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BRIEF RESEARCH REPORT article

Front. Med. Technol.

Sec. Diagnostic and Therapeutic Devices

Frailty is associated with low physical activity and poor sleep quality in patients undergoing myeloablative allogeneic hematopoietic cell transplantation: A Fitbit® Pilot Study

Provisionally accepted
Caryn LibbertCaryn Libbert1Fiona HeFiona He2Najla El JurdiNajla El Jurdi1Helen FagreliusHelen Fagrelius1Mark JuckettMark Juckett1Joseph E. MaakaronJoseph E. Maakaron1William JuckettWilliam Juckett1Donald R DengelDonald R Dengel1Shernan Grace HoltanShernan Grace Holtan1,3*
  • 1University of Minnesota Health Sciences, University of Minnesota Medical Center, Minneapolis, Minnesota, United States
  • 2Allina Health, Minneapolis, Minnesota, United States
  • 3Roswell Park Comprehensive Cancer Center, University at Buffalo, Buffalo, United States

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Introduction: Frailty, a multidimensional syndrome of reduced physiologic reserve, is associated with poorer outcomes following allogeneic hematopoietic cell transplantation (alloHCT), even among younger adults. This pilot study explores whether wearable sensor data reflecting physical activity and sleep are associated with pre-transplant frailty status in patients undergoing myeloablative alloHCT. Methods: Adults undergoing first myeloablative alloHCT at the University of Minnesota from June 2022 to January 2023 were enrolled and given Fitbit® Sense devices. Frailty was assessed pre-transplant using Fried Phenotype criteria. Activity and sleep data were collected from hospital admission to day +30 post-transplant. Descriptive and inferential statistics assessed differences across frailty phenotypes. Results: Nine patients were included: 2 not frail, 5 pre-frail, and 2 frail. Not frail patients demonstrated significantly higher daily steps and active minutes, and lower sedentary time compared to pre-frail and frail groups (all p < 0.01). Frail individuals had significantly reduced deep and REM sleep. The nadir for sleep and peak in sedentary behavior occurred around day +15 post-transplant. Conclusion: Pre-transplant frailty was associated with decreased physical activity and less restorative sleep during the peri-transplant period. These findings support further study of wearable data to guide personalized supportive care strategies in alloHCT recipients.

Keywords: Allogeneic Hematopoietic Cell Transplant, Frailty, STEPS, Sleep, Fitbit

Received: 07 Apr 2025; Accepted: 29 Oct 2025.

Copyright: © 2025 Libbert, He, El Jurdi, Fagrelius, Juckett, Maakaron, Juckett, Dengel and Holtan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Shernan Grace Holtan, sghmd@pm.me

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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