Activity trackers like the Fitbit can count steps and measure sleep, but a new study suggests they can also be used to gauge patients’ symptoms and overall functional status after hematopoietic stem cell transplant (HSCT).
Researchers used Fitbits to track the physical activity of 32 HSCT recipients and found that decreases in average daily steps were associated with increases in pain, fatigue, and other symptoms, as well as a reduction in self-reported activities.
The researchers say the findings, published in Quality of Life Research, indicate that activity trackers could be a useful tool for tracking symptoms and physical function systematically, especially for patients who may not be able to self-report their symptoms using questionnaires because of language barriers, literacy, or cognitive or health status.
“We found that changes in daily steps are highly correlated with pain and fatigue,” said Antonia Bennett, PhD, of the University of North Carolina at Chapel Hill.
“These wearables provide a way to monitor how patients are doing, and they provide continuous data with very little patient burden.”
For this study, Dr Bennett and her colleagues evaluated daily steps, as measured by Fitbit Flex activity trackers, and symptoms in 32 adults who underwent autologous or allogeneic HSCT to treat leukemia, lymphoma, myeloma, myelodysplastic syndromes, aplastic anemia, or solid tumor malignancy.
The patients wore the activity trackers and completed assessments about their symptoms and quality of life for 4 weeks during transplant hospitalization and 4 weeks after discharge.
Each week, the patients reported symptomatic treatment toxicities using single items from PROCTCAE and symptoms, physical health, mental health, and quality of life using PROMIS_ Global-10. The researchers compared these answers with pedometry data, summarized as average daily steps per week, using linear mixed models.
These analyses showed that decreases in a patient’s average daily steps were associated with increases in the following:
- Pain (852 fewer steps per unit increase in pain score, P<0.001)
- Fatigue (886 fewer steps, P<0.001)
- Vomiting (518 fewer steps, P<0.01)
- Shaking/chills (587 fewer steps, P<0.01)
- Diarrhea (719 fewer steps, P<0.001)
- Shortness of breath (1018 fewer steps, P<0.05)
- Reduction in carrying out social activities (705 fewer steps, P<0.01)
- Reduction in carrying out physical activities (618 fewer steps, P<0.01)
- Global physical health (101 fewer steps, P<0.001).
However, decreases in daily steps were not linked to global mental health or quality of life.
“Studies like this demonstrate that wearable devices can measure an aspect of physical function that is directly related to symptomatic toxicities following treatment,” said William Wood, MD, of the University of North Carolina at Chapel Hill.
“As clinicians, we often want to know–overall, how well are our patients doing with treatment? Are they better, worse, or about the same? Data from wearable devices may allow us to answer these questions with much more precision than we’ve had in the past.”
