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Kanzawa-Lee G, Krauss JC, Knoerl R. Exploring Chemotherapy-Induced Peripheral Neuropathy Management Practice Patterns Among Oncology Clinicians. Semin Oncol Nurs 2024; 40:151685. [PMID: 38937199 DOI: 10.1016/j.soncn.2024.151685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/09/2024] [Accepted: 05/22/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES Approximately 60% of cancer survivors receiving neurotoxic chemotherapy experience chemotherapy-induced peripheral neuropathy (CIPN) (eg, hand and foot numbness, tingling, or pain). There is only one recommended pharmacological treatment (duloxetine) and one modestly beneficial nonpharmacological treatment (exercise) for CIPN. However, data suggest national guideline recommendations are not routinely practiced. Further, less is known about nurses' CIPN management practices. The purpose of this convergent mixed methods study was to explore oncology clinicians' self-reported practices and perceptions regarding CIPN prevention and management. METHODS Oncology clinicians at three cancer centers completed a survey about their recommendations for CIPN prevention and management in practice. A subset of clinicians also participated in a semi-structured interview to explore their perspectives of and motivations for implementing CIPN assessment, prevention, and management in practice. Quantitative data were described (eg, frequency or median) and qualitative data were analyzed using inductive content analysis. RESULTS This study (N = 44 survey responses; n = 9 interviews) resulted in four themes: (1) clinicians primarily recommend gabapentin for CIPN management and often observe cryotherapy used for CIPN prevention, but these interventions are complicated by discomfort, intolerable side effects, and efficacy concerns; (2) clinicians perceive CIPN as troublesome and desire additional information and resources regarding CIPN prevention and management; (3) CIPN-related education provided by clinicians may be limited by patient retention of the amount of education received about cancer treatment and other factors; (4) clinicians use subjective CIPN assessment to screen at each visit for common CIPN symptoms (eg, numbness or tingling) and the impact of symptoms on day-to-day activities. CONCLUSIONS Discrepancies persist between evidence-based guidelines on CIPN management and current oncology clinician practices. IMPLICATIONS FOR NURSING PRACTICE Clinician involvement is needed when developing education and resources to help oncology clinicians provide the most evidence-based care to potentially prevent and manage their patients' CIPN.
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Affiliation(s)
| | - John C Krauss
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Robert Knoerl
- School of Nursing, University of Michigan, Ann Arbor, MI
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Kanzawa-Lee GA, Larson JL, Resnicow K, Ploutz-Snyder R, Krauss JC, Smith EML. Home-based aerobic exercise feasibility in oxaliplatin-receiving newly-diagnosed cancer survivors. Eur J Oncol Nurs 2024; 71:102649. [PMID: 38954929 DOI: 10.1016/j.ejon.2024.102649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/01/2024] [Accepted: 06/22/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE Physical activity (PA) is beneficial but difficult to maintain during chemotherapy. This pilot RCT explored the feasibility of the MI-Walk intervention-an 8-week motivational enhancement therapy- and home-based brisk walking intervention-among gastrointestinal (GI) cancer survivors receiving chemotherapy. METHODS Sixty stage II-IV GI cancer survivors were recruited from 5 sites at their second infusion visit. Participants were randomized to receive PA education alone or the MI-Walk intervention: motivational enhancement therapy consisting of 3 motivational interviewing and self-efficacy-enhancing counseling sessions, a Fitbit Charge 2, exercise diaries, telephone follow-up, scripted motivational email messages, and optional weekly walking groups. RESULTS The enrollment and completion rates were 62% and 90%, respectively. The MI-Walk participants (n = 29; mean age = 56.79, SD = 11.72; 97% white; 79% male) reported a baseline moderate-vigorous PA duration of 250.93 (SD = 636.52) min/wk. The mean MI-Walk Intervention acceptability score was 50.32 (SD = 12.02) on a scale of 14-70. Mean Fitbit and counseling helpfulness scores on a 5-point scale were 3.67 (SD = 1.43) and 3.44 (SD = 1.36), respectively. Participants' Fitbit moderate-vigorous PA 8-week averages ranged from 0 to 716.88 min/wk; 64% of participants adhered to ≥127 min/wk. Several characteristics (e.g., age, comorbidity, PA level, employment status, BMI, education level, gender, symptoms) were associated with enrollment, attrition, and intervention acceptability and adherence (p < 0.05). CONCLUSION Enrollment and retention were adequate. The Fitbit and counseling were the most helpful. Acceptability and adherence varied based on participant characteristics; therefore, intervention tailoring and further research among cancer survivors less physically active at baseline and most in need of complex exercise intervention are needed. CLINICALTRIALS gov NCT03515356.
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Affiliation(s)
- Grace A Kanzawa-Lee
- School of Nursing, University of Michigan, Ann Arbor, MI, USA; Smith's Currently at School of Nursing, University of Alabama, Birmingham, AL, USA.
| | - Janet L Larson
- School of Nursing, University of Michigan, Ann Arbor, MI, USA; Smith's Currently at School of Nursing, University of Alabama, Birmingham, AL, USA
| | - Kenneth Resnicow
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - John C Krauss
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Ellen M Lavoie Smith
- School of Nursing, University of Michigan, Ann Arbor, MI, USA; Smith's Currently at School of Nursing, University of Alabama, Birmingham, AL, USA
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Ozdemir D, Arslan S, Artac M, Karaarslan F. Topical menthol for chemotherapy-induced peripheral neuropathy: a randomised controlled trial in breast cancer. BMJ Support Palliat Care 2024:spcare-2023-004483. [PMID: 39038990 DOI: 10.1136/spcare-2023-004483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 06/12/2024] [Indexed: 07/24/2024]
Abstract
OBJECTIVES Chemotherapy-induced peripheral neuropathy (CIPN) symptom is one of the side effects of paclitaxel in breast cancer patients. This randomised controlled study was conducted to investigate the effect of topical menthol applied on the hands and feet of breast cancer patients receiving chemotherapy on CIPN symptoms. METHODS 60 breast cancer patients receiving chemotherapy were randomly assigned to an intervention group (n=30), which received topical menthol treatment, or a control group (n=30), which received standard care. Both groups continued their routine pharmacological treatments throughout the study. The intervention group applied 1% menthol topically to their hands and feet two times a day. The effect of the intervention on CIPN symptoms was evaluated 3 weeks and 6 weeks after the intervention. RESULTS The intervention group showed a significantly greater improvement in CIPN symptoms over time compared with the control group, with an effect size of η2=0.214 for the group×time interaction. Additionally, the intervention group exhibited a notable positive change in the exposure subscale of the CIPN rating scale, with an effect size of η2=0.114. CONCLUSIONS Topical application of menthol significantly mitigates the symptoms of CIPN in breast cancer patients. This study supports the use of menthol as an effective adjunctive treatment for CIPN. TRIAL REGISTRATION NUMBER NCT05429814.
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Affiliation(s)
| | - Selda Arslan
- Department of Internal Medicine Nursing, Necmettin Erbakan University, Nursing Faculty, Meram, Turkey
| | - Mehmet Artac
- Department of Medical Oncology, Necmettin Erbakan University Meram Faculty of Medicine, Meram, Turkey
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Zhang X, Wang A, Wang M, Li G, Wei Q. Non-pharmacological therapy for chemotherapy-induced peripheral neurotoxicity: a network meta-analysis of randomized controlled trials. BMC Neurol 2023; 23:433. [PMID: 38082216 PMCID: PMC10712106 DOI: 10.1186/s12883-023-03485-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neurotoxicity (CIPN) is the most common adverse effect in patients undergoing chemotherapy, and no effective interventions are currently available for its prevention and treatment. Non-pharmacological therapies appear to be beneficial for the prevention and treatment of CIPN, but it remains unclear which therapy is most effective. The aim of this study was to identify the most effective non-pharmacological therapy for CIPN patients. METHODS PubMed, Web of Science, Embase, and Cochrane Library were searched for randomized controlled trials on non-pharmacological therapies for CIPN. The primary outcomes included pain and peripheral neuropathological symptoms, and the secondary outcomes included quality of life, sensory and motor symptoms. The pairwise analysis and a network meta-analysis were performed using a random effects model. RESULTS A total of 46 articles were included in this study, involving 2,878 participants. Our study showed that massage was more effective in pain-alleviating compared with acupuncture [SMD = 0.81, 95%CI (0.04, 1.57)], vitamin and gabapentin [SMD = 2.56, 95%CI (1.39, 3.74)], and usual care and placebo [SMD = 0.9, 95%CI (0.31, 1.49)]. As for attenuating peripheral neuropathological symptoms, massage was more effective than usual care and placebo [SMD = 0.75, 95%CI (0.33, 1.17)], sensorimotor training [SMD = 1.17, 95%CI (0.24, 2.10)], electrostimulation [SMD=-1.18, 95%CI (-2.14, -0.21)], multimodal exercise [SMD=-0.82, 95%CI (-1.57, -0.08)], and resistance training [SMD = 1.03, 95%CI (0.11, 1.95)]. Massage was also more effective than other non-pharmacological therapies in improving quality of life, sensory and motor symptoms. CONCLUSIONS According to our study, massage has advantages in alleviating pain, improving quality of life, and improving peripheral neuropathological symptoms and has better effect than other non-pharmacological interventions, representing certain clinical significance. However, the results of this study should be interpreted with caution due to the limitations of the included studies. In the future, more high-quality multi arm randomized controlled trials can be attempted to provide direct comparisons of the relative effects of non-pharmacological interventions.
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Affiliation(s)
- Xia Zhang
- Rehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Ao Wang
- Rehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Miaowei Wang
- Rehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Guo Li
- Rehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Quan Wei
- Rehabilitation Medicine Center, Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China.
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Sturgeon KM, Kok DE, Kleckner IR, Guertin KA, McNeil J, Parry TL, Ehlers DK, Hamilton A, Schmitz K, Campbell KL, Winters‐Stone K. Updated systematic review of the effects of exercise on understudied health outcomes in cancer survivors. Cancer Med 2023; 12:22278-22292. [PMID: 38018376 PMCID: PMC10757127 DOI: 10.1002/cam4.6753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/22/2023] [Accepted: 11/13/2023] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION The American College of Sports Medicine provided guidelines for exercise prescriptions in cancer survivors for specific cancer- and treatment-related health outcomes. However, there was insufficient evidence to generate exercise prescriptions for 10 health outcomes of cancer treatment. We sought to update the state of evidence. METHODS We conducted a systematic review of these 10 understudied health outcomes (bone health, sleep, cardiovascular function, chemotherapy-induced peripheral neuropathy (CIPN), cognitive function, falls and balance, nausea, pain, sexual function, and treatment tolerance) and provided an update of evidence. RESULTS While the evidence base for each outcome has increased, there remains insufficient evidence to generate exercise prescriptions. Common limitations observed across outcomes included: variability in type and quality of outcome measurement tools, variability in definitions of the health outcomes, a lack of phase III trials, and a majority of trials investigating breast or prostate cancer survivors only. CONCLUSION We identified progress in the field of exercise oncology for several understudied cancer- and treatment-related health outcomes. However, we were not able to generate exercise prescriptions due to continued insufficient evidence base. More work is needed to prescribe exercise as medicine for these understudied health outcomes, and our review highlights several strategies to aid in research acceleration within these areas of exercise oncology.
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Affiliation(s)
- Kathleen M. Sturgeon
- Department of Public Health SciencesCollege of Medicine, Penn State UniversityHersheyPennsylvaniaUSA
| | - Dieuwertje E. Kok
- Division of Human Nutrition and HealthWageningen University & ResearchWageningenThe Netherlands
| | - Ian R. Kleckner
- Department of Pain & Translational Symptom Science, School of NursingUniversity of Maryland BaltimoreBaltimoreMarylandUSA
| | - Kristin A. Guertin
- Department of Public Health SciencesUniversity of Connecticut HealthStorrsConnecticutUSA
| | - Jessica McNeil
- Department of Kinesiology, School of Health and Human SciencesUniversity of North Carolina at GreensboroGreensboroNorth CarolinaUSA
| | - Traci L. Parry
- Department of Kinesiology, School of Health and Human SciencesUniversity of North Carolina at GreensboroGreensboroNorth CarolinaUSA
| | - Diane K. Ehlers
- Division of Epidemiology, Department of Quantitative Health SciencesMayo Clinic ArizonaPhoenixArizonaUSA
| | - Andrew Hamilton
- Oregon Health & Science University, LibraryPortlandOregonUSA
| | - Kathryn Schmitz
- Division of Hematology/Oncology, University of Pittsburgh School of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Kristin L. Campbell
- Department of Physical TherapyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Kerri Winters‐Stone
- Division of Oncological Sciences, School of MedicineOregon Health & Science UniversityPortlandOregonUSA
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Thomsen SN, Lahart IM, Thomsen LM, Fridh MK, Larsen A, Mau-Sørensen M, Bolam KA, Fairman CM, Christensen JF, Simonsen C. Harms of exercise training in patients with cancer undergoing systemic treatment: a systematic review and meta-analysis of published and unpublished controlled trials. EClinicalMedicine 2023; 59:101937. [PMID: 37096190 PMCID: PMC10121410 DOI: 10.1016/j.eclinm.2023.101937] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/26/2023] Open
Abstract
Background Exercise is recommended for people with cancer. The aim of this study was to evaluate the harms of exercise in patients with cancer undergoing systemic treatment. Methods This systematic review and meta-analysis included published and unpublished controlled trials comparing exercise interventions versus controls in adults with cancer scheduled to undergo systemic treatment. The primary outcomes were adverse events, health-care utilization, and treatment tolerability and response. Eleven electronic databases and trial registries were systematically searched with no date or language restrictions. The latest searches were performed on April 26, 2022. The risk of bias was judged using RoB2 and ROBINS-I, and the certainty of evidence for primary outcomes was assessed using GRADE. Data were statistically synthesised using pre-specified random-effect meta-analyses. The protocol for this study was registered in the PROESPERO database (ID: CRD42021266882). Findings 129 controlled trials including 12,044 participants were eligible. Primary meta-analyses revealed evidence of a higher risk of some harms, including serious adverse events (risk ratio [95% CI]: 1.87 [1.47-2.39], I2 = 0%, n = 1722, k = 10), thromboses (risk ratio [95% CI]: 1.67 [1.11-2.51], I2 = 0%, n = 934, k = 6), and fractures (risk ratio [95% CI]: 3.07 [3.03-3.11], I2 = 0%, n = 203, k = 2) in intervention versus control. In contrast, we found evidence of a lower risk of fever (risk ratio [95% CI]: 0.69 [0.55-0.87], I2 = 0% n = 1109, k = 7) and a higher relative dose intensity of systemic treatment (difference in means [95% CI]: 1.50% [0.14-2.85], I2 = 0% n = 1110, k = 13) in intervention versus control. For all outcomes, we downgraded the certainty of evidence due to imprecision, risk of bias, and indirectness, resulting in very low certainty of evidence. Interpretation The harms of exercise in patients with cancer undergoing systemic treatment are uncertain, and there is currently insufficient data on harms to make evidence-based risk-benefits assessments of the application of structured exercise in this population. Funding There was no funding for this study.
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Affiliation(s)
- Simon N. Thomsen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen OE, Denmark
| | - Ian M. Lahart
- Faculty of Health, Education, and Wellbeing, School of Sport, University of Wolverhampton, Walsall Campus, Walsall, WS1 3BD, UK
| | - Laura M. Thomsen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen OE, Denmark
| | - Martin K. Fridh
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital of Copenhagen – Rigshospitalet, Juliane Maries Vej 9, 2100, Copenhagen OE, Denmark
| | - Anders Larsen
- University Hospitals Centre for Health Research, Copenhagen University Hospital - Rigshospitalet, Ryesgade 27, 2200, Copenhagen N, Denmark
| | - Morten Mau-Sørensen
- Department of Oncology, Centre for Cancer and Organ Diseases, University Hospital of Copenhagen - Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen OE, Denmark
| | - Kate A. Bolam
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Lidingovagen, 5626, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Alle 23, 141 35, Stockholm, Sweden
| | - Ciaran M. Fairman
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Jesper F. Christensen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen OE, Denmark
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
- Digestive Disease Center, Bispebjerg Hospital, Nielsine Nielsens Vej 11, 2400, Copenhagen, Denmark
| | - Casper Simonsen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen OE, Denmark
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Stoller S, Capozza S, Alberti P, Lustberg M, Kleckner IR. Framework to leverage physical therapists for the assessment and treatment of chemotherapy-induced peripheral neurotoxicity (CIPN). Support Care Cancer 2023; 31:293. [PMID: 37086308 DOI: 10.1007/s00520-023-07734-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 04/04/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE Chemotherapy-induced peripheral neurotoxicity (CIPN) is a highly prevalent, dose-limiting, costly, and tough-to-treat adverse effect of several chemotherapy agents, presenting as sensory and motor dysfunction in the distal extremities. Due to limited effective treatments, CIPN can permanently reduce patient function, independence, and quality of life. One of the most promising interventions for CIPN is physical therapy which includes exercise, stretching, balance, and manual therapy interventions. Currently, there are no physical therapy guidelines for CIPN, thus limiting its uptake and potential effectiveness. METHODS Utilizing the authors' collective expertise spanning physical therapy, symptom management research, oncology, neurology, and treating patients with CIPN, we propose a comprehensive clinical workflow for physical therapists to assess and treat CIPN. This workflow is based on (1) physical therapy guidelines for treating neurologic symptoms like those of CIPN, (2) results of clinical research on physical therapy and exercise, and (3) physical therapy clinical judgement. RESULTS We present detailed tables of pertinent physical therapy assessment and treatment methods that can be used in clinical settings. CIPN assessment should include detailed sensory assessment, objective strength assessments of involved extremities, and validated physical performance measures incorporating static and dynamic balance, gait, and functional mobility components. CIPN treatment should involve sensorimotor, strength, balance, and endurance-focused interventions, alongside a home-based exercise prescription that includes aerobic training. We conclude with action items for oncology teams, physical therapists, patients, and researchers to best apply this framework to address CIPN. CONCLUSIONS Physical therapists are in a unique position to help assess, prevent, and treat CIPN given their training and prevalence, yet there are no physical therapy clinical practice guidelines for CIPN. Our preliminary suggestions for CIPN assessments and treatments can catalyze the development of guidelines to assess and treat CIPN. We urge oncology teams, physical therapists, patients, and researchers to develop, adapt, and disseminate this framework to help alleviate the burden of chemotherapy on patients with cancer.
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Affiliation(s)
- Stefanie Stoller
- Department of Physical and Occupational Therapy, Duke University Hospital, Durham, NC, USA
| | - Scott Capozza
- Rehabilitation Department, Yale New Haven Hospital, New Haven, CT, USA
| | - Paola Alberti
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy and NeuroMI (Milan Center for Neuroscience), Milan, Italy
| | - Maryam Lustberg
- Breast Medical Oncology, Yale Cancer Center, New Haven, CT, USA
| | - Ian R Kleckner
- Department of Pain & Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA.
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Keats MR, Yu X, Sweeney Magee M, Forbes CC, Grandy SA, Sweeney E, Dummer TJB. Use of Wearable Activity-Monitoring Technologies to Promote Physical Activity in Cancer Survivors: Challenges and Opportunities for Improved Cancer Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4784. [PMID: 36981693 PMCID: PMC10048707 DOI: 10.3390/ijerph20064784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
The aim of this review was to explore the acceptability, opportunities, and challenges associated with wearable activity-monitoring technology to increase physical activity (PA) behavior in cancer survivors. A search of Medline, Embase, CINAHL, and SportDiscus was conducted from 1 January 2011 through 3 October 2022. The search was limited to English language, and peer-reviewed original research. Studies were included if they reported the use of an activity monitor in adults (+18 years) with a history of cancer with the intent to motivate PA behavior. Our search identified 1832 published articles, of which 28 met inclusion/exclusion criteria. Eighteen of these studies included post-treatment cancer survivors, eight were on active cancer treatment, and two were long-term cancer survivor studies. ActiGraph accelerometers were the primary technology used to monitor PA behaviors, with Fitbit as the most commonly utilized self-monitoring wearable technology. Overall, wearable activity monitors were found to be an acceptable and useful tool in improving self-awareness, motivating behavioral change, and increasing PA levels. Self-monitoring wearable activity devices have a positive impact on short-term PA behaviors in cancer survivors, but the increase in PA gradually attenuated through the maintenance phase. Further study is needed to evaluate and increase the sustainability of the use of wearable technologies to support PA in cancer survivors.
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Affiliation(s)
- Melanie R. Keats
- School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Division of Medical Oncology, Department of Medicine, Dalhousie University & Nova Scotia Health, Halifax, NS B3H 4R2, Canada
- Beatrice Hunter Cancer Research Institute, Halifax, NS B3H 4R2, Canada
| | - Xing Yu
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Molly Sweeney Magee
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Cynthia C. Forbes
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull HU6 7RX, UK
| | - Scott A. Grandy
- School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Division of Medical Oncology, Department of Medicine, Dalhousie University & Nova Scotia Health, Halifax, NS B3H 4R2, Canada
- Beatrice Hunter Cancer Research Institute, Halifax, NS B3H 4R2, Canada
- Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Ellen Sweeney
- Beatrice Hunter Cancer Research Institute, Halifax, NS B3H 4R2, Canada
- Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Trevor J. B. Dummer
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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