title: Use of a Fitness Tracker to Promote Physical Activity in Children With Acute Lymphoblastic Leukemia.
abstract: BACKGROUND
  Children with cancer identify fatigue as a pervasive symptom, which increases during the corticosteroid pulse in acute lymphoblastic leukemia (ALL) maintenance. The FitBit is a fitness tracker that downloads activity measurements to the Internet in real time. In this feasibility study, we explored if children who received daily FitBit coaching for 2 weeks before a maintenance steroid pulse had an increase in steps per day and determined the relationship between steps per day prepulse and fatigue postpulse.
  
  
  METHODS
  Seventeen children in ALL maintenance, aged 6-15, wore the FitBit for 3 days to establish a baseline. A tailored weekly step goal was then set with the child and parent. Daily emails with feedback and FitBit screenshots were sent over the 2-week intervention. Self-report of fatigue was measured at baseline, after 2 weeks (i.e. before the steroid pulse), and after 5 days of steroids.
  
  
  RESULTS
  There was a trend toward increased steps per day from weeks 1-2 (P = 0.079); fatigue was low and did not increase during the corticosteroid pulse. A significant correlation (r = -0.66, P = 0.005) was found between the steps per day during week 2 and fatigue after the steroid pulse with higher steps associated with lower fatigue.
  
  
  CONCLUSIONS
  The intervention was feasible in this small sample. The average steps each time period (week 1, week 2, and during steroids) was over 10,000, demonstrating that children with ALL can be active during treatment. Physical activity may be protective of fatigue during a corticosteroid pulse.
authors.affiliation: School of Nursing, University of Minnesota, Minneapolis, Minnesota.|Children's Minnesota, Minneapolis, Minnesota.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Hooke
authors.affiliation: Children's Minnesota, Minneapolis, Minnesota.
authors.forename: Laura
authors.initials: L
authors.lastname: Gilchrist
authors.affiliation: Children's Minnesota, Minneapolis, Minnesota.
authors.forename: Lynn
authors.initials: L
authors.lastname: Tanner
authors.affiliation: Children's Minnesota, Minneapolis, Minnesota.
authors.forename: Nicole
authors.initials: N
authors.lastname: Hart
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia.
authors.forename: Janice S
authors.initials: JS
authors.lastname: Withycombe
mesh_terms: D061725:Accelerometry / Q000295:instrumentation* / Q000379:methods*; D000293:Adolescent; D002648:Child; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D010865:Pilot Projects; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications
keywords: acute lymphoblastic leukemia; children; fatigue; fitness tracker; physical activity