A Feasibility Study to Measure Physical Activity, Fatigue, Sleep–Wake Disturbances, and Depression in Young Adults During Chemotherapy

Abstract

Little is known about the physical activity (PA) of young adults (YAs) during cancer therapy. In this feasibility study, 14 YAs (20-34 years old) completed a six-minute walk test, recorded their steps per day for one week, and answered weekly self-reports about physical activity, fatigue, sleep-wake disturbances, and depression during one cycle of chemotherapy. Findings suggest YAs are willing to complete a PA study during chemotherapy and have variable sleep and activity schedules. Their symptoms varied in severity, with highest scores for fatigue. Studies to improve PA in YAs during chemotherapy are warranted to manage short-and long-term treatment effects.Keywords: cancer care continuum, chemotherapy, exercise, physical activity, supportive care P hysical activity (PA) during treatment for cancer is an evidence-based intervention recommended to relieve disease-and treatment-related symptoms such as fatigue and sleep disturbances.1-3 Maintaining PA during cancer treatment may also mitigate the long-term negative effects of inactivity, such as deconditioning and weight gain, that often occur during and after the cancer treatment period.4,5 Staying physically active may also promote better disease outcomes for patients at high risk for developing second cancers.6 Many young adults (YAs) with cancer, however, become sedentary during their months of chemotherapy due to common physical and psychosocial symptoms, such as fatigue and depressed mood. Frequent clinic and hospital visits disrupt daily activity and sleep routines, making it difficult to maintain previously established habits and schedules.PA research to date has focused mainly on outcomes in adults with common cancers, especially following the completion of therapy, and little is known about PA in YAs with cancer. Emerging evidence suggests that adolescent cancer survivors experience significant declines in PA during treatment that may last past completion of treatment. [7][8][9] Studies are needed to describe PA in YAs during active treatment and to test PA interventions for YAs receiving chemotherapy.The aims of this study were to: (1) test the feasibility of procedures to measure four symptoms (fatigue, sleep disturbance, wake disturbance, and emotional disturbancedepression) and PA in YAs; and (2) gather feasibility data related to functional status, symptom severity, and PA over the course of one cycle of chemotherapy. These data will inform the design of a trial to test an age-specific intervention to improve symptom management, PA, and quality of life outcomes for YAs who may become long-term cancer survivors. MethodsData collection began on the first day of a chemotherapy cycle and lasted 2 weeks. This feasibility study was conducted at the University of Virginia Medical Center between November 2010 and May 2012. ParticipantsInclusion criteria included patients who: (1) were diagnosed with any cancer between the ages of 18 and 39; (2) were receiving chemotherapy on a cycle every 3-4 weeks; (3) were in their first through sixth month of chemothera...

A scoping review of studies exploring physical activity among adolescents and young adults diagnosed with cancer

“…Of the quantitative articles reviewed (n = 21; 66%), physical activity was treated as an outcome in 17 articles (81% 5,17,[38][39][40]43,44,[46][47][48][49][50][51][52][54][55][56] ), a moderator in 1 article (5% 45 ), a predictor in 1 article (5% 57 ), and a covariate in 2 articles (10% 41,42 ). # Ten of the quantitative articles (48%) explored the relationship between physical activity and descriptive (eg, age, cancer stage, and education), physical (eg, aerobic capacity, body mass index, and fatigue), personal/psychological (eg, mood, posttraumatic growth, and quality of life), social (eg, social support and support group involvement), other health behaviors (eg, smoking), and other factors (eg, program preferences/interest).…”

“…The remaining articles (n = 89) and the 43 articles for which we did not hear back from the corresponding authors were subsequently excluded . In total, 32 articles representing 26 unique studies met eligibility criteria and were therefore reviewed…”

“…Moreover, outcomes that AYAs view as important were seldom, if ever, assessed. For example, fatigue, reported to be the most prevalent and distressing effect of cancer and its treatments, was assessed in only 4 studies, and only 2 of these studies examined the effect of physical activity on fatigue . Similarly, cognitive functioning and fertility, also among the top concerns for AYAs, were assessed in only 1 study, and the relationship between physical activity and these outcomes was not explored.…”

Measures and Methods for Symptom and Symptom Cluster Assessment in Adolescents and Young Adults with Cancer

“…35 Adult PROMIS measures for fatigue, sleep disturbance, wake disturbance, and depression are acceptable and feasible for use with YAs receiving chemotherapy. 36 Because the pediatric item banks are specified for respondents ages 8 to 18 and the adult item banks for those over 18, PROMIS does not provide single instruments for use across the specific age range for AYAs.…”

Compliance and satisfaction with intensive physiotherapy treatment during chemotherapy in patients with bone tumours and evaluation of related prognostic factors: An observational study

“…Starting physiotherapy treatment during chemotherapy does not seem to produce side effects (Courneya et al, ), conversely, several authors found a positive impact in terms of physical activity (Braam et al, ; Erickson, Adelstein, & Letzkus, ; Velthuis, Agasi‐Idenburg, Aufdemkampe, & Wittink, ). Despite this indication, rehabilitation is rarely encouraged in the clinical practice during chemotherapy or it is postponed until the latter is finished.…”