Can Steps per Day Reflect Symptoms in Children and Adolescents Undergoing Cancer Treatment?

Authors

Janice S. Withycombe, Author Affiliations: Clemson University School of Nursing, South Carolina (Dr Withycombe); Duke University School of Medicine, Durham, North Carolina (Mss McFatrich, Lin, Lucas, and Mann and Dr Reeve); Children's National Health System (Dr Hinds) and George Washington University (Dr Hinds), DC; University of North Carolina, Chapel Hill (Dr Bennett); University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pennsylvania (Dr Maurer); Emory University School of Medicine (Dr Castellino) and Children's Healthcare of Atlanta, Georgia (Dr Castellino); and St Jude Children's Research Institute, Memphis, Tennessee (Dr Baker).
Molly McFatrich
Pamela S. Hinds
Antonia Bennett
Li Lin
Scott H. Maurer
Nicole R. Lucas
Courtney M. Mann
Sharon M. Castellino
Justin N. Baker
Bryce B. Reeve

Document Type

Journal Article

Publication Date

2-5-2022

Journal

Cancer nursing

DOI

10.1097/NCC.0000000000001062

Abstract

BACKGROUND: Multiple symptoms occur in children receiving cancer therapy. Decreased steps per day may be associated with burdensome symptoms. OBJECTIVE: To evaluate associations between self-reported symptoms (pain interference, anxiety, depressive symptoms, psychological stress, and fatigue) and function (physical function-mobility and physical activity) and cumulative symptom count with steps per day. METHODS: Five sites enrolled English-speaking children, 8 to 17 years, receiving treatment for a first cancer diagnosis. Patient-reported outcome (PRO) surveys were administered before (T1) and after (T2) a course of chemotherapy. Garmin VivoFit 3 (Garmin International, Olathe, KS) accelerometers were worn 7 days prior to each data point. Univariate changes in scores over time were evaluated with dependent-sample t tests. Pearson correlations examined associations between PRO domains and step count. Multivariable mixed-effect models examined associations between steps and PROs. RESULTS: Participants' (n = 65) steps per day decreased during treatment (4099 [T1] and 3135 [T2]; P < .01), with larger reductions observed during hospitalization and in younger children compared with adolescents. Steps significantly correlated with PROMIS (Patient-Reported Outcome Measurement Information System) Pediatric physical activity and physical function-mobility. Decreased steps per day were associated with increased fatigue and cumulative symptom count. CONCLUSIONS: In children and adolescents with cancer, steps per day can serve as an indicator of fatigue, cumulative symptom count, physical activity, and physical functioning-mobility. IMPLICATIONS FOR PRACTICE: Child self-reports of physical activity and physical function are valid during cancer therapy and should be captured. In the absence of self-report, decreasing step count may prompt additional assessments related to fatigue or cumulative symptom count and trigger early interventions to support physical activity and physical function-mobility.

APA Citation

Withycombe, Janice S.; McFatrich, Molly; Hinds, Pamela S.; Bennett, Antonia; Lin, Li; Maurer, Scott H.; Lucas, Nicole R.; Mann, Courtney M.; Castellino, Sharon M.; Baker, Justin N.; and Reeve, Bryce B., "Can Steps per Day Reflect Symptoms in Children and Adolescents Undergoing Cancer Treatment?" (2022). GW Authored Works. Paper 321.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/321

Department

Pediatrics