Background 

Multiple symptoms occur in children receiving cancer therapy. Decreased steps per day may be associated with burdensome symptoms.

Objective 

To evaluate associations between self-reported symptoms (pain interference, anxiety, depressive symptoms, psychological stress, and fatigue) and function (physical function-mobility and physical activity) and cumulative symptom count with steps per day.

Methods 

Five sites enrolled English-speaking children, 8 to 17 years, receiving treatment for a first cancer diagnosis. Patient-reported outcome (PRO) surveys were administered before (T1) and after (T2) a course of chemotherapy. Garmin VivoFit 3 (Garmin International, Olathe, KS) accelerometers were worn 7 days prior to each data point. Univariate changes in scores over time were evaluated with dependent-sample t tests. Pearson correlations examined associations between PRO domains and step count. Multivariable mixed-effect models examined associations between steps and PROs.

Results 

Participants’ (n = 65) steps per day decreased during treatment (4099 [T1] and 3135 [T2]; P < .01), with larger reductions observed during hospitalization and in younger children compared with adolescents. Steps significantly correlated with PROMIS (Patient-Reported Outcome Measurement Information System) Pediatric physical activity and physical function-mobility. Decreased steps per day were associated with increased fatigue and cumulative symptom count.

Conclusions 

In children and adolescents with cancer, steps per day can serve as an indicator of fatigue, cumulative symptom count, physical activity, and physical functioning-mobility.

Implications for Practice 

Child self-reports of physical activity and physical function are valid during cancer therapy and should be captured. In the absence of self-report, decreasing step count may prompt additional assessments related to fatigue or cumulative symptom count and trigger early interventions to support physical activity and physical function-mobility.

中文翻译：

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每天的步数能否反映接受癌症治疗的儿童和青少年的症状？

背景 

接受癌症治疗的儿童会出现多种症状。每天减少步数可能与繁重的症状有关。

客观的 

评估自我报告的症状（疼痛干扰、焦虑、抑郁症状、心理压力和疲劳）与功能（身体功能-活动性和身体活动）和累积症状计数与每天步数之间的关联。

方法 

五个地点招募了 8 至 17 岁的讲英语的儿童，他们接受了第一次癌症诊断的治疗。患者报告结果 (PRO) 调查在化疗之前 (T1) 和之后 (T2) 进行。Garmin VivoFit 3 (Garmin International, Olathe, KS) 加速度计在每个数据点前 7 天佩戴。使用相关样本t检验评估分数随时间的单变量变化。Pearson 相关性检查了 PRO 域和步数之间的关联。多变量混合效应模型检查了步骤和 PRO 之间的关联。

结果 

参与者（n = 65）在治疗期间每天的步数减少（4099 [T1] 和 3135 [T2]；P < .01），与青少年相比，在住院期间和年幼儿童中观察到的减少幅度更大。步数与 PROMIS（患者报告的结果测量信息系统）儿科身体活动和身体功能活动度显着相关。每天减少步数与疲劳和累积症状计数增加有关。

结论 

在患有癌症的儿童和青少年中，每天的步数可以作为疲劳、累积症状计数、身体活动和身体机能活动度的指标。

对实践的启示 

儿童对身体活动和身体功能的自我报告在癌症治疗期间是有效的，应该被记录下来。在没有自我报告的情况下，减少步数可能会提示与疲劳或累积症状计数相关的额外评估，并触发早期干预以支持身体活动和身体功能活动。