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

Sehgal, Sameep; Chowdhury, Ananda S.; Rabih, Fadi; Gadre, Abhishek; Park, Margaret M.; Li, Manshi; Wang, Xiaofeng; Highland, Kristin B.

doi:10.1007/s00408-019-00239-y

Cited by 34 publications

(34 citation statements)

References 25 publications

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“…Daily step count in the present study was lower than in other studies that measured PA using an accelerometer in patients with PAH. 3,19 Mainguy et al evaluated patients with PAH and healthy individuals and found a mean daily step count of 5041 versus 9189 steps per day in the control group, matched by sex, age, and body mass index. 3 Sehgal et al found a higher mean daily step count of 5847.…”

Section: Discussionmentioning

confidence: 99%

“…3 Sehgal et al found a higher mean daily step count of 5847. 19 In a study to detect fluctuations in the PA level in individuals with PAH according to the weather, patients had daily averages ranging from 5567 AE 2434 steps per day in mild weather to 3995 AE 2013 steps per day on days with temperatures higher than or equal to 25 C. 20 These numbers are similar to ours, especially taking into account that Brazil has a predominantly tropical climate and on most days, the temperature is higher than 25 C. It is important to mention that the PA level may vary among countries, not only because of climate, but also due to other socioeconomic and cultural characteristics. For example, Brazilian patients with Chronic Obstructive Pulmonary Disease (COPD) patients are more physically active than Austrian patients.…”

Section: Discussionmentioning

confidence: 99%

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Association of daily physical activity with psychosocial aspects and functional capacity in patients with pulmonary arterial hypertension: a cross‐sectional study

Nakazato

Mendes²,

Paschoal

et al. 2021

Pulm. circ.

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Pulmonary arterial hypertension (PAH) impairs exercise tolerance and daily physical activity (PA). Aside from the hemodynamic limitations, physical, cognitive and emotional factors may play a relevant and as yet unexplored role. We investigated whether there is an association between the PA level and psychological disorders, health-related quality of life, and daily activities. We also searched for an association of the PA level with clinical factors and functional capacity. This was an analytical, cross-sectional, observational study conducted in a Brazilian University Hospital. Twenty stable PAH subjects wore an accelerometer for a week and completed an activity diary. They answered the quality of life questionnaire (SF-36), as well as the anxiety and depression scale (HADS), and the Manchester Respiratory Activities of Daily Living questionnaire (MRADL). Transthoracic echocardiography, the 6-Minute walk test (6MWT), the 1-minute sit-to-stand test (STST), and spirometry were performed. For statistical analysis we used Chi-square tests or Fisher's test as appropriate and the Mann-Whitney test to compare numerical values between two groups. The relationship between the parameters was assessed using the Spearman correlation test. The mean age was 44.3 years, 80% were women, 80% had idiopathic PAH, and 20% had connective tissue disease . The mean daily step count was 4,280 Â± 2,351, and the mean activity time was 41.6 Â± 19.3 minutes. The distance covered (6MWT) was 451.5 m, and the number of movements (1-STST) was 23.8. Thirty percent scored positive for anxiety, and 15% for depression (HADS). There was a significant correlation between accelerometer data and walking distance (6MWT), number of movements (1-STST), level of daily physical activity (MRADL), and depression symptoms. Our findings support the hypothesis that other aspects beyond physical and hemodynamic ones might impact the daily physical activity of patients with PAH.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of daily physical activity with psychosocial aspects and functional capacity in patients with pulmonary arterial hypertension: a cross‐sectional study

Nakazato

Mendes²,

Paschoal

et al. 2021

Pulm. circ.

View full text Add to dashboard Cite

show abstract

“…Promotion of exercise and PA, as well as physical therapist-led physical training programs, are important and have many health benefits for patients with chronic illnesses, including sarcoidosis [ 25 , 34 ]. A randomized clinical trial studied the effect of counseling combined with the use of an accelerometer and a smartphone/web-based application on PA in patients with COPD and diabetes mellitus [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…The use of commercially available, technology-based wearable activity trackers (ATs) is growing, for research and recreational purposes, both among healthy persons and among those with chronic illness. Beneficial effects of AT-based counseling have been demonstrated in patients with chronic diseases [ 24 , 25 ]. In a recent study by our group, we found that wearing an AT stimulated patients to be more physically active [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Benefit of Wearing an Activity Tracker in Sarcoidosis

Drent

Elfferich

Breedveld

et al. 2020

JPM

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Sarcoidosis causes many disabling symptoms, including fatigue and exercise limitations, which have been shown to improve by physical activity programs. The aim of this study was to estimate the effect of continuous activity monitoring using an electronic activity tracker (AT) on exercise performance and fatigue of sarcoidosis patients, compared to controls (cohort study), and the effect of additional personal coaching (randomized trial) over a period of 3 months. Fifty-four sarcoidosis patients received an AT (Group Ia: 27 with coaching and Group Ib: 27 without). A historical group of sarcoidosis patients (Group II; n = 41) who did not follow a physical activity program served as controls. Exercise performance of patients wearing an AT (Group I) improved compared with controls (Group II), including the 6MWD, % predicted (∆4.4 ± 9.1 versus ∆0.7 ± 5.0, respectively), and fatigue levels decreased (∆−3.9 ± 5.7 versus ∆−1.8 ± 5.3). Patients with coaching (Group Ia) showed greater improvement of exercise capacity over time than patients without coaching (Group Ib) as shown by the Steep Ramp Test results (watts: ∆20.2 ± 33.8 versus ∆5.7 ± 26.4; and SRT, VO2max, % predicted: ∆1.6 ± 2.6 versus ∆0.7 ± 2.3). Sarcoidosis patients wearing an AT achieved improvement of exercise performance and reduction of fatigue. We therefore recommend encouraging sarcoidosis patients to wear an AT to stimulate physical activity and reduce fatigue. The additional benefit of coaching needs to be explored in future studies.

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“…In the future, health tracking apps may complement the clinical picture but are currently difficult to interrogate directly by ACHD specialists and thus probably of limited immediate value. 31 Infection with SARS-CoV-2 should be suspected in ACHD patients presenting with fever, onset or worsening of dyspnoea, lower than usual peripheral oxygen saturation but also in case of unexplained worsening of ventricular function or new arrhythmia. Rarely these patients may present with overt cardiogenic shock.…”

Section: Outpatient Assessment and Managementmentioning

confidence: 99%

Adult congenital heart disease and the COVID-19 pandemic

Radke

Frenzel

Baumgartner

et al. 2020

Heart

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Adults with congenital heart disease (ACHD) may be at high risk in the case of COVID-19. Due to the heterogeneity of ACHD and secondary complications, risk profiles are, however, not uniform. This document aims to give an overview of relevant data and outline our pragmatic approach to disease prevention and management. Based on anatomy and additional physiological factors including symptoms, exercise capacity, heart failure, pulmonary hypertension and cyanosis, we propose a pragmatic approach to categorising patients into low-risk, intermediate-risk and high-risk groups. We regard especially patients with complex cyanotic conditions, those with palliated univentricular hearts, heart failure, severe valvular disease or pulmonary hypertension as high-risk patients. To avoid infection, we recommend self-isolation and exemption from work for these cohorts. Infected ACHD patients with low or moderate risk and without signs of deterioration may be remotely followed and cared for at home while in self isolation. High-risk patients or those with signs of respiratory or cardiovascular impairment require admission ideally at a tertiary ACHD centre. Especially patients with complex, cyanotic disease, heart failure and arrhythmias require particular attention. Treatment in patients with cyanotic heart disease should be guided by the relative degree of desaturation compared with baseline and lactate levels rather than absolute oxygen saturation levels. Patients with right heart dilatation or dysfunction are potentially at increased risk of right heart failure as mechanical ventilation and acute respiratory distress syndrome can lead to increase in pulmonary arterial pressures.

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

Cited by 34 publications

References 25 publications

Association of daily physical activity with psychosocial aspects and functional capacity in patients with pulmonary arterial hypertension: a cross‐sectional study

Association of daily physical activity with psychosocial aspects and functional capacity in patients with pulmonary arterial hypertension: a cross‐sectional study

Benefit of Wearing an Activity Tracker in Sarcoidosis

Adult congenital heart disease and the COVID-19 pandemic

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