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Use of a Fitness Tracker to Promote Physical Activity in Children With Acute Lymphoblastic Leukemia
Mary C Hooke1,2, Laura Gilchrist2, Lynn Tanner2
1School of Nursing, University of Minnesota, Minneapolis, Minnesota.
Insights
This study found that children with acute lymphoblastic leukemia (ALL) who increased their daily steps using FitBit coaching before steroid treatment experienced less fatigue. Physical activity may help manage fatigue during cancer therapy.
Area of Science:
- Pediatric Oncology
- Digital Health Interventions
- Cancer Symptom Management
Background:
- Fatigue is a common and debilitating symptom for children undergoing acute lymphoblastic leukemia (ALL) maintenance therapy.
- Corticosteroid pulses, a standard treatment for ALL, often exacerbate fatigue in pediatric patients.
- Wearable fitness trackers offer a novel approach to monitor and potentially influence physical activity levels in this population.
Purpose of the Study:
- To assess the feasibility of using FitBit coaching to increase daily physical activity in children with ALL during maintenance therapy.
- To determine if increased physical activity prior to a corticosteroid pulse is associated with reduced fatigue post-pulse.
- To explore the relationship between daily step counts and self-reported fatigue levels in pediatric cancer patients.
Main Methods:
- A feasibility study involving 17 children (aged 6-15) with ALL in maintenance.
- Baseline activity levels were established using FitBit, followed by a 2-week intervention with tailored step goals and daily email feedback.
- Fatigue was measured using self-report at baseline, pre-steroid pulse, and post-steroid pulse.
Main Results:
- A trend towards increased daily steps was observed during the 2-week intervention (P = 0.079).
- Children maintained an average of over 10,000 steps per day throughout the study periods.
- A significant inverse correlation was found between step counts in week 2 and fatigue levels after the steroid pulse (r = -0.66, P = 0.005), indicating higher activity was linked to lower fatigue.
Conclusions:
- FitBit coaching is a feasible intervention for promoting physical activity in children with ALL undergoing maintenance therapy.
- Children with ALL can achieve high levels of physical activity, exceeding 10,000 steps daily, even during cancer treatment.
- Increased physical activity prior to corticosteroid administration may offer a protective effect against post-pulse fatigue in pediatric ALL patients.
Background:
Children with cancer identify fatigue as a pervasive symptom, which increases during the corticosteroid pulse in acute lymphoblastic leukemia (ALL) maintenance. The FitBit is a fitness tracker that downloads activity measurements to the Internet in real time. In this feasibility study, we explored if children who received daily FitBit coaching for 2 weeks before a maintenance steroid pulse had an increase in steps per day and determined the relationship between steps per day prepulse and fatigue postpulse.
Procedure:
Seventeen children in ALL maintenance, aged 6-15, wore the FitBit for 3 days to establish a baseline. A tailored weekly step goal was then set with the child and parent. Daily emails with feedback and FitBit screenshots were sent over the 2-week intervention. Self-report of fatigue was measured at baseline, after 2 weeks (i.e. before the steroid pulse), and after 5 days of steroids.
Results:
There was a trend toward increased steps per day from weeks 1-2 (P = 0.079); fatigue was low and did not increase during the corticosteroid pulse. A significant correlation (r = -0.66, P = 0.005) was found between the steps per day during week 2 and fatigue after the steroid pulse with higher steps associated with lower fatigue.
Conclusions:
The intervention was feasible in this small sample. The average steps each time period (week 1, week 2, and during steroids) was over 10,000, demonstrating that children with ALL can be active during treatment. Physical activity may be protective of fatigue during a corticosteroid pulse.
