Physical Activity in Osteosarcoma Patients During and Post Therapy: A Single Site Prospective Observational Study

Osteosarcoma is the most common primary bone tumor in childhood and adolescence. Many patients face long-term impairments in their mobility and function after treatment, leading to a decrease in their quality of life. Exercise has been shown to improve functional recovery and improve quality of life in patients with cancer, though data specific to children with osteosarcoma are sparse. Exercise has also been shown to be feasible in patients undergoing chemotherapy, with numerous potential benefits to health and quality of life. To design the most effective exercise interventions for children and adolescents with osteosarcoma, we must first understand the activity patterns in this population throughout the treatment and survivorship continuum.

In this study, we provided wearable activity trackers to osteosarcoma patients to evaluate physical activity patterns. Inclusion criteria allowed for any age, gender, or stage of treatment (including after treatment completion).

Twenty-six patients had valid data defined as 3 or more days with more than 10 h of continuous heart rate data. The average steps per day across all treatment stages including post treatment was 3184 ± SD 2552.74, range 0-27,828 steps on treatment days and 4884 ± 2447.30, range 0-22,500 steps on off treatment days. Values for specific treatment periods (neoadjuvant, adjuvant, relapse, off therapy) are presented. Though activity patterns varied widely between patients, all patients except one were below recommended values for daily step counts until after therapy was complete.

Our results suggest that tailoring an exercise program to encourage activity on days when patients receive antineoplastic therapy, and to have the more intensive exercise days well after antineoplastic therapy, may be a good approach. Further research is needed to define interventions to improve physical activity in this population.