Physical activity levels are low in patients with pulmonary hypertension

González-Saiz, Laura; Santos‐Lozano, Alejandro; Fiuza‐Luces, Carmen; Sanz-Ayán, Paz; Quezada-Loaiza, Carlos A.; Ruiz-Casado, Ana; Alejo, Lidia B; Flox-Camacho, Ángela; Morán, María; Lucı́a, Alejandro; Escribano, Pilar

doi:10.21037/atm.2018.05.37

Cited by 19 publications

(23 citation statements)

References 11 publications

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“…The proportion of people with PH engaging in regular physical activity was lower than pre-diagnosis, in keeping with previous literature. 6 , 7 , 9 This may result from exercise barriers, together with uncertainty regarding the role and safety of exercise. More than half the study cohort (63%) reported a previous adverse event during exercise.…”

Section: Discussionmentioning

confidence: 99%

“…While the incidence of PH is higher in women than men, 32 the magnitude of this difference appears compounded in this study (likely due to responder bias), and therefore experiences and perspective unique to men may be under-represented. Too tired or fatigued (18) Too breathless 124 (17) Frustration at physical limitations 65 (9) Limited by pain (9) Fear 7Cost 46 (6) Safety concerns 43 (6) Exercise is unenjoyable 39 5Limited mobility 37 (5) Unsure what exercise to do 35 Data were derived from a question asking respondents to identify all perceived barriers to exercise. Each respondent could select multiple options; therefore the total number of responses is larger than the number of individual respondents.…”

Section: Study Limitationsmentioning

confidence: 99%

“… 5 Despite this, patients with PH are known to be more sedentary and report reduced quality of life compared to age- and gender-matched controls. 6 – 9 …”

Section: Introductionmentioning

confidence: 99%

“…5 Despite this, patients with PH are known to be more sedentary and report reduced quality of life compared to age-and gender-matched controls. [6][7][8][9] Several studies have used activity monitoring devices to quantify physical activity in patients with PH, including measurement of metabolic equivalents (METs). 10 Patients with idiopathic pulmonary arterial hypertension (PAH) were seen to have lower mean daily step counts, daily energy expenditures, and reduced duration of moderate physical activities (classified as >3 METs) 6 Patients with PAH were observed to spend up to 92.1% of their average day in sedentary behaviour, significantly more than controls (p <0.001).…”

mentioning

confidence: 99%

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‘Tired, afraid, breathless … .’ An international survey of the exercise experience for people living with pulmonary hypertension

et al. 2020

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Objectives: To identify patterns of exercise behaviour, attitudes towards exercise, barriers and enablers of exercise for people living with Pulmonary Hypertension (PH). Accessibility of rehabilitation services from a patient perspective was also explored. Methods: a voluntary, international survey of people living with PH was conducted, with mixed quantitative and qualitative data collection, in an online and paper format. Results: Data from 187 participants in 19 countries were included in the analyses. 52% (95/183) of people with PH reported that they attempted to engage in regular physical activity. This was less than the proportion who did so prior to diagnosis (61%, 112/184, p=0.006), and was accompanied by uncertainty and anxiety about exercise. 63% (113/180) of the cohort reported experiencing previous adverse events whilst exercising, which was associated with a greater likelihood of ongoing exercise concerns and anxiety. Fear, frustration and uncertainty about exercise were noted as common barriers to engaging in exercise with PH. Other barriers to exercise included intrinsic factors such as debilitating breathlessness and fatigue, and external factors such as cost and access to appropriate services. Most respondents (76%, 128/169) did not have access to a multi-disciplinary rehabilitation service, although an overwhelming majority (92%, 159/172) reported this would be helpful. Respondents rated education; a supervised, structured exercise program; and psychology input as the most important components of a multi-disciplinary rehabilitation service for PH. Conclusion: Health professionals must work together with consumers to co-design rehabilitation services that will facilitate exercise and increased activity for people living with PH.

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Section: Discussionmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

“… 5 Despite this, patients with PH are known to be more sedentary and report reduced quality of life compared to age- and gender-matched controls. 6 – 9 …”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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‘Tired, afraid, breathless … .’ An international survey of the exercise experience for people living with pulmonary hypertension

et al. 2020

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“…The program was designed to be adaptable to everyday life subsequently affecting physical activity habits of oneself, but we did not verify (due to fi nancial limitations) this issue by objective assessment of daily activities by accelerometry. 41,42 Such changes in daily habits could contribute to promoting long-term benefi ts, therefore absence of long-term follow-up we could consider as the study limitation.…”

Section: The Study Limitationsmentioning

confidence: 99%

Individualized home-based exercise program for idiopathic pulmonary arterial hypertension patients: a preliminary study

Butāne¹,

Šmite²,

Sablinskis³

et al. 2019

Cor Vasa

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SOUHRNÚvod: Je prokázáno, že rehabilitační cvičení je přínosnou formou nefarmakologické léčby pacientů se stabilní plicní arteriální hypertenzí (PAH). Většina studií hodnotila i výsledky programů nabízených v nemocnicích a prováděných pod odborným dohledem. Je třeba zajistit lepší přístup pacientů k této významné formě intervence; současně je nutno zaměřit výzkum i na dlouhodobé účinky programů cvičení prováděného samotnými pacienty v domácím prostředí. Cílem naší studie bylo zhodnotit adherenci, bezpečnost i účinek 12týdenního individualizovaného programu cvičení v domácím prostředí pro pacienty s idiopatickou PAH. Metody: Náš projekt byla prospektivní pilotní nekontrolovaná intervenční studie. Pro účast v ní bylo z lotyšského registru PAH vybráno šest pacientů s idiopatickou PAH, potvrzenou pravostrannou srdeční katetrizací. Následně byl vypracován 12týdenní cvičební program přizpůsobený každému pacientovi podle jeho funkčního stavu a domácího prostředí. Program byl zaměřen na posilování, dechová, aerobní cvičení i techniky relaxace nervového systému i svalstva, monitorování sebekontroly, každotýdenní kontrolu pacienta telefonem a osobní návštěvy v ordinaci, kde fyzioterapeut mohl upravovat režim i sledovat jeho dodržování pacientem; současně se dbalo o maximální bezpečnost pacientů. Primárními sledovanými parametry z hlediska účinku programu byly zátěžová kapacita, způsob dýchání a kvalita života, z hlediska adherence to byly dny s cvičením a z hlediska bezpečnosti jakákoli příhoda jako "varovaní" během cvičení, neúplné zotavení a zhoršení symptomů plicní hypertenze. Výsledky: Výsledky prokázaly poměrně vysokou míru adherence k předepsanému cvičebnímu režimu (průměr 92,5 %). V průběhu programu nebyly zaznamenány žádné nežádoucí příhody. Výsledky prokázaly význam zajištění optimálních dovedností jak z hlediska objektivních sledovaných parametrů, tak subjektivních symptomů. Výsledky šestiminutového testu chůze (6-minute walking test, 6MWT) prokázaly, že vypracovaný program významně zlepšuje zátěžovou kapacitu (průměrné zlepšení 39 ± 17,5 m). U čtyř účastníků (66,7 %) byl pozorován minimální klinicky významný rozdíl (minumum clinically important difference, MCID) ve vzdálenosti překonané pacienty s PAH při 6MWT (25-33 m). Statisticky významné zlepšení ve výchylkách pohybu hrudníku potvrzují změny ve způsobu dýchání naznačující větší zapojení bránice při dýchání po absolvování programu. Výsledky neprokázaly významné zlepšení v žádné z domén z dotazníku SF-36. Nicméně polovina účastníků studie dosáhla po absolvování programu hodnoty MCID (11 %) podle příslušných stupnic fyzického zdraví. Závěr: Předběžné výsledky této studie prokázaly, že vypracovaný individualizovaný program pro cvičení v domácích podmínkách je bezpečný, snadno jej lze provozovat a umožňuje postupně zvyšovat intenzitu zátěže; současně zlepšuje fyzický funkční stav klinicky stabilizovaných pacientů s idiopatickou PAH. Hypotéza této studie podporuje představu o nutnosti provádět další výzkum formou randomizovaných kontrolovaných studií s ověřováním ...

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Physical activity and its clinical correlates in chronic thromboembolic pulmonary hypertension

et al. 2022

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Limited data are available on physical activity (PhA) levels in chronic thromboembolic pulmonary hypertension (CTEPH) patients, as well as on the clinical utility of PhA measurements using questionnaires and accelerometers.We aimed to study PhA levels of CTEPH patients and their clinical correlates, and to compare PhA levels measured by the International Physical Activity Questionnaire (IPAQ) with measures from accelerometers. This is a crosssectional study (n = 50). PhA levels were measured using accelerometers and questionnaires (IPAQ). Clinical parameters evaluated were walked distance on the 6-min-walking test (6MWT), pulmonary vascular resistance, N-terminal brain natriuretic peptide and quality of life (HRQoL) (Cambridge Pulmonary Hypertension Outcome Review questionnaire). Time spent in sedentary behavior was lower in self-reported measurement (279 ± 165 min/day) compared with accelerometry (446 ± 117 min/day, p < 0.000). Accelerometer-derived data showed that CTEPH patients spent 60% of the recorded time in sedentary behaviors and 2% in moderate-to-vigorous PhA (MVPA). Correlation analysis showed that MVPA was significantly correlated with 6MWT (p = 0.023) and symptom domain of HRQoL (p = 0.044). Self-reported MVPA was significantly higher than the one registered by the accelerometer (411 ± 569 vs. 131 ± 108 min/week, p = 0.027). Bland−Altman analysis indicated poor agreement between the two methods. Our results showed that CTEPH patients spend most of their days in sedentary behaviors and only a small amount of time in MVPA. Only MVPA was associated with HRQoL and CTEPH severity. In addition, we showed a poor agreement between selfreported and accelerometer-derived PhA in CTEPH patients, with the former overestimating the overall PhA.

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Physical activity levels are low in patients with pulmonary hypertension

Abstract: Daily PA is reduced in patients with PH, often to a level that may decrease their odds of survival. Efforts should be made to promote the implementation of healthy PA habits in this patient population.

Cited by 19 publications

References 11 publications

‘Tired, afraid, breathless … .’ An international survey of the exercise experience for people living with pulmonary hypertension

‘Tired, afraid, breathless … .’ An international survey of the exercise experience for people living with pulmonary hypertension

Individualized home-based exercise program for idiopathic pulmonary arterial hypertension patients: a preliminary study

Physical activity and its clinical correlates in chronic thromboembolic pulmonary hypertension

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