Physical Activity Measurement Feasibility In Chemotherapy-Receiving Gastrointestinal Cancer Survivors

Abstract

Oxaliplatin, a standard chemotherapy for invasive gastrointestinal (GI) cancer, can cause immediate and lasting side effects. Intractable fatigue and neuropathy are common and particularly severe 4-7 days after each oxaliplatin infusion but could be lessened with moderate-vigorous (MV) physical activity (PA). The best MVPA measurement method in PA intervention trials during oxaliplatin treatment is unclear. PURPOSE: To describe the feasibility of MVPA measurement in a pilot RCT of home-based brisk walking compared to PA education alone in stage II-IV GI cancer survivors receiving oxaliplatin (N = 60). METHODS: Patients were recruited at the second oxaliplatin infusion and randomized 1:1 to the 8-week intervention or PA education group. The intervention group received motivational interviewing, a Fitbit Charge 2, and other PA supports. Pearson bivariate correlations were performed among the self-report (PA vital sign [VS] interview) and objective measures (ActiGraph GT9X and Fitbit) of MVPA minutes per week. RESULTS: Mean MVPA minutes at 8 weeks were 273.8 (SD 252.34; n = 24) by Fitbit, 136.01 (SD 67.28; n = 11) by ActiGraph vector magnitude, and 272.52 (SD 666.48; n = 24) by self-report in the intervention group; and 107.07 (SD 36.04; n = 17) by ActiGraph and 145.02 (SD 154.63; n = 27) by self-report in the control group. The intervention group’s ActiGraph-PAVS correlation was moderate (r = 0.714). Self-report and objective MVPA were not correlated in the control group at 8 weeks and intervention group at baseline. Technical errors (n = 7), devices lost while exercising (n = 2), and noncompliance (n = 5; i.e., not wearing when less active than usual) led to missing ActiGraph data. Patients often struggled to respond to the PAVS, because their MVPA differed 1- and 2-weeks post-infusion. CONCLUSION: Self-reported MVPA (the PAVS) may be unreliable in GI cancer survivors during oxaliplatin treatment, due to high response variability, influenced by acutely changing chemotherapy side effects and lack of objective MVPA awareness. For the few compliant participants, ActiGraph measurement the week after infusion may represent true MVPA levels, but re-evaluation of the Fitbit MVPA cut-off points and required duration of ActiGraph measurement is still needed among oxaliplatin-receiving patients.