Abstract
In addition to patient reported outcome measures, accelerometers may provide useful information on the outcome of sarcoma patients treated with limb salvage. The StepWatch (SW) Activity Monitor (SAM) is a two-dimensional accelerometer worn on the ankle that records an objective measure of walking performance. The purpose of this study was to validate the SW in a cross-sectional population of adult patients with lower extremity sarcoma treated with limb salvage. The main outcome was correlation of total steps with the Toronto Extremity Salvage Score (TESS). In a sample of 29 patients, a mean of 12 days of SW data was collected per patient (range 6–16), with 2767 average total steps (S.D. 1867; range 406–7437). There was a moderate positive correlation between total steps and TESS (r = 0.56, P = 0.002). Patients with osseous tumors walked significantly less than those with soft tissue sarcoma (1882 versus 3715, P < 0.01). This study supports the validity of the SAM as an activity monitor for the objective assessment of real world physical function in sarcoma patients.
Highlights
Multimodal treatment of lower extremity sarcoma has achieved gains in mortality alongside a shift to limb salvage over the past several decades [1]
While continuing to assess oncologic outcomes, there is a growing focus on measuring health-related quality of life and function with the use of patient-reported outcomes (PRO) [2]. Assessing these patient-centered outcomes is important for conducting comparative effectiveness research [3]
In a cross-sectional population of patients with lower extremity sarcoma treated with limb salvage at a single institution between 2010 and 2012, patients were recruited to wear the StepWatch as part of a prospective cohort
Summary
Multimodal treatment of lower extremity sarcoma has achieved gains in mortality alongside a shift to limb salvage over the past several decades [1]. While continuing to assess oncologic outcomes, there is a growing focus on measuring health-related quality of life and function with the use of patient-reported outcomes (PRO) [2]. Assessing these patient-centered outcomes is important for conducting comparative effectiveness research [3]. One assessment of functional outcome through a PRO measure is the Toronto Extremity Salvage Score (TESS) [4]. The TESS is a valid and reliable PRO measure designed to assess physical function and impairment following treatment for sarcoma. As an adjunct or alternative to survey-based PRO, objective measurement of walking performance in daily life may be valuable to understand how patients function, evaluate treatment options, and better educate patients on anticipated outcomes
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