title: Relationship between patterns of daily physical activity and fatigue in cancer survivors.
abstract: OBJECTIVE
  This study investigated: (1) physical activity behaviour of cancer survivors throughout the day, (2) the relationship between objective and subjective measures of physical activity, and (3) the relationship between daily physical activity and fatigue.
  
  
  METHODS
  Physical activity was measured objectively using 3D-accelerometry (expressed in counts per minute (cpm)), and subjectively using a Visual Analogue Scale (VAS; 0-10) implemented on a smartphone in 18 cancer survivors (6 male; age 55.7 ± 10.2 yrs; free from cancer, last treatment ≥three months previously), and matched controls. Fatigue was scored thrice daily on a smartphone (0-10 VAS).
  
  
  RESULTS
  Mean daily physical activity of cancer survivors did not deviate from controls (1108 ± 287 cpm versus 1223 ± 371 cpm, p = .305). However, in cancer survivors physical activity significantly decreased from morning to evening (p < .01) and increased levels of fatigue throughout the day were reported (p < .01). Furthermore, a positive correlation was found between levels of fatigue and the magnitude of the decline in physical activity from afternoon to evening (p < .05). Objective and subjective measured physical activity showed low correlations.
  
  
  CONCLUSIONS
  This study demonstrated imbalanced activity patterns in cancer survivors. Also, the more a survivor felt fatigued, the greater the decline in activity behaviour throughout the day. The low correlation between objective and subjective physical activity suggests low awareness in cancer survivors about their daily physical activity performed. Ambulatory monitoring provides new insights in both patterns of physical activity and fatigue, which might be a valuable tool to provide activity management more efficiently during treatment of fatigue.
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Post Box 310, 7500 AH Enschede, The Netherlands; University of Twente, Faculty of Electrical Engineering, Biomedical Signals and Systems, Telemedicine Group, Post Box 217, 7500 AE Enschede, The Netherlands. Electronic address: j.timmerman@rrd.nl.
authors.forename: J G
authors.initials: JG
authors.lastname: Timmerman
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Post Box 310, 7500 AH Enschede, The Netherlands. Electronic address: m.dekker@rrd.nl.
authors.forename: M G H
authors.initials: MG
authors.lastname: Dekker-van Weering
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Post Box 310, 7500 AH Enschede, The Netherlands; University of Twente, Faculty of Electrical Engineering, Biomedical Signals and Systems, Telemedicine Group, Post Box 217, 7500 AE Enschede, The Netherlands. Electronic address: t.tonis@rrd.nl.
authors.forename: T M
authors.initials: TM
authors.lastname: Tönis
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Post Box 310, 7500 AH Enschede, The Netherlands; University of Twente, Faculty of Electrical Engineering, Biomedical Signals and Systems, Telemedicine Group, Post Box 217, 7500 AE Enschede, The Netherlands. Electronic address: h.j.hermens@ewi.utwente.nl.
authors.forename: H J
authors.initials: HJ
authors.lastname: Hermens
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Post Box 310, 7500 AH Enschede, The Netherlands; University of Twente, Faculty of Electrical Engineering, Biomedical Signals and Systems, Telemedicine Group, Post Box 217, 7500 AE Enschede, The Netherlands. Electronic address: m.vollenbroek@rrd.nl.
authors.forename: M M R
authors.initials: MM
authors.lastname: Vollenbroek-Hutten
mesh_terms: D061725:Accelerometry; D000204:Activity Cycles / Q000502:physiology; D000368:Aged; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009369:Neoplasms / Q000150:complications* / Q000523:psychology* / Q000628:therapy; D009426:Netherlands; D011788:Quality of Life; D057566:Self Report
keywords: Accelerometry; Activity management; Ambulatory monitoring; Cancer survivor; Fatigue; Physical activity