Fitness trackers improve fatigue, but not HRQoL, in breast cancer survivors

Wearable activity trackers improve physical activity and cut sedentary time in breast cancer survivors, but do not appear to bear significant benefits on health-related quality of life (HRQoL), according to a new study.

“The ACTIVATE* Trial intervention conducted in breast cancer survivors that used wearable technology, telephone coaching and goal-setting increased MVPA and reduced total sitting time,” said researchers. “Despite these changes, the current analyses suggest the intervention was not associated with strong improvements in patient reported outcomes.”

Eighty-three women (mean age, 62±6.4 years) were included in the randomized trial. After 12 weeks, participants who received the intervention showed significantly lower fatigue scores than their control group counterparts (difference, 4.6 points, 95 percent confidence interval [CI], 1.3–7.8). Other HRQoL variables, including physical, social, emotional and functional well-being subscales, showed no such between-group differences. [Psychooncology 2019;doi:10.1002/pon.5298]

In terms of population proportions, 60.5 percent of the women who were given the wearable device reported clinically relevant improvements in fatigue, as opposed to only 27.5 percent of the control arm.

The intervention-related improvements in fatigue were attenuated slightly following 12 more weeks of maintenance (within-group change, –0.9, 95 percent CI, –3.2 to 1.5).

Those assigned to the intervention arm received its three components delivered over a 12-week period. Participants were given a wrist-worn activity monitoring device, to be worn for the entire duration of the trial. They also underwent a single face-to-face session of goal-setting and behavioural feedback, as well as received five counselling sessions held over the telephone.

Women who were randomly assigned to be controls were entered into a waitlist and received the wearable device after a 12-week delay.

The wearable intervention also resulted in small but significant improvements in Trial Outcome Index (TOI) scores, which is a summary of physical and functional outcomes. From baseline to the end of the study, after the maintenance phase, TOI improved by a significant 3.7 points (95 percent CI, 0.6–6.9; p=0.02). However, change of similar magnitude and direction was also reported in the waitlist control arm (change, 3.6 points; 95 percent CI, 1.1–6.1; p=0.006).

“This study adds to the growing evidence base that objectively measured physical activity done after treatment in breast cancer survivors is associated with decreased fatigue levels. This evidence adds support to clinical recommendations for cancer survivors to incorporate physical activity as part of their post-treatment rehabilitation and recovery plan,” said the researchers.

“Future [studies] examining wearable activity trackers should report not only behavioural outcomes, but clinical and patient-reported outcomes as well,” they added. “Such interventions will lend to a better understanding of the role of wearable activity trackers in cancer survivorship.”

*Activity and Technology