Using a fitness tracking device (Fitbit Charge [FC]) as a prognostic tool was feasible and acceptable in a study evaluating 80 colorectal cancer (CRC) patients. The researchers found that patients’ activity levels correlated with performance status. In addition, the baseline activity level was associated with toxicities. Therefore, a routine assessment of a patient’s performance activity using these devices can provide objective and useful information about the patient’s fitness and ability to tolerate treatment
The FC was used to obtain physical activity (PA) data with a further assessment of the possible correlation between PA, physician-assessed performance status (PS), and treatment toxicity using a cutoff of 5000 steps per day (SPD). This amount was chosen because it is half of the Generally Recommended Daily Goal of 10,000 SPD, previously used as a sedentary lifestyle limit
In the study, patients with CRC undergoing treatment at a National Cancer Institute-designated Comprehensive Cancer Center were prospectively enrolled in the medical arm if they began new systemic chemotherapy or in the surgical arm if they were planning a curative resection .
At baseline, patients were given an FC device that they could wear every day for 4 days, with instructions to wear it for as many hours as they were comfortable.
The mean SPD was calculated and any postoperative complication in patients who underwent surgery or had toxicity greater than Grade 3 in the medical patient’s arm was considered a toxicity of interest (TOI). This was stratified by the cut-off of 5000 SPD. This incidence was compared with patients who averaged more or less than 5000 SPD.
A total of 68 (85%) patients met the feasibility criteria, with 35 (87.5%) medical and 33 (82.5%) surgical patients exceeding the feasibility threshold.
Investigators reported that many participants wore the device continuously (after or near 24 hours) and use of the device did not appear to decrease over time. Overall, the FC tests were well received by the patients. Of 85 patients who were asked to participate, only 1 declined to participate in this study because they were overwhelmed with diagnosis and treatment.
Virtually all of the patients (91%) who participated in the study found the FC to be easy to carry and use. A majority (81%) said the device did not interfere with their daily activity.
The SPD correlated well with the physician-assessed PS, and the finding persisted in both the medical and surgical cohorts. Although this was not a primary endpoint, the researchers believe the results are encouraging (FIGURES 1 and 2).
For example, patients who experienced toxicities had a numerically lower SPD compared to patients who did not. The researchers found that in the medical setting, patients who experienced toxicities showed an increase in SPD count at follow-up, but this difference was insignificant and of little clinical relevance. The researchers found that patients who experienced TOI and related hospitalizations may have been prescribed physical therapy, resulting in improved mobility in the hospital or outpatient setting, which was not a variable recorded in the study.
The researchers concluded that using a monitor to determine the patient’s physical activity is possible and that SPD correlates with ECOG performance status.