Objectively measured versus self-reported physical activity in children and adolescents with cancer

Abstract

ObjectiveExisting research recognizes low levels of physical activity in pediatric patients with cancer, but much uncertainty exists about their capability to self-reflect physical activity levels. The objective of this study was to compare results of subjective self-reports and objective accelerometers regarding levels of daily walking as well as moderate-to-vigorous physical activities.MethodsResults of the objective assessment tool StepWatchTM Activity Monitor and self-reporting with a standardized questionnaire were compared in 28 children and adolescents during cancer treatment.ResultsThe patients were 13.8±2.8 years of age and 3.4±2.0 months after cancer diagnosis. The Bland-Altman plots indicated a fairly symmetrical under- and over-estimation for daily minutes of walking with the limits of agreement ranging from -100.8 to 87.3 min (d = -6.7 min). Mean difference for moderate-to-vigorous physical activity was almost zero but limits of agreement are ranging from -126.8 to 126.9 min. The comparison for the days with at least 60 min of moderate-to-vigorous physical activity showed a marked difference with 3.0±2.6 self-reported days versus only 0.1±0.4 measured days.ConclusionsThese findings suggest that physical activity in pediatric cancer patients should preferably be assessed with objective methods. Greater efforts are needed to implement supervised exercise interventions during treatment incorporating methods to improve self-reflection of physical activity.

Assessment of physical function in children with cancer: A systematic review

“…Other outcome measures gaining a negative moderate rating were the ASKp and the KiGGS‐AQ. The ASKp displayed ceiling effects and the KIGGS‐AQ did not correlate with objectively measured activity levels . This limitation of the KIGGS‐AQ is in line with literature reporting that children tend to overestimate their moderate‐to‐vigorous physical activity, a limitation worth considering given the prevalence of inactivity in paediatric cancer populations .…”

“…Nine hundred articles were excluded based on title and abstract with substantial agreement between reviewers ( K = 0.63, 95% CI 0.47–0.79). Thirty‐seven articles were sourced in full text, of which 21 were excluded leaving 16 articles (see Figure ) that assessed the measurement properties of 12 outcome measures (see Table ). Content and construct validity were most commonly assessed.…”

“…Results for the Lansky Play Performance Scale also found moderate evidence against the use of the measure, with two studies finding inadequate inter‐rater reliability scores ( r = 0.65, rho = 0.74). There was moderate evidence against the use of the Activity Scale for Kids – performance version (ASKp), with ceiling effects in excess of 12%, and moderate evidence against the use of the German Health Interview and Examination Survey for Children and Adolescents – Activity questionnaire (KiGGS‐AQ), results showing poor correlation between questionnaire and accelerometry.…”

“…Thirty-seven articles were sourced in full text, of which 21 were excluded leaving 16 articles [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] (see Figure 3) that assessed the measurement properties of 12 outcome measures (see Table 2). Content and construct validity were most commonly assessed.…”

Feasibility and effects of a home-based intervention using activity trackers on achievement of individual goals, quality of life and motor performance in patients with paediatric cancer

“…A previous study showed that young patients with cancer have problems to reliably self-reflect levels of physical activity. 16 While a relevant number of patients overestimated their daily minutes of walking, underestimation occurred same as often. Lacking self-reflection of physical activity levels seems to be an important issue for children during cancer treatment.…”