Association between daily physical functioning and accelerometer-measured physical activity in colon cancer patients: An ecological momentary assessment study

Authors: Liao Y, Robertson M, Demark-Wahnefried W, Peterson S, Basen-Engquist K

Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020

Abstract Body:
Purpose of the study: To test if daily self-reported physical functioning is associated with device-measured physical activity in a sample of colon cancer patients’ daily lives. Methods: This study analyzed data from a pilot study arm as part of the Cyberinfrastructure for Comparative Effectiveness Research (CYCORE) feasibility trial, which recruited colorectal cancer patients (stage I-IV) for two bursts of 5-day monitoring of ecological momentary assessment (EMA) and accelerometer wear. This study used data from the evening EMA surveys that asked questions about physical functioning. These included 10 items adapted from a quality-of-life measure (SF-36) that asked “Today, how much did your health limit you in…” A summary score was calculated based on the SF-36 scoring rules with a range from 0 to 100. Actigraph data was processed to estimate daily minutes in moderate-to-vigorous physical activity (MVPA). Multilevel linear regression models were conducted to test the between-subject (BS) and within-subject (WS) associations between daily physical functioning scores and total MVPA minutes. Results: A total of 48 colon cancer patients enrolled in the pilot study arm. Of them, 39 had at least one completed EMA evening survey during the monitoring period. Three out of the 39 patients did not have any valid accelerometer data. Thus, 36 patients were included in the current analysis. They were 50% female, 78% white, and average age was 54 years old (ranged 25-70, SD=11.5). Patients on average had 5 days of EMA- accelerometer matched data (ranged 1-10, SD=2.8). Their average physical functioning score was 84 (ranged 29-100, SD=18) and average daily MVPA minutes was 42 (ranged 0-159, SD=38.2). A positive association was found between physical functioning and MVPA minutes at the BS level (β=0.15, p=0.04). There was no significant association at the WS level. Conclusion: Colon cancer patients’ physical functioning was not associated with that day’s device-measured physical activity. However, patients who generally engaged in more MVPA than others reported better physical functioning. Remote monitoring tools such as EMA and accelerometry provide us opportunity to investigate dynamic associations in cancer patients’ behavioral performance and outcomes in their daily lives.

Keywords: Remote monitoring Patient-reported outcome Physical activity