Physical activity measurements and findings in the presurgery period
| Study | Device used and wear protocol | Physical activity variables and their definitions | Physical activity findings | Clinical/health-related outcomes and findings |
| RCTs | ||||
| Bond et al31 44 45 | SenseWear armband worn on the upper right triceps muscle during all waking hours for 7 consecutive days at both baseline and postintervention follow-up (mean 90±65 days preoperation) Minimum wear requirement: ≥6 hours of wear per day on ≥4 days during both the baseline and postintervention follow-up periods | Time spent in MVPA (≥3 METs as determined by SenseWear proprietary software) in total and accumulated in 10 min bouts, and steps per day | MVPA accumulated in 10 min bouts increased in the intervention group by 16.6±20.7 min/day vs no change in control (−0.3±12.7 min/day, p=0.001). Total MVPA increased in the intervention group by 21.0±26.9 min/day vs no change in control (-0.1±16.3 min/day, p=0.001). Daily steps increased in the intervention group by 2027.6±1886.9 steps/day vs no change in control (202.7±1374.3 steps/day, p<0.001) | Intervention group reported significantly greater improvements in health-related quality of life, physical activity enjoyment, physical activity self-efficacy and physical activity motivation from baseline to end of intervention No differences between groups in weight change (kg) over the intervention period |
| Dronkers et al46 | NL1000 pedometer used to measure daily steps during the intervention period | Mean number of steps per day | There was no significant difference in mean number of daily steps between the intervention (4980) and control (5003) groups (p>0.05), no SD or CIs provided | Intervention group had a greater improvement in inspiratory muscle endurance than the control group from baseline to end of intervention. No differences between groups in changes in timed up-and-go test, chair rise time, maximal inspiratory pressure, self-reported physical activity, physical work capacity, fatigue or health-related quality of life from baseline to end of intervention (preoperation), or postoperative complications or length of stay |
| Huber et al29 | SenseWear armband worn at baseline and postintervention (1-week preoperation) Minimum wear requirement not reported | METs (kcal/hour/kg) and average steps per day determined by SenseWear proprietary software | From baseline to postintervention, there were no significant differences in mean changes in METs (0.3 (95% CI −2.2 to 2.7)) or daily steps (−687 (95% CI −2172 to 798)) between intervention and control group | From baseline to postintervention, there were no significant differences between the intervention and control group in chair stand test, KOOS measurements (function, pain, symptoms, quality of life), knee range of motion, 20 m walk test, timed up and go test, self-reported physical activity or health-related quality of life |
| Moug et al34 51 | activPAL adhered to the anterior thigh and worn for 3–5 days at baseline and postintervention (1–2 weeks before surgery) Minimum wear requirement not reported | Proprietary activPAL software to determine sedentary time (sitting/lying down), active time and average steps per day | From baseline to postintervention, there were no significant mean differences between intervention and control group in median steps per day (785 (95% CI −1195 to 2765)), per cent of week spent active (0.3 (95% CI −1.7 to 2.2)) or per cent of week spent sedentary (−2.7 (−13.2 to 7.9)) | No differences between groups in weight, BMI, waist circumference, sit-to-stand test, 6MWT, quality of life, positive or negative affect scores, depression, Functional Assessment of Cancer Therapy score or muscle mass from baseline to end of intervention |
| Non-randomised parallel group | ||||
| Loughney et al36 and West et al37 | SenseWear Pro armband worn continuously on the upper right arm for three consecutive weekdays (72 hours) worn at baseline (immediately following neoadjuvant chemoradiotherapy) and end of intervention. Participants in the exercise training group removed the monitor during in-hospital exercise training sessions Minimum wear requirement not reported | Step count (steps/day), METs, active energy expenditure (kcal/day), physical activity duration (min/day), lying down (min/day), sleep efficiency (%), sleep duration (min/day) and total energy expenditure (kcal/day) determined by SenseWear proprietary software | From baseline to end of intervention, the intervention group had larger improvements in sleep efficiency (p=0.02), sleep duration (p=0.03) and lying down time (p=0.03) compared with the control group. There were no significant between-group differences in steps per day, METs, active energy expenditure, physical activity duration or total energy expenditure from baseline to end of intervention | The intervention group showed significantly larger improvements in estimated lactate threshold and VO2 at peak compared with the control group at end of intervention vs baseline. No between-group differences in BMI, forced expiry volume of 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC or haemoglobin across the study period |
| Single-arm trials | ||||
| Alejo et al30 | Hip-worn Actigraph GT3x worn for a minimum of 5 days at baseline (before neoadjuvant treatment) and postintervention (immediately before surgery) Minimum wear requirement: ≥10 hours per day on at least 5 days including 2 weekend days | Sedentary time (<100 cpm), time spent in MVPA (≥1952 cpm) | There were no significant changes in sedentary time (mean difference −24 (95% CI −60 to 10) min/week) or MVPA (mean difference 178 (95% CI −21 to 376) min/week) from baseline to postintervention | From baseline to postintervention, there was significant improvement in VO2peak, depression and emotional function No changes in BMI, handgrip strength, 5 repetition sit-to-stand test, anxiety or quality of life |
| Grimes et al32 | Wrist-worn Axivity AX3 worn 24 hours per day for 7 days prior to the clinic visit (intervention) and 7 days immediately after the visit Minimum wear requirement: >72 hours of continuous wear at both time points | Average acceleration (mg) per day based on auto-calibrated Euclidian norm minus one (ENMO) | There was a significant increase in overall daily ENMO after the standard clinical intervention (median baseline ENMO 14.3 mg (IQR 9.75–22.04), median postintervention ENMO 20.91 mg (IQR 14.83–27.53), p=0.02 | No significant difference in self-reported physical activity from preintervention to postintervention |
| McAdams-DeMarco et al33 | Wrist-worn Actigraph GT9x worn 24 hours a day for the week prior to intervention, and for 1 week following the 1-month and 2-month prehabilitation evaluations Minimum wear requirement: ≥3 days of wear per week | Mean counts per minute | There was no significant change in mean cpm from baseline (1717) to 1 month (1741, 1% change, p=0.90) but there was a significant increase by the second month (2814, 64% change, p=0.004), no SD or CIs provided | Compared with age-matched, sex-matched and race-matched controls, length of stay was shorter for patients who had received prehabilitation |
| Ngo-Huang et al47 and Parker et al52 | Hip-worn Actigraph GT3X+ worn during all waking hours for two consecutive weeks at the approximate midpoint of each phase of therapy and averaged across all programme weeks for each patient Minimum wear requirement: ≥10 hours per day on ≥7 days at each timepoint Non-wear was classified as at least 60 consecutive minutes of zero counts with allowance of up to 2 min with counts 0–100 | Time spent in LPA (100-1951 cpm) and MVPA (≥1952 cpm, in total and in bouts lasting ≥10 min) Ngo-Huang 2019 also reported sedentary time (presumably <100 cpm) | Averaged across the intervention period, participants had 923.8±294.5 min/week LPA; 158.7±146.7 min/week total MVPA; 55.1±92.9 min/week MVPA in 10 min bouts and 4462.9±620.2 min/week sedentary time | There were significant improvements in 6MWT distance, five times sit-to-stand test, and 3-metre walk test (metres per second) from baseline to preoperative follow-up visit There were no significant changes in handgrip strength, physical function scores or functional assessment of cancer therapy scores |
| Williams et al35 | Wrist-worn COOSA Heart Rate Monitor (accelerometer) at baseline, end of telephone intervention (6 weeks) and end of intervention (12 weeks) Minimum wear requirement: not specified | Steps per day | Compared with baseline, daily step counts did not change at 6 weeks (median difference 1750, p=0.07) but did increase at 12 weeks (median 6700 (IQR 3000–14 600)), a significant median increase of 2700/day compared with baseline (p<0.01) | There were significant improvements in incremental shuttle walk test, short physical performance battery tests (including chair stand, balance, gait speed) from baseline to 6 weeks with further improvements in shuttle walk test at 12 weeks. Significant improvements in health-related quality of life were seen from baseline to 12 weeks (but not at 6 weeks) There were no changes in anxiety or depression at any time points |
BMI, body mass index; cpm, counts per minute; KOOS, Knee Injury and Osteoarthritis Outcome Score; LPA, light physical activity; METs, metabolic equivalents; MVPA, moderate-to-vigorous physical activity; 6MWT, 6 min walk test; RCT, randomised controlled trial; VO2, oxygen consumption.