Reliability of Ambulatory Walking Activity in Patients With Hematologic Malignancies

Abstract 

Knols RH, de Bruin ED, Aufdemkampe G, Uebelhart D, Aaronson NK. Reliability of ambulatory walking activity in patients with hematologic malignancies.

Objectives

To determine the relative and absolute reliability of the assessment of ambulatory walking activity during 2 consecutive weeks in patients with hematologic malignancies recovering at home from their medical treatment and to compare the physical activity level of hematologic cancer patients after high-dose chemotherapy with healthy subjects.

Design

Test-retest study of 2 consecutive 7-day recordings using the microprocessor-based step accelerometer 3 (SAM3).

Setting

Home and community.

Participants

Patients (n=23) with hematologic malignancies recovering from high-dose chemotherapy and healthy controls (n=30).

Interventions

Not applicable.

Main Outcome Measures

The intraclass correlation coefficient (ICC_3,1) and its 95% confidence interval (CI), SE of measurement procedure and its 95% CI, the smallest detectable difference (SDD), the coefficient of variation (CV), and t tests for the variables total steps and peak activity.

Results

The day-to-day and week-to-week CVs for walking activity and peak activity were 35.17% and 13.17% and 18.61% and 6.90%, respectively. For relative reliability, the ICCs for 2 consecutive 7-day recordings including the 95% CI for total steps and peak activity were 0.90 (95% CI, 0.75–0.98) and 0.85 (95% CI, 0.66–0.94), respectively. The absolute reliability for total steps and peak activity including the SE of measurement procedure and the 95% CI were 564 (95% CI, ±1106) and 2.42 steps (95% CI, ±4.74), respectively, for 2 consecutive 7-day recordings. The week-to-week SDD was 1564 for total steps and 6.70 for peak activity. The 7-day mean for total step activity was 5355 for the patients with hematologic malignancies and 6364 for healthy subjects (P<0.05).

Conclusions

The results of this study indicate that there is good relative reliability for the assessment of 2 consecutive 7-day recordings of ambulatory walking activity, and it showed that the SDD derived from this sample may be useful in detecting changes in daily walking activity in hematologic cancer patients who are recovering from intensive medical treatment. The study also documented compromised levels of ambulatory walking activity among hematologic cancer patients recovering from high-dose chemotherapy as compared with healthy controls.

Key words: Hematologic neoplasms, Physical activity, Rehabilitation, Technology assessment, Walking

List of Abbreviations: BMI, body mass index, CI, confidence interval, CV, coefficient of variation, FACT-F, Functional Assessment of Cancer Therapy–Fatigue, GVHD, graft-versus-host disease, ICC, intraclass correlation coefficient, SDD, smallest detectable difference, SAM3, StepWatch Activity Monitor 3