Demographic, clinical and lifestyle-related correlates of accelerometer assessed physical activity and fitness in newly diagnosed patients with head and neck cancer

Figures & data

Figure 1. Flowchart.

Table 1. Demographic, clinical and lifestyle related characteristics and physical activity and fitness of patients with at least one valid measurement of physical activity or fitness (n = 216).

Characteristics	Total group
Age, mean (SD) years	62 (9.8)
Gender, male, n (%)	162 (75)
BMI, n (%)
Underweight	11 (5)
Normal weight	91 (42)
Overweight	79 (37)
Obesity	32 (15)
Unknown	3 (1)
Level of education, n (%)
Low level	65 (30)
Intermediate/high level	148 (69)
Unknown	3 (1)
Alcohol consumption, n (%)
Never	19 (9)
Yes	135 (63)
Former	28 (13)
Unknown	34 (16)
Smoking, n (%)
Never	26 (12)
Yes	57 (26)
Former smoker	101 (47)
Unknown	32 (15)
Tumor site, n (%)
Oral cavity	60 (28)
Oropharynx – HPV positive	38 (18)
Oropharynx – HPV negative	29 (13)
Oropharynx – HPV unknown	8 (4)
Hypopharynx	20 (9)
Larynx	57 (26)
Unknown primary	4 (2)
Tumor stage, n (%)
Stage I, II or III	127 (59)
Stage IV	89 (41)
Comorbidity, n (%)
None/mild	134 (62)
Moderate/severe	69 (32)
Unknown	13 (6)
Living status, n (%)
Alone	52 (24)
With partner/child	162 (75)
Unknown	2 (1)
Wear time accelerometer^a, mean minutes/day (SD)	859.0 (98.0)
Total physical activity^a, mean minutes/day (SD)	229.4 (83.4)
Moderate to vigorous activity^a, mean minutes/day (SD)	17.9 (16.1)
Cardiorespiratory fitness^b, predicted VO2max in ml/kg/min (SD)	27.9 (10.9)
Women^c, predicted VO2max in ml/kg/min (SD)	25.0 (7.1)
Men^d, predicted VO2max in ml/kg/min (SD)	28.7 (11.6)
Hand grip strength^e, kg (SD)	38.1 (10.8)
Women^f, kg (SD)	26.8 (6.3)
Men^g, kg (SD)	41.9 (9.2)
Lower body muscle function^h, times standing during 30 s chair-stand test (SD)	14.3 (4.6)

SD: standard deviation; n: number; BMI: body mass index; HPV: human papilloma virus.

^a n-103; ^bn-71; ^cn = 31; ^dn = 93; ^en-3; ^fn = 54; ^gn = 159; ^hn-17.

Table 2. Demographic, clinical and lifestyle related characteristics of participants with accelerometer data and without accelerometer data.

Characteristics	No accelerometer data (n = 103)	Accelerometer data (n = 113)
Age, mean (SD)	61.3 (10.5)	62.7 (9.1)
Gender, male, n (%)	78 (76)	84 (74)
BMI, mean (SD) kg/m^2	25.5 (4.8)	25.8 (4.5)
BMI category, n (%)
Underweight	5 (5)	6 (5)
Normal weight	48 (47)	43 (38)
Overweight	33 (32)	46 (41)
Obesity	16 (16)	16 (14)
Unknown	1 (1)	2 (2)
Level of education, n (%)
Low level	32 (31)	33 (29)
Intermediate/high level	70 (68)	78 (69)
Unknown	1 (1)	2 (2)
Alcohol consumption, n (%)
Never drinker	9 (9)	10 (9)
Drinker	60 (58)	75 (66)
Former drinker	12 (12)	16 (14)
Unknown	22 (21)	12 (11)
Smoking, n (%)
Never smoker	12 (12)	14 (12)
Smoker	30 (29)	27 (24)
Former smoker	41 (40)	60 (53)
Unknown	20 (19)	12 (11)
Tumor site, n (%)
Oral cavity	37 (36)	23 (20)
Oropharynx HPV positive	10 (10)	28 (25)
Oropharynx HPV negative	14 (14)	15 (13)
Oropharynx HPV status unknown	3 (3)	5 (4)
Hypopharynx	9 (9)	11 (10)
Larynx	27 (26)	30 (27)
Unknown primary	3 (3)	1 (1)
Tumor stage, n (%)
Stage I, II or III	72 (70)	55 (49)
Stage IV	31 (30)	58 (51)
Comorbidity, n (%)
None/mild	58 (56)	76 (67)
Moderate/severe	36 (35)	33 (29)
Unknown	9 (9)	4 (4)
Living status, n (%)
Alone	27 (26)	25 (22)
With partner/child	76 (74)	86 (76)
Unknown	0 (0)	2 (2)

n: number; SD: standard deviation; BMI: body mass index; HPV: human papilloma virus.

Table 3. Univariable and multivariable regression analyses of potential correlates of accelerometer assessed physical activity and fitness.

	Physical activity, min/d		Cardiorespiratory fitness, ml/kg/min		Hand grip strength, kg		Lower body function, times standing
	Univariable	Multivariable (n = 107 patients)	Univariable	Multivariable (n = 141 patients)	Univariable	Multivariable (n = 173 patients)	Univariable	Multivariable (n = 161 patients)
	β (95%CI)	β (95%CI)	β (95%CI)	β (95%CI)	β (95%CI)	β (95%CI)	β (95%CI)	β (95%CI)
Age	–2.0 (–3.7 to –0.4)**		–0.2 (–0.4 to 0.05)**	–0.2 (–0.4 to 0.0)*	–0.2 (–0.4 to –0.1)**	–0.3 (–0.4 to –0.2)**	–0.2 (–0.2 to –0.1)**	–0.2 (–0.2 to –0.1)**
Gender: male vs. female	–26.2 (–61.6 to 9.2)		3.6 (–0.7 to 8.0)	4.7 (0.4 to 9.0)**	15.1 (12.4 to 17.8)**	14.6 (12.0 to 17.2)**	–0.5 (–2.0 to 1.0)
BMI			0.3 (–0.2 to 0.7)		0.4 (0.1 to 0.7)**		–0.0 (–0.1 to 0.1)
Underweight	–78.1(–149.8 to –6.5)**^,^a		–5.3 (–13.9 to 3.2)^a		–3.0 (–9.7 to 3.6)	–0.5 (–5.9 to 4.8)^a,^b	–2.9 (–5.8 to –0.1)**^,^a
Normal weight	REF		REF		REF	REF	REF
Overweight	6.5 (–28.4 to 41.3)^a		2.3 (1.7 to 6.3)^a		4.5 (1.3 to 7.7)**	3.9 (1.3 to 6.5)**^,^a	0.1 (–1.4 to 1.5)^a
Obesity	–7.9 (–56.0 to 40.3)		–1.0 (–6.8 to 4.8)		5.3 (1.0 to 9.6)**	5.6 (2.1 to 9.1)**^,^b	–1.2 (–3.1 to 0.7)
Highest level of education
Low level	REF		REF		REF		REF	REF
Intermediate or high	54.5 (21.4 to 87.6)**	39.9 (6.1 to 73.6)**	–1.0 (–5.2 to 3.2)		2.8 (–0.4 to 6.0)*		2.4 (1.0 to 3.7)**	1.5 (0.2 to 2.9)**
Regular alcohol consumption
Never	REF		REF		REF		REF
Active	–11.0 (–66.3 to 44.4)^c		–1.0 (–8.7 to 6.8)^c		2.7 (–2.1 to 8.6)		0.5 (–1.7 to 2.7)
In the past	–73.6 (–139.8 to –7.3)**^,^c		–6.1 (–15.4 to 3.2)^c		0.9 (–5.7 to 7.4)		–1.0 (–3.6 to 1.7)
Smoking
Never smoker	REF		REF		REF	REF	REF	REF
Smoker	–14.0 (–70.5 to 42.5)		1.9 (–5.3 to 9.0)		1.5 (–3.6 to 6.6)^d	1.1 (–2.7 to 4.9)	–2.5 (–4.7 to –0.3)**^,^d	–2.7 (–4.7 to –0.8)**
Former smoker	–4.2 (–55.2 to 46.6)		0.8 (–5.8 to 7.5)		6.7 (1.9 to 11.4)**^,^d	3.5 (0.1 to 6.9)**	–0.7 (–2.8 to 1.3)^d	–1.1 (–3.0 to 0.7)
Tumor site
Oropharynx HPV positive	REF		REF		REF		REF
Oropharynx HPV negative	–53.6 (–106.3 to –1.0)**^,^e^,^f		–2.9 (–10.0 to 4.3)		–4.4 (–12.0 to –1.6)**^,^f		–1.7 (–4.1 to 0.7)
Hypopharynx	–30.9 (–89.4 to 27.7)		–0.1 (–7.2 to 7.0)		–6.7 (–12.6 to –0.9)**^,^g		–2.0 (–4.7 to 0.6)
Larynx	–9.0 (–52.3 to 34.3)^f		2.6 (–2.9 to 8.2)		–1.7 (–6.1 to 2.7)^f,^g		–2.3 (–4.2 to –0.3)**
Oral cavity	–6.0 (–52.3 to 40.4)^e		–0.3 (–5.7 to 5.1)		–4.5 (–8.9 to –0.2)**		–0.6 (–2.5 to 1.3)
Tumor stage
Stage I/II/III	REF		REF		REF		REF
Stage IV	–39.5 (–69.9 to –9.1)**	–39.1 (–68.8 to –9.5)**	–4.0 (–7.6 to –0.4)**	–4.1 (–7.7 to –0.5)**	1.1 (–1.8 to 4.1)		0.2 (–1.2 to 1.5)
Comorbidity
None or mild	REF		REF		REF	REF	REF	REF
Moderate or severe	–51.9 (–85.4 to –18.3)**	–40.8 (–74.5 to –7.1)**	–1.4 (–5.9 to 3.0)		–6.0 (–9.0 to –2.9)**	–3.9 (–6.4 to –1.5)**	–2.3 (–3.7 to –1.0)**	–1.5 (–2.8 to –0.3)**
Living status
With partner/child	REF		REF		REF	REF	REF
Living alone	–15.8 (–53.6 to 22.1)		–2.1 (–6.6 to 2.4)		–3.8 (–7.2 to –0.4)**	–2.9 (–5.9 to 0.0)*	–1.8 (–3.3 to –0.3)**

BMI: body mass index; HPV: human papilloma virus; REF: reference category.

*p<.10.

^** p<.05.

^a Significant difference between underweight and overweight (p=.02 for total physical activity, p=.08 for cardiorespiratory fitness, p=.03 for hand grip strength, p=.05 for lower body muscle function).

^b Significant difference between underweight and obesity (p=.02 for hand grip strength).

^c Significant difference between active alcohol consumption and a history of alcohol consumption (p<.01 for total physical activity and p=.10 for cardiorespiratory fitness).

^d Significant difference between smoker and former smoker (p<.01 for hand grip strength, p=.02 for lower body muscle function).

^e Significant difference between HPV negative oropharyngeal tumors and oral cavity tumors (p=.09 for total physical activity).

^f Significant difference between HPV negative oropharyngeal tumors and laryngeal tumors (p=.09 for total physical activity, p=.04 for hand grip strength).

^g Significant difference between tumors of the hypopharynx and laryngeal tumors (p=.07 for hand grip strength).