Physical activity level as an outcome measure for use in cancer cachexia trials: a feasibility study

Cancer cachexia impacts on treatment options, quality of life and survival. New treatments are emerging but need to be assessed using outcomes which patients find meaningful. One approach is the measurement of physical activity levels by small lightweight monitors, but experience is limited in cancer patients. This study formally assessed the acceptability of wearing an ActivPAL (TM) monitor for 1 week using compliance based on analysis of movement data. The optimal period of monitoring was explored by comparing mean values of daily step count and energy expenditure (EE) for 2 or 4 and 6 days of monitoring. The relationships between step count, stepping EE and non-stepping EE were also explored. Sixty patients (mean age 68 years; Eastern Cooperative Oncology Group performance status 0-2) with lung or upper gastrointestinal cancer took part. All but one found that the monitor acceptable and mean [95% CI] compliance was 98% [94-100%]. Median daily step counts and EE scores over 2 or 4 days were significantly higher than those from 6 days (p a parts per thousand currency signaEuro parts per thousand 0.01). Step count was strongly related to stepping and non-stepping EE (r = -0.911, p < 0.01). The ActivPAL (TM) is acceptable to patients with outcomes obtained over 6 days recommended for use in future studies.