Abstract
Purpose
Physical activity (PA) is an important outcome in lung cancer; however, there is lack of consensus as to the best method for assessment. The Physical Activity Scale for the Elderly (PASE) is a commonly used questionnaire. The aim of this study was to assess the clinimetric properties of the PASE in lung cancer, specifically validity, predictive utility and clinical applicability (floor/ceiling effects, responsiveness and minimal important difference [MID]).
Methods
This is a prospective observational study. Sixty-nine participants (62 % male, median [IQR] age 68 years [61–74]) with lung cancer completed the PASE at diagnosis at 2, 4 and 6 months. Additional measures included movement sensors (steps/day), physical function, health-related quality of life, functional capacity (6-min walk distance [6MWD]), and muscle strength. Spearman’s rank correlation coefficient was used to assess relationships. Linear regression analyses were conducted to determine predictive utility of the PASE for health status at 6 months. Responsiveness (effect size) and MID (distribution-based estimation) were calculated.
Results
The PASE was administered on 176 occasions. The PASE had moderate convergent validity with movement sensors (rho = 0.50 [95 %CI = 0.29–0.66], p < 0.005) and discriminated between participants classed as sedentary/insufficient/sufficient according to PA guidelines (p < 0.005). The PASE had fair-moderate construct validity with measures of physical function (rho = 0.57 [95 %CI = 0.46–0.66], p < 0.005), 6MWD (rho = 0.40 [95 %CI = 0.23–0.55], p < 0.005), and strength (rho = 0.37 [95 %CI = 0.18–0.54], p < 0.005). The PASE (at diagnosis) exhibited predictive utility for physical function (Bcoef = 0.35, p = 0.008) and quality of life (Bcoef = 0.35, p = 0.023) at 6 months. A small floor effect was observed (3 %); however, there was no ceiling effect. There was a small responsiveness to change (effect size = 0.23) and MID between 17 and 25 points.
Conclusions
The PASE is a valid measure of self-reported PA in lung cancer.
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Acknowledgments
The authors would like to thank the The University of Melbourne, Royal Melbourne Hospital, Austin Hospital and Peter MacCallum Cancer Centre physiotherapy and respiratory medicine departments; Dr Ross Clark; and the participants for their contribution to the study.
Conflicts of interest
CG is funded by a National Health and Medical Research Council (NHMRC) Translating Research Into Practice Fellowship, Australia. One of the studies which contributed data was supported by a Victorian Cancer Agency Grant, Australia. The authors declare no conflicts of interest. The authors do not have a financial relationship with the organisation that sponsored the research. The authors have full control of all primary data and agree to allow the journal to review their data if requested.
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Granger, C.L., Parry, S.M. & Denehy, L. The self-reported Physical Activity Scale for the Elderly (PASE) is a valid and clinically applicable measure in lung cancer. Support Care Cancer 23, 3211–3218 (2015). https://doi.org/10.1007/s00520-015-2707-8
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DOI: https://doi.org/10.1007/s00520-015-2707-8