Improved functional assessment in cancer patients using home-based digital technologies

Figures

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  Fig. 1. CONSORT diagram for study participants.

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  Fig. 2. At-home physical activity and gait metrics derived by DHTs stratified by self-reported KPS in participants with cancer. a Box-plot of overall activity metrics derived from the wrist accelerometer as measured by time spent in sedentary, light, moderate, non-sedentary activity, average activity and mean activity level within the most intense 6 min, based on the accelerometer signal magnitude. Moderate activity time, non-sedentary time, mean activity level and maximum 6 min activity level differed significantly across self-reported KPS (KPS [70 below] compared to KPS [100] and KPS [80–90]. b Box-plot of at-home gait metrics derived from the lumbar accelerometer: average and 95th percentile of gait speed and total number of steps per day, which showed significant differences across self-reported KPS. Each dot represents the average daily value of a participant over two weeks of monitoring. Au = Arbitrary units. m/s.

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  Fig. 3. At-home physical activity and gait metrics derived by DHTs among participants with cancer and previously evaluated healthy participants of younger and older age range. a Compared to healthy participants both in younger and older age groups, the participants with cancer showed significantly lower activity in time spent in moderate and non-sedentary activity and mean activity level within most intense 6 min of activity. b Average and 95th percentile gait speed and total number of steps per day were also significantly lower in participants with cancer compared to both the older and younger healthy participants. Au = arbitrary units.

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  Fig. 4. Scatter plots between at-home physical activity and gait metrics and patient-reported outcomes - PROMIS Physical Function 10a. We observed increased levels of at-home activity associated with higher reported physical function scores. Higher PROMIS score indicates better self-reported function. Spearman’s correlations are reported.

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  Fig. 5. Scatter plots between at-home physical activity and gait metrics and patient-reported outcomes – PROMIS Fatigue 7a. We observed that participants with lower reported fatigue have higher measured physical activity and gait. Higher PROMIS score indicates increased self-reported fatigue. Spearman’s correlations are reported.

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  Fig. 6. Comfort and usability assessment of Digital Health Technologies among participants with cancer. Participants were asked to rate the comfort of wearing the DHTs at home and their usability at the end of the study. More than 75% and 100% of the participants reported comfort for lumbar and wrist sensors, respectively. While 63% of the participants reported that they would wear the lumbar sensor for more than a week, more than 90% reported they would wear wrist sensor for more than a week. 87% of the participants would wear the sensors at home during their treatment to monitor their physical activity, and 95% would like their clinicians to have access to their at-home activity data. Two participants did not complete the wearability questionnaires and seven participants did not complete the additional usability questionnaires.