Counting Steps: A New Way to Monitor Patients with Pulmonary Arterial Hypertension

Lung. 2019 Aug;197(4):501-508. doi: 10.1007/s00408-019-00239-y. Epub 2019 May 29.

Abstract

Rationale: Activity levels in patients with pulmonary arterial hypertension (PAH) have correlated with surrogate markers of disease severity. It is not known whether physical activity measures are useful in monitoring patients with PAH.

Objectives: This pilot study aimed to evaluate whether change in physical activity measured by an accelerometer correlates with changes in six-minute walk distance (6MWD), echocardiographic parameters, NT-proBNP, or health-related quality-of-life measures (HRQOL).

Methods: The study design was a prospective, observational study in subjects with prevalent PAH. Subjects wore a wrist-worn accelerometer (Fitbit Charge HR®) between two outpatient visits. Daily step count and activity levels were recorded, and the change over time was correlated with changes in 6MWD, echocardiographic parameters, HRQOL, and NT-proBNP.

Measurements and main results: 30 subjects were enrolled, of which 20 patients had adequate accelerometer data to be analyzed over the study duration. The mean duration of follow-up was 136.4 ( ± 47.3) days. The change in daily step count correlated with a change in 6MWD (r 0.43, p 0.05). Changes in duration spent in moderately active (r 0.52, p 0.02), lightly active (r 0.48, p 0.05), and sedentary activity levels (r - 0.54, p 0.02) correlated with a change in HRQOL. Changes in activity levels did not correlate with echocardiographic measures or NT-pro BNP.

Conclusions: Changes in daily step count and time spent at fairly active, lightly active, and sedentary activity levels correlate with changes in 6MWD, and HRQOL in subjects with PAH suggesting that accelerometry may be a useful monitoring tool.

Keywords: Accelerometer; Health-related quality of life; Physical activity; Pulmonary hypertension; Six-minute walk test.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actigraphy / instrumentation*
  • Biomarkers / blood
  • Echocardiography
  • Exercise Tolerance*
  • Fitness Trackers*
  • Humans
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Pilot Projects
  • Predictive Value of Tests
  • Prospective Studies
  • Pulmonary Arterial Hypertension / diagnosis*
  • Pulmonary Arterial Hypertension / physiopathology
  • Quality of Life
  • Sedentary Behavior
  • Surveys and Questionnaires
  • Time Factors
  • Walk Test
  • Walking*

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain