Maddocks Matthew, Granger Catherine L
King's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK.
Department of Physiotherapy, The University of Melbourne.
Curr Opin Support Palliat Care. 2018 Sep;12(3):219-226. doi: 10.1097/SPC.0000000000000372.
Physical activity has emerged as an important health outcome and its assessment, in particular with objective monitors, has proliferated in recent years. This review considers recent advances in physical activity measurement and clinical trials in cancer and chronic respiratory diseases where physical activity was a primary or key secondary outcome focusing on methodological learning points.
There is growing data on (i) the validity of commercial 'consumer' physical activity monitors, e.g. FitBit, and (ii) the role of hybrid physical activity assessments; combining objective and subjective measures to understand physical activity quantity and quality. In both cases, adherence is challenging and can be optimized using short monitoring protocols, e.g., 3-4 days, and by providing clear instructions and support materials to participants. Studies in cancer and chronic respiratory disease have found mixed effects from physical activity interventions based on pedometers, behavior change techniques, online resources, and/or therapeutic nutrition. The most responsive physical activity outcomes and minimum clinically important differences are still to be understood.
Physical activity measures provide an opportunity to detect changes in health behavior. However, measuring physical activity as a trial endpoint is challenging and focusing effort to ensure optimal participant compliance is important.
身体活动已成为一项重要的健康指标,近年来,其评估方法,尤其是借助客观监测设备的评估方法不断涌现。本综述探讨了身体活动测量方面的最新进展,以及在癌症和慢性呼吸道疾病的临床试验中,以身体活动作为主要或关键次要指标的相关研究,并重点关注方法学上的经验教训。
越来越多的数据表明:(i)商业“消费级”身体活动监测设备(如FitBit)的有效性;(ii)混合身体活动评估的作用,即将客观和主观测量方法相结合,以了解身体活动的量和质。在这两种情况下,坚持监测都具有挑战性,可以通过采用简短的监测方案(如3 - 4天),并向参与者提供清晰的说明和支持材料来优化。在癌症和慢性呼吸道疾病的研究中,基于计步器、行为改变技术、在线资源和/或治疗性营养的身体活动干预产生了不同的效果。身体活动最敏感的指标以及最小临床重要差异仍有待明确。
身体活动测量为检测健康行为的变化提供了契机。然而,将身体活动作为试验终点进行测量具有挑战性,集中精力确保参与者达到最佳依从性非常重要。