Using actigraphy to evaluate physical activity in patients with pleural effusion: a pilot study

Area of Science:

• Pulmonology
• Oncology
• Rehabilitation Medicine

Background:

• Malignant pleural effusions (MPEs) are common in cancer patients, causing significant activity limitation.
• Current treatments focus on symptom relief, but the impact on physical activity and intervention effectiveness requires further study.
• Actigraphy offers an objective measure of physical activity to assess MPE management.

Purpose of the Study:

• To evaluate the association between physical activity, quality of life (SF-6D utility score), and dyspnea (Borg scale) after thoracentesis in MPE patients.
• To determine if actigraphy metrics can predict improvements in quality of life and dyspnea.
• To understand the temporal relationship between activity changes and symptom improvement post-thoracentesis.

Main Methods:

• Prospective, observational, single-center study of adults with symptomatic MPEs.
• Participants wore actigraphy devices for objective physical activity monitoring (mean 17.7 hours/day).
• Quality of life (SF-6D) and dyspnea (Borg scale) were assessed at weeks 1 and 2 post-thoracentesis.

Main Results:

• Higher average steps (week 2) and calorie expenditure (week 1) correlated with better SF-6D utility scores.
• No actigraphy metrics significantly predicted changes in SF-6D utility scores from week 1 to week 2.
• Greater early increases in activity (calories, MVPA, triaxial movement) in week 1 predicted larger reductions in Borg scale dyspnea.
• Higher triaxial movement in week 2 was associated with lower dyspnea in week 2.

Conclusions:

• Improved quality of life post-thoracentesis is linked to average activity levels.
• Dyspnea improvement is more strongly associated with early gains in physical activity.
• Actigraphy provides valuable insights into the functional recovery and symptom management of MPE patients.