The relationship between ambulatory step activity, self-reported physical functioning and standardised timed walking in patients with haematological malignancies

Abstract

N K (2010). The relationship between ambulatory step activity, self-reported physical functioning and standardised timed walking in patients with haematological malignancies. Disability and Rehabilitation, 32(22):1819-1826. Postprint available at: http://www.zora.uzh.ch Similarly, ambulatory activity monitoring did not correlate significantly with self-reported functional status in patients with chronic obstructive pulmonary disease. [20] To the best of our knowledge, only one previous report has investigated the relationship between ambulatory step activity monitoring, self-reported physical functioning and the 6-minute standardized walking test in cancer patients.[28] There was moderate agreement between the 7-Day Physical Activity Recall and the accelerometer with longitudinal serial correlation coefficients of 0.54 (baseline), 0.24 (year 1), and 0.53 (year 2), all p-values <0.01.To summarize, the association observed between self-reported physical functioning, standardized timed walking and the outputs of ambulatory step activity varies from none to almost perfect in studies of various chronic disease populations. Only one study has investigated this issue in cancer patients, and none among HSCT patients. The aim of the current study was to determine the degree of association between self-reported physical functioning, standardized timed walking and the outputs of ambulatory step activity monitoring among outpatients with haematological malignancies recovering from HSCT. Methods ParticipantsThis study presents a cross-sectional analysis of baseline data collected from a subset of 117 ambulatory hematological patients after completion of HSCT at the University HospitalZurich and the Cantonal Hospital of St. Gallen, Switzerland. These baseline data were 4 collected before the patients were randomized between an ambulatory physical exercise intervention and a usual care (i.e., non-exercising) control group. Adult patients were considered eligible for the study if they had completed their HSCT treatment. Patients were excluded from the study in case of graft versus host disease (GVHD) except for grade I not requiring treatment, painful joints, instable osteolyses, chronic pain, lesions of the central or peripheral nervous system, uncontrolled cardiovascular disease, thyroid disease or diabetes.The study was approved by the local ethical committee. All patients provided written informed consent. MeasurementsAmbulatory step activity levels were assessed with the Step Activity Monitor 3 (SAM3, Cymatech Corporation, Seattle, WA, USA). The patients were instructed to wear the SAM3 for 7 consecutive days. Activity monitoring over a 7-day period has previously been found to result in reliable and representative measures of an individual's movements on a day-to-day basis.[17] All participants were instructed to leave the SAM3 on the ankle if they had to rest or lay down during the day and to perform their daily activities as usual. The parameters assessed by the SAM3 for this study were: (1) `average steps/day`, (2) ...

Are Patient-Reported Outcomes of Physical Function a Valid Substitute for Objective Measurements?

“…The weak association between the pro-pf and cardiorespiratory fitness is in line with results of two earlier studies that showed a weakly-to-moderately significant positive correlation between the pro-pf and the 6-minute walk test in patients with cancer 12,14 . The association between the pro-pf and objectively measured physical activity in patients with cancer has also been investigated in three previous studies, two of which found a weakly-to-moderately significant association 12,13 ; another study found no significant association 18 . The strength of our study lies in its evaluation of both associations in the same large population of patients with cancer and the use of "gold standard" objective assessments.…”

“…If agreement is sufficient, the pro-pf could be used instead of time-consuming and expensive objective measurements of physical activity (with accelerometers, for instance) and fitness (with the maximal exercise test). Earlier studies showed that the association between the pro-pf and physical activity 12,13 and between the pro-pf and cardio respiratory fitness (assessed using the submaximal 6-minute walk test) 12,14 was weak to moderate (Pearson correlation coefficients: 0.33-0.55). However, those studies did not investigate the interrelationships of the pro-pf and physical activity and cardiorespiratory fitness in the same sample, hampering a direct comparison.…”

Cardiopulmonary fitness in patients undergoing hematopoietic SCT: a pilot study

“…The median VO 2peak for our group of 20.9 mL/kg/min compares with a VO 2peak of 22.8 mL/kg/min in independently living 55-86-year-old men. 26 Patients in our cohort walked a pre-HCT median of 480 m (range 305-690 m), compared with a reported mean 6MW distance of 575.8 m in other patients with hematological malignancies, 27 and a mean of 384 m in post-allogeneic HCT patients. 21 The 6MW distance has demonstrated prognostic value in other clinical populations, including patients with chronic obstructive pulmonary disease or heart failure, older adults and those with solid tumors, hematological malignancies and post-transplant survivors.…”

Exercise and Stress Management Training Prior to Hematopoietic Cell Transplantation: Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 0902

“…One randomized study in HCT patients reported differences in some objective measures of strength and endurance, but not in self-reported symptoms or QOL, suggesting that the detected functional differences were not clinically meaningful 49 or that these measures are not reflective of physical functioning. 50 The SF-36 PCS and MCS are global subscales that may not capture improved strength or endurance. However, the CTXD was developed specifically to measure distress related to HCT, and it has shown sensitivity to change over the course of treatment.…”