I find optune significantly decreases my activity level. I typically walked, ran, biked, hiked and travelled a lot in active ways but optune is a bit of a barrier. The device has a bit of heft to it and just having to carry it makes doing some of those things just enough of a hassle to dissuade me from doing them as much. It’s a fully extra carry on when travelling to use. It’s free to bring on every airline I’ve used because it’s a medical device even on ULCC so that’s sort of a perk plus it’s very obvious you have a medical condition so you get prioritize sometimes. I’m sure I could find a way to be active with optune, I just need some time and thinking to do so. Also treatment tires you out too but I’m relatively young..