# Association between continuous device-based physical activity monitoring over six months and cardiorespiratory, metabolic and body composition outcomes in post-surgery cancer survivors - An observational cohort analysis within a randomized controlled trial (CRBP-TS Study)

## TL;DR

This study shows that long-term physical activity tracking using wearables is linked to better heart and metabolic health in cancer survivors.

## Contribution

The study introduces long-term device-based physical activity monitoring in cancer survivors and links it to cardiorespiratory and metabolic outcomes.

## Key findings

- Higher MVPA and steps are associated with improved cardiorespiratory fitness and cardiac output.
- More steps correlate with lower insulin and leptin levels, indicating better metabolic health.
- Wearable devices provide reliable data for assessing the health benefits of long-term physical activity in cancer survivors.

## Abstract

The current guidelines for physical activity often rely on self-reported data or short-term activity tracking. We aimed to explore device-based long-term physical activity tracking and its possible association with cancer survivors’ cardiorespiratory fitness (CRF), metabolic health, and body composition.

In this observational analysis of a randomized controlled trial (CRBP-TS study), we reanalyzed data from 111 patients with breast, prostate, and colorectal cancer. Dependent variables included cardiorespiratory outcomes, body composition, metabolic biomarkers, and fatigue. A multiple linear regression model was used to analyze the data, considering age, gender, BMI, and baseline values. A consumer wearable device measured moderate-to-vigorous physical activity (MVPA) and steps continuously over six months, ensuring a detailed and accurate record of the participants' daily physical activity.

Physical activity data from all participants indicated a mean of moderate physical activity 108 min/wk (SD ± 88), vigorous physical activity 41 min/wk (SD ± 36), and 8498 steps/day (SD ± 2490). We observed that higher levels of MVPA were significantly associated with higher maximum oxygen uptake (VO2max; β = 0.5, 95% CI [0.02 to 1.0], p = 0.042), higher peak power output (PPO; β = 0.04, 95% CI [0.003 to 0.08], p = 0.037), and higher cardiac output (β = 0.6, 95% CI [0.2 to 1.1], p = 0.009). Additionally, more steps correlated significantly with higher VO2max (β = 0.27, 95% CI [0.04 to 0.51], p = 0.023), higher cardiac output (β = 0.2, 95% CI [0.013 to 0.47], p = 0.039), lower fat mass (β= -0.24, 95% CI [-0.44 to 0.03], p = 0.028), lower insulin (β=-4.2, 95% CI [-6.4 to -2.0], p < 0.000), and lower leptin (β=-0.56, 95% CI [-0.97 to -0.15], p = 0.008).

Continuous activity tracking with wearable devices provides an objective and standardized opportunity to investigate the amount of aerobic physical activity and its association with systemic health outcomes in cancer survivors. Our long-term activity data support a positive relationship between aerobic physical activity and cardiorespiratory fitness as well as metabolic health.

DRKS-ID: DRKS00020499; Registered 17 March 2020, https://drks.de/search/en/trial/DRKS00020499.

• A positive association exists between MVPA or steps and higher VO2max and cardiac output in cancer survivors.

• An inverse association exists for additional steps and lower insulin and leptin metabolic biomarkers in cancer survivors.

• Consumer wearable devices are a suitable measurement method for objectively quantifying the effects of long-term aerobic physical activity on health outcomes.