Moving beyond Karnofsky and ECOG Performance Status Assessments with New Technologies

Table 3

Clinical studies incorporating EAM systems in cancer populations.

Reference	Sample, = number of participants	Device	Study design	Study objective	Results relevant to EAM measured PA data
	Descriptive and feasibility studies
[33]	Breast cancer survivor , noncancer controls	ActiGraph Accelerometer: survivors, Model GT1M,; controls, Model AM-7164	Case control study	Compare level of PA and sedentary behavior between survivors and controls	Breast cancer survivors are more sedentary than noncancer controls
[34]	Cancer survivor, = 7,285,825,; noncancer controls, = 162,502,859	ActiGraph AM-7164	Case control study	Compare PA levels among cancer survivors and controls	Neither group met the CDC guidelines for physical activity,; survivors, 95.5%; controls, 87.3%
[27]	Lung and upper gastrointestinal cancer patients (ECOG PS 0–2)	ActivPAL	Prospective, observational study	Assessment of patient acceptability using compliance based on analysis of movement data	EAM device fulfilled the definition of acceptability; 98% wore the EAM ≥80% of the time
	Reliability/accuracy of EAM devices
[35]	Hematologic malignancy; Patients, ,; healthy controls,	Step Accelerometer 3 (SAM3)	Prospective, case control study	Compare reliability of the assessment of PA and compare PA levels between patients and controls	Device, good reliability; Cancer patients, significantly less active than healthy subjects (5355 versus 6364 steps, )
[36]	Advanced cancer patients (KPS 40–100), ,; healthy volunteers,	ActivPAL	Prospective, observational study	EAM measured PA data was validated against video-recorded observations and EE measured by DLW protocol	Step count error higher in patients with KPS 40–60% versus KPS 70–100% (33 versus 24%, )
	Correlative studies
[37]	Breast cancer patients, ,; noncancer control,	ActiGraph Model GT3X	Prospective, case control study	Examine the effect of PA level on working memory	Greater PA level was positively and significantly associated with better working memory performance across both arms (
[38]	Colon cancer survivors	ActiGraph Model GT3X	Cross-sectional, observational study	Determine the association of EAM measured MVPA with QoL and physical functioning	MVPA was significantly associated with better QoL () and physical function ()
[26]	Incurable thoracic cancer patients (ECOG PS 0–2)	ActivPAL	Retrospective study	Determine the correlation between EAM measured PA and ECOG PS	Decline in ECOG PS was significantly associated with decline in EAM measured step count ()
	Interventional studies
[39]	Breast cancer survivors (stages I–IIIA)	Pedometer; Digi-Walker SW-200; (home-based; 12 weeks; 30 minutes, 5 days a week, ≥moderate intensity)	RCT; Arm 1: standard public health recommendation; Arm 2: breast cancer specific print materials; Arm 3: pedometer; Arm 4: combination of print materials and pedometer	Determine the effects of breast cancer-specific PA print materials, pedometer, or their combination, on self-reported PA and QoL in breast cancer survivors	Significant intervention effect on self-reported physical activity and walking but no intervention effect on daily steps. Effect seen in all interventional arms. Combination arm, significantly improved QoL ()
[40]	Breast and prostate cancer patients receiving radiation therapy	Pedometer, details not reported; Home-based; 4 weeks; moderate intensity walking (10,000 steps/day); resistance bands daily	RCT; Arm 1: exercise intervention; Arm 2: no exercise intervention	Examine the feasibility and initial efficacy of a home-based aerobic and progressive resistance exercise intervention for aerobic capacity, strength, muscle mass, CRF, and QoL	Significantly greater increase in daily steps, higher QoL, and lower CRF in intervention group after intervention and at 3-month follow-up.

EE: energy expenditure, DLW: doubly labeled water, EAM: electronic activity monitor, MVPA: moderate to vigorous intensity physical activity, QoL: quality of life, PA: physical activity, RCT: randomized controlled trial, and CRF: cancer-related fatigue.