Activity behaviours and quality of life in patients with malignant pleural effusion

Accelerometery is used to measure activity behaviours in patients with malignant pleural effusion (MPE). This study aimed to evaluate physical activity and sedentary behaviour profiles of patients with MPE in Hong Kong, and to explore relationships between activity behaviours and quality of life (QoL). We also compared clinician-recorded performance status measures with objective measures of activity levels.

Participants wore an Actigraph GT3X+ accelerometer continuously for 7 consecutive days. The EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) was used to assess five dimensions of QoL and correlate with activity behaviours. The Eastern Cooperative Oncology Group (ECOG) performance status was documented by clinicians at baseline.

Fifty-one patients with MPE received accelerometers; 94% had ≥1 valid day of data. Participants spent 76% (sd 2.32) of waking hours sedentary, 23% (sd 1.40) of waking hours in light activity and 0.3% (median, interquartile range 0.0-1.5) in moderate-to-vigorous physical activity (MVPA). Higher light activity and MVPA behaviours were associated with increased participation in self-care tasks (r_s=-0.43, p=0.003; r_s=-0.45, p=0.001, respectively) and usual activities (r_s=-0.42, p=0.003; r_s=-0.45, p=0.001, respectively). Patients with an ECOG status of 0 or 1 spent an average of 75% of waking hours sedentary.

This is the first report of physical activity behaviours in patients with MPE in Hong Kong, demonstrating high sedentary behaviours and low physical activity which correlated to dimensions of QoL. Clinician-rated performance status was not reflected in accelerometery data, suggesting a discrepancy between performance status measures and objective measures of activity in patients with MPE.