Objectively Recorded Physical Activity And Perceived Distress At The Beginning Of Oncological Treatment

BACKGROUND Interest in the use of wearables in medical care is increasing. Wearables can be used to monitor different variables, such as vital signs and physical activity. A crucial point for using wearables in oncology is if patients already under the burden of severe disease and oncological treatment can accept and adhere to the device. At present, there are no specific recommendations for the use of wearables in oncology, and little research has examined the purpose of using wearables in oncology. OBJECTIVE The purpose of this review is to explore the use of wearables in clinical trials during cancer treatment, with a special focus on adherence. METHODS PubMed and EMBASE databases were searched prior and up to October 3, 2019, with no limitation in the date of publication. The search strategy was aimed at studies using wearables for monitoring adult patients with cancer during active antineoplastic treatment. Studies were screened independently by 2 reviewers by title and abstract, selected for inclusion and exclusion, and the full-text was assessed for eligibility. Data on study design, type of wearable used, primary outcome, adherence, and device outcome were extracted. Results were presented descriptively. RESULTS Our systematic search identified 1269 studies, of which 25 studies met our inclusion criteria. The types of cancer represented in the studies were breast (7/25), gastrointestinal (4/25), lung (4/25), and gynecologic (1/25); 9 studies had multiple types of cancer. Oncologic treatment was primarily chemotherapy (17/25). The study-type distribution was pilot/feasibility study (12/25), observational study (10/25), and randomized controlled trial (3/25). The median sample size was 40 patients (range 7-180). All studies used a wearable with an accelerometer. Adherence varied across studies, from 60%-100% for patients wearing the wearable/evaluable sensor data and 45%-94% for evaluable days, but was differently measured and reported. Of the 25 studies, the most frequent duration for planned monitoring with a wearable was 8-30 days (13/25). Topics for wearable outcomes were physical activity (19/25), circadian rhythm (8/25), sleep (6/25), and skin temperature (1/25). Patient-reported outcomes (PRO) were used in 17 studies; of the 17 PRO studies, only 9 studies reported correlations between the wearable outcome and the PRO. CONCLUSIONS We found that definitions of outcome measures and adherence varied across studies, and limited consensus among studies existed on which variables to monitor during treatment. Less heterogeneity, better consensus in terms of the use of wearables, and established standards for the definitions of wearable outcomes and adherence would improve comparisons of outcomes from studies using wearables. Adherence, and the definition of such, seems crucial to conclude on data from wearable studies in oncology. Additionally, research using advanced wearable devices and active use of the data are encouraged to further explore the potential of wearables in oncology during treatment. Particularly, randomized clinical studies are warranted to create consensus on when and how to implement in oncological practice.

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The Use of Wearables in Clinical Trials During Cancer Treatment: Systematic Review

JMIR mhealth and uhealth ◽

10.2196/22006 ◽

2020 ◽

Vol 8 (11) ◽

pp. e22006

Author(s):

Ulrikke Lyng Beauchamp ◽

Helle Pappot ◽

Cecilie Holländer-Mieritz

Keyword(s):

Physical Activity ◽

Clinical Trials ◽

Cancer Treatment ◽

Controlled Trial ◽

Severe Disease ◽

Vital Signs ◽

Sensor Data ◽

Special Focus ◽

Oncological Treatment ◽

Patient Reported

Background Interest in the use of wearables in medical care is increasing. Wearables can be used to monitor different variables, such as vital signs and physical activity. A crucial point for using wearables in oncology is if patients already under the burden of severe disease and oncological treatment can accept and adhere to the device. At present, there are no specific recommendations for the use of wearables in oncology, and little research has examined the purpose of using wearables in oncology. Objective The purpose of this review is to explore the use of wearables in clinical trials during cancer treatment, with a special focus on adherence. Methods PubMed and EMBASE databases were searched prior and up to October 3, 2019, with no limitation in the date of publication. The search strategy was aimed at studies using wearables for monitoring adult patients with cancer during active antineoplastic treatment. Studies were screened independently by 2 reviewers by title and abstract, selected for inclusion and exclusion, and the full-text was assessed for eligibility. Data on study design, type of wearable used, primary outcome, adherence, and device outcome were extracted. Results were presented descriptively. Results Our systematic search identified 1269 studies, of which 25 studies met our inclusion criteria. The types of cancer represented in the studies were breast (7/25), gastrointestinal (4/25), lung (4/25), and gynecologic (1/25); 9 studies had multiple types of cancer. Oncologic treatment was primarily chemotherapy (17/25). The study-type distribution was pilot/feasibility study (12/25), observational study (10/25), and randomized controlled trial (3/25). The median sample size was 40 patients (range 7-180). All studies used a wearable with an accelerometer. Adherence varied across studies, from 60%-100% for patients wearing the wearable/evaluable sensor data and 45%-94% for evaluable days, but was differently measured and reported. Of the 25 studies, the most frequent duration for planned monitoring with a wearable was 8-30 days (13/25). Topics for wearable outcomes were physical activity (19/25), circadian rhythm (8/25), sleep (6/25), and skin temperature (1/25). Patient-reported outcomes (PRO) were used in 17 studies; of the 17 PRO studies, only 9 studies reported correlations between the wearable outcome and the PRO. Conclusions We found that definitions of outcome measures and adherence varied across studies, and limited consensus among studies existed on which variables to monitor during treatment. Less heterogeneity, better consensus in terms of the use of wearables, and established standards for the definitions of wearable outcomes and adherence would improve comparisons of outcomes from studies using wearables. Adherence, and the definition of such, seems crucial to conclude on data from wearable studies in oncology. Additionally, research using advanced wearable devices and active use of the data are encouraged to further explore the potential of wearables in oncology during treatment. Particularly, randomized clinical studies are warranted to create consensus on when and how to implement in oncological practice.

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Physiotherapy and Physical Activity as Factors Improving the Psychological State of Patients With Cancer

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.772694 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ewelina Zyzniewska-Banaszak ◽

Jolanta Kucharska-Mazur ◽

Aleksandra Mazur

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Substance Use ◽

Emotional State ◽

Well Being ◽

Psychological State ◽

Oncological Treatment ◽

Patients With Cancer ◽

Fatigue Syndrome

Physiotherapy in oncology is a process closely related to cancer treatment methods. Rehabilitation is based on physical activity in various forms involving the musculoskeletal system but also affects the emotional state. Physical activity influences physical and psychological well-being of people undergoing oncological treatment, in the course of which the most common psychiatric disorders are depression, substance use disorder, sleep disorders, fatigue syndrome, resulting in worsening of the quality of life. Difficulties in implementing physical exercise in cancer patients pose a challenge to treatment teams.

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The role of physical exercise in the development of breast cancer

Physiotherapy ◽

10.1515/physio-2015-0014 ◽

2015 ◽

Vol 23 (3) ◽

Cited By ~ 1

Author(s):

Agata Adasik

Keyword(s):

Breast Cancer ◽

Physical Activity ◽

Physical Exercise ◽

Scientific Evidence ◽

Experimental Studies ◽

Experimental Models ◽

Protective Effects ◽

Oncological Treatment ◽

Beneficial Effects

AbstractBreast cancer is one of the most common types of cancer among women worldwide. Epidemiological and experimental studies confirm the beneficial effects of physical exercise both in patients who have suffered a relapse and in those who are in the course of a treatment. Researchers suggest that regular physical effort performed 3-5 times a week at 20-40 MET reduces the risk of development of breast cancer. Scientific evidence suggests that aerobic training can be safe and effective even during the oncological treatment, which, depending on the stage of the disease, may consist of surgical treatment combined with chemotherapy, radiotherapy or hormone therapy. In addition, it significantly improves the function of the circulatory and respiratory systems, reduces fatigue and improves the quality of life of patients struggling with the disease. There are many theories on the mechanisms that are triggered by aerobic workout. Despite the numerous studies on this subject, which have been conducted over the years, we still cannot say how physical activity reduces the risk of development of breast cancer. The most frequently mentioned biological mechanisms include the influence of oestrogen, metabolic hormones, growth factor, inflammatory markers, response from the immune system, insulin resistance and oxidative stress. Many studies into the process of carcinogenesis are carried out in laboratory conditions on animals. Due to application of different experimental models, the results of such studies are often ambiguous. Nevertheless, scientists see a huge potential in this kind of experiments, because some of them have already attested to the protective effects of physical exercise against the appearance of breast cancer, but also they have increased our understanding of the processes through which this risk is reduced. Perhaps, in the future physical activity will become a part of a cancer treatment thanks to the results of such studies.

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