Accuracy of perceived physical activity and fitness levels among childhood cancer survivors

Abstract

Background: Childhood cancer survivors do not engage in sufficient physical activity and have low fitness levels. Perceived physical activity and fitness levels may influence survivors' engagement in health behaviours. We aimed to investigate survivors' perceptions of physical activity and fitness levels and identify how accurate their perceptions were. We further explored survivors' attitudes toward physical activity, including perceived importance and desire to increase activity levels. Procedure:We recruited 116 childhood cancer survivors (8-18 years) and assessed their perceived physical activity levels using a questionnaire and the Godin's Leisure Score Index. Accuracy of their perceptions was established by comparing their perceived physical activity levels with the recommended guidelines. Survivors reported their perceived fitness levels using the International Fitness Scale. We compared survivors' perceptions with their performance on the 6-minute walk test using weighted Cohen's kappa to determine interrater agreement between perceived and objectively measured fitness.Results: Most survivors did not meet the physical activity guidelines (<420 min/week).One-third incorrectly perceived whether their self-reported physical activity levels were appropriate (84% underestimated, while 16% overestimated). Survivors had average fitness and were inaccurate at perceiving their fitness level. Survivors highly valued the importance of being able to do physical activity, and 89% reported a desire to increase their physical activity. Conclusions:Our results reveal that many survivors are not accurate when perceiving their physical activity and fitness levels. Emphasising the need for objective fitness assessments, and patient education in clinical practice may support survivors to accurately perceive their physical activity and fitness levels, thus improving health behaviours.

A Digital Educational Intervention With Wearable Activity Trackers to Support Health Behaviors Among Childhood Cancer Survivors: Pilot Feasibility and Acceptability Study

“…We assessed the survivors’ aerobic fitness using the 6-minute walk test (6MWT) at baseline, after the intervention (week 12), and at follow-up (week 24). The 6MWT has previously been used in childhood cancer survivors and is a good predictor of aerobic fitness [ 9 , 10 ]. Before and after the intervention, the 6MWT was administered by an accredited exercise physiologist (LH), in accordance with the American Thoracic Society recommendations [ 29 ].…”

“…In addition, physical activity may have a positive influence on survivors’ health-related quality of life (HRQoL) [ 7 ]. Nevertheless, many survivors do not engage in sufficient levels of physical activity [ 8 ], have poor perceptions of their activity levels [ 9 ], and have below-average fitness levels [ 10 ].…”

Inflammatory biomarkers after an exercise intervention in childhood acute lymphoblastic leukemia survivors

“…One review article highlighted the broad beneficial anti-inflammatory effects of regular exercise training even after adjustment for potential confounders such as body mass index (BMI), and indicated that habitual exercise may be capable of delaying immune dysregulation and immunosenescence, which is associated with aging [33]. In contrast, harmful effects linked to extreme exercise training workloads exist as well [28,33], but childhood cancer survivors are not likely to partake in extreme exercise as the majority of them report low levels of physical activity [34,35].…”

“…However, most of them (65.7%) did not achieve their age-predicted heart rate maximum, and some (6.9%) presented chronotropic incompetence (CI). In addition, 35.8% of the 216 ALL survivors studied were at high risk of developing CI [9]. CI is common in patients with CVD, as it produces exercise intolerance and is an independent predictor of adverse cardiovascular events and mortality [10].…”