Physical activity in patients with cancer: self-report versus accelerometer assessments

Joeri A.J Douma,Maaike B De Beaufort,Jan H Smit,Jorine A Vermaire,Caroline S Kampshoff,Willem Van Mechelen,Frans Nollet,Laurien M Buffart,Saskia Persoon,Irma M Verdonck-De Leeuw,Marie José Kersten,Mai J Chinapaw,Teatske M Altenburg

doi:10.1007/s00520-019-05203-3

Abstract

PurposeThe level of daily physical activity in patients with cancer is frequently assessed by questionnaires, such as the Physical Activity Scale for the Elderly (PASE). Objective assessments, with for example accelerometers, may be a good alternative. The aim of this study was to investigate the agreement between the PASE questionnaire and accelerometer-assessed physical activity in a large group of patients with different types of cancer.MethodsBaseline accelerometer and PASE questionnaire data of 403 participants from the REACT (Resistance and Endurance Exercise After Chemotherapy, n = 227), the EXIST (Exercise Intervention After Stem-Cell Transplantation, n = 74), and NET-QUBIC (NEtherlands QUality of Life And Biomedical Cohort Studies In Cancer, n = 102) studies were available for the current analyses. Physical activity was assessed by the PASE questionnaire (total score) and accelerometers (total minutes per day > 100 counts). Linear mixed models regression analysis was used to assess the agreement between the PASE questionnaire and accelerometer-assessed physical activity.ResultsThe mean (SD) PASE score was 95.9 (75.1) points and mean (SD) time in physical activity measured with the accelerometer was 256.6 (78.8) min per day. The agreement between the PASE score and the accelerometer data was significant, but poor (standardized regression coefficient (B) = 0.36, 95%CI = 0.27; 0.44, p < 0.01).ConclusionAgreement between the PASE questionnaire and accelerometer-assessed physical activity was poor. The poor agreement indicates that they measure different physical activity constructs and cannot be used interchangeably to assess the level of daily physical activity in patients with cancer.

Highlights

Regular daily physical activity is associated with a reduced risk of cancer development and a reduction in mortality after the diagnosis of cancer [1,2,3]
640 patients participated in the Resistance and Endurance exercise After ChemoTherapy (REACT) (n = 277), Exercise Intervention after Stem cell Transplantation (EXIST) (n = 109), and NET-QUBIC studies (n = 254)
The agreement between the Physical Activity Scale for the Elderly (PASE) questionnaire and accelerometer-assessed physical activity expressed in min/day was significant but poor (B = 0.36, 95%confidence intervals (CI) = 0.27; 0.44, p < 0.01) (Table 2 and Fig. 2)

Summary

Introduction

Regular daily physical activity is associated with a reduced risk of cancer development and a reduction in mortality after the diagnosis of cancer [1,2,3]. Physical activity and exercise interventions have significant beneficial effects on the level of fatigue and quality of life in patients with cancer [4,5,6]. Previous studies have shown that the magnitude of these beneficial effects is greater in patients with worse baseline values of physical activity [6]. Correct estimation of the levels of physical activity in patients with cancer is of utmost importance to estimate its effect on various health outcomes and to estimate the effectiveness of intervention programs. It might be important to identify physically inactive patients correctly in order to offer these patients an exercise intervention program. Various measurement methods are available to estimate levels of physical activity of patients with cancer, there is no gold standard for measuring physical activity in daily life on a large scale [7, 8]

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