Wearable Fitness Trackers May Improve Health in Childhood Cancer Survivors

Wearable fitness trackers have continued to grow in popularity in recent years, and they may be feasible interventions to promote fitness in childhood cancer survivors, according to recent research conducted in Australia.

“Wearable activity trackers can provide objective and non-biased measures of the level and intensity of physical activity in children affected by cancer, which can be useful for healthcare teams and the child,” said study author Lauren Ha, PhD candidate, accredited exercise physiologist at the School of Health Sciences, UNSW Medicine & Health, in Australia, said in an interview with Oncology Nursing News.

Oncology Nursing News: Can you explain your study on wearable trackers in pediatric cancer survivors, and why it was relevant to conduct?

Ha: The study I conducted was a systematic review that aimed to evaluate how effective wearable activity trackers were to monitor or improve physical activity levels in children affected by cancer.

The study was highly relevant to conduct, as many children and adolescents on cancer treatment, or who have finished cancer treatment, do not participate in adequate physical activity levels. Physical activity is essential for young people as it helps to improve fitness, muscle strength and, most importantly, helps to reduce the risk of chronic illnesses such as cardiovascular disease. Childhood survivors are at risk of developing treatment-related chronic illnesses, including cardiovascular disease, obesity and secondary cancers, so encouraging them to be active is particularly important.

Activity trackers have become popular tools to monitor and motivate individuals to increase physical activity levels. Our team was interested in whether activity trackers did improve physical activity levels in pediatric cancer patients and survivors. If activity trackers were found to be effective, then they could be a low-cost strategy to help children increase activity, therefore improving fitness levels and decreasing their risk of cardiovascular disease.

What health outcomes were you analyzing, and why did you choose these?

The main health outcome we analyzed was physical activity levels, specifically steps per day or number of minutes of moderate-vigorous physical activity (MVPA) per day. We decided to analyze steps per day as most activity trackers measure daily step count, and moderate-vigorous physical activity because the physical activity guidelines recommend that children (5-11 years) and adolescents (12-17 years) should aim to achieve at least 60 minutes of MVPA per day.

Additionally, we analyzed whether other health outcomes such as fitness, fatigue and quality of life improved. Pediatric patients may also experience decreases in fitness levels and quality of life, or increased fatigue levels during the cancer continuum. Therefore, we were interested in whether the use of activity trackers had any impact on these health outcomes.

What were the findings?

Our review found that the studies that used activity trackers within pediatric cancer patients and survivors were highly diverse in study design, study population and intervention features.

Additionally, there were two different types of activity trackers – activity trackers were either used as a measuring tool that did not provide feedback to the wearer or used as a self-monitoring tool that did provide feedback to the wearer.

The physical activity interventions using activity trackers that we assessed did not find any increases in step counts or (MVPA), however, they did report positive impacts in other health outcomes such as improvements in fitness, mood and quality of life. Overall, it appears that successful outcomes depend on a range of other factors including the type of intervention being implemented in pediatric cancer patients and survivors.

Do wearable fitness trackers encourage people to be active, or are they just more convenient to track (rather than writing things down, etc.)

Activity trackers that provide feedback to the user (i.e., step counts or time spent in (MVPA)) have the potential to motivate and engage people to increase their physical activity levels; however, further research is needed to understand how activity trackers can be effective at improving physical activity levels when incorporated into different interventions.

How can oncology nurses use this data to discuss the potential benefit of wearable trackers with their patients?

Oncology nurses can discuss with patients the importance of physical activity and the potential benefits of using an activity tracker to monitor how much physical activity they are achieving. They are widely available and can provide a breadth of information including intensities of physical activity, duration of physical activity, energy expenditure, sleep and time spent in sedentary behaviors.

What are next steps/unanswered questions?

Our next steps are to pilot a digital health educational program involving the use of activity trackers for childhood cancer survivors. We are investigating whether our patient-centered digital program is feasible and acceptable for survivors to use in their homes, and if they improve physical activity and fitness levels. I am excited to explore and harness the potential of innovative technologies to help young patients and survivors improve physical activity levels.