, aged 18 years or older, cognitively intact, and with Palliative Performance Scale scores greater than 30%, were recruited from a multidisciplinary brain metastases clinic. A cross-sectional survey interview assessed self-reported QoL (McGill Quality of Life Questionnaire), self-reported physical function (Late-Life Function and Disability Instrument), and symptoms (Edmonton Symptom Assessment System). Participants wore activPAL™ (PAL Technologies, Ltd., Glasgow, UK) accelerometers recording triaxial movement for seven days during palliative whole brain radiotherapy.
  
  
  RESULTS
  A total of 31 patients were recruited. Median survival was 171 days from time of study consent, with 90% (28 of 31) of deaths by two year follow-up. Participants who stood for 1.6 hours or more per day had better QoL (mean=1.0; 95% confidence interval [CI]=0.1 to 1.9; P=0.034). Participants who stood for 1.6 hours or more per day had better QoL (mean=1.0; 95% CI=0.1 to 1.9; P=0.034). Participants who sat or were supine for 20.7 hours or more per day had better advanced lower extremity functioning (mean=-6.1; 95% CI=-11.9 to -0.3; P=0.040) and total functioning (mean=-10.6; 95% CI=-21.1 to -0.04; P=0.049), but worse depression (mean=2.1; 95% CI=0.3 to 3.9; P=0.028), anxiety (mean=2.8; 95% CI=0.7 to 5.0; P=0.012), and feeling of well-being (mean=1.9; 95% CI=0.2 to 3.6; P=0.028).
  
  
  CONCLUSIONS
  Sedentary behavior appears to be associated with better physical functioning but worse psychosocial functioning in cancer patients with brain metastases.
authors.affiliation: Department of Symptom Control and Palliative Care, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada. Electronic address: Sonya.Lowe@albertahealthservices.ca.
authors.forename: Sonya S
authors.initials: SS
authors.lastname: Lowe
authors.affiliation: Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Brita
authors.initials: B
authors.lastname: Danielson
authors.affiliation: Department of Symptom Control and Palliative Care, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Crystal
authors.initials: C
authors.lastname: Beaumont
authors.affiliation: Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Watanabe
authors.affiliation: Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Vickie E
authors.initials: VE
authors.lastname: Baracos
authors.affiliation: Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
mesh_terms: D061725:Accelerometry; D001932:Brain Neoplasms / Q000503:physiopathology* / Q000523:psychology / Q000532:radiotherapy / Q000556:secondary*; D003430:Cross-Sectional Studies; D003863:Depression; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010166:Palliative Care; D011788:Quality of Life; D057185:Sedentary Behavior; D057566:Self Report; D012720:Severity of Illness Index; D016683:Supine Position; D011795:Surveys and Questionnaires; D016019:Survival Analysis
keywords: Cancer; brain metastases; oncology; physical activity; quality of life