Physical Activity and Sleep Measures Using a Fitness Tracking Device during Hematopoietic Cell Transplantation: A Pilot Study.

Patients undergoing hematopoietic cell transplantation (HCT) experience decline in their physical activity during their transplant admission. There is limited experience with prospective monitoring of transplant recipients. We therefore measured physical activity and sleep patterns of subjects undergoing autologous and allogeneic HCT. Eighty-three patients were consented for this study. Sixty-three patients competed the study and had their physical activity prospectively assessed using the fitness-tracking device Fitbit HR. Outcomes included adherence, physical activity, readmission, hematopoietic engraftment, and 100-day survival. Sixty percent of patients (n = 37) underwent autologous HCT, and 40% (n = 26) underwent allogenic HCT. Both groups had a comparable number of steps at admission to the hospital. The number of daily steps during the study period was lower in the allogeneic group (2159 versus 3008, P = .07), as was the minimum number of steps recorded over the transplant admission (allogeneic HCT = 395 versus autologous HCT = 848, P = .01). Patients undergoing allogeneic HCT were less active on the day before discharge (1956 steps versus 3183 steps, P = .08). In multivariate analysis, physical activity was not associated with HCT-related outcomes. Patients undergoing HCT experience significant decline in their physical activity during their transplant admission that does not recover by the time of discharge. This effect can be objectively measured using fitness tracking devices.

Factors Influencing Patients' Intention to Perform Physical Activity During Hematopoietic Cell Transplantation.

OBJECTIVES: To examine theoretical and medical variables influencing a patient's intention to perform physical activity during hospitalization for hematopoietic cell transplantation (HCT). SAMPLE & SETTING: 54 patients undergoing HCT at the Seidman Cancer Center in Cleveland, Ohio. METHODS & VARIABLES: A longitudinal, prospective cohort design was used. Instruments included the Self-Report Habit Index, tailored to assess exercise habit, the Memorial Symptom Assessment Scale-Short Form, and an investigator-constructed survey of intention, attitude, control, and subjective norm toward physical activity. Descriptive statistics, univariate logistic regression, and linear regression were used. RESULTS: Intention for physical activity remained high at all time points. Previous exercise habits were not related to intention. Inverse relationships between symptom distress and the theoretical constructs that influence intention occurred at the critical time points of nadir and discharge during transplantation. IMPLICATIONS FOR NURSING: Nurses should reinforce physical activity regardless of exercise habits. Symptom distress may influence physical activity differently during the transplantation trajectory.