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Published on: April 19, 2019
Preoperative Patient-reported Physical Functioning and Postoperative Wearable-measured Physical Activity in Cancer
Shugo Yajima1, Shin Kobayashi2, Tadayoshi Hashimoto3,4
1Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan.
Introduction:
It remains unclear whether preoperative patient-reported physical functioning (PF) correlates with postoperative wearable-measured physical activity in cancer patients. Clarifying this relationship could indicate whether brief self-report items capture information relevant to subsequent postoperative outpatient activity.
Methods:
We analyzed 119 postoperative cancer patients from the SCRUM-MONSTAR LIFELOG study using four preoperative Medical Outcomes Study Short Form-36 (SF-36) PF items (stair climbing, vigorous activity, moderate activity, and carrying items; composite score 0-8), the Geriatric-8 (G8) screening tool, and wrist-based wearable accelerometry data. Spearman rank correlations, Wilcoxon rank-sum tests, and overlap-weighted analyses adjusted for clinical covariates were performed. Exploratory residual-based analyses examined the discordance between preoperative assessment and postoperative activity.
Results:
Patients with full PF (PF = 8; n = 53) versus impaired PF (PF < 8; n = 66) showed lower sedentary time (median 83.6% vs 87.3%; p = 0.031), higher moderate-to-vigorous physical activity (MVPA; 4.1% vs 2.7%; p = 0.015), and higher mean acceleration (21.8 vs 16.8 milligravity units; p = 0.044). All four SF-36 PF items showed consistent associations with sedentary time (Spearman ρ: -0.24 to -0.27) and MVPA (ρ: +0.23 to +0.29). G8-vulnerable patients showed higher sedentary time (87.2% vs 82.7%; p = 0.021) and lower MVPA (2.9% vs 4.1%; p = 0.045). After overlap-weighted adjustment, differences were attenuated. In exploratory analyses, age showed the most consistent, although weak, association with the discrepancy between preoperative assessment and postoperative activity.
Conclusions:
The preoperative SF-36 PF items showed weak but consistent unadjusted associations with postoperative physical activity, although attenuated after adjustment for baseline clinical covariates. These findings suggest that brief preoperative self-report items may capture information relevant to subsequent physical activity behavior in cancer patients, with group-level differences partly reflecting shared clinical context.
