Physical Activity and Symptoms in Pulmonary Arterial Hypertension

Background

Fatigue is a common symptom in patients with pulmonary arterial hypertension (PAH); however, the impact of fatigue on daily physical activity in PAH is unknown. Accelerometry is a validated measure for assessing physical activity. We hypothesized that patients with PAH reporting higher levels of fatigue would have lower daily physical activity measured by accelerometry.

Methods

We performed a prospective cohort study of 15 women with PAH. On Day 1, subjects completed the Multidimensional Fatigue Inventory (MFI), the United States Cambridge Pulmonary Hypertension Outcome Review (US CAMPHOR), and a 6 minute walk test. Subjects wore the accelerometer on their dominant hip and completed an activity diary for 7 days. On Day 15, subjects repeated the MFI, the US CAMPHOR, and then wore the accelerometer and completed an activity diary for an additional 7 days. All multivariate analyses were adjusted for age, body mass index and PAH type.

Results

The mean age was 50.5 years and 53% had idiopathic or heritable PAH. Over the two weeks, subjects were mostly sedentary (85% of the time) while 10% of their time was spent performing low level activity. Lower average daily counts were associated with worse self-reported energy levels, whereas less day-to-day physical activity variability was associated with more self-reported mental fatigue, physical fatigue and total activity. Higher percentage of activity bouts was also associated with worse energy.

Conclusions

Women with PAH may spend most time being sedentary and lower self-reported energy levels are associated with less daily activity. Interventions to improve symptoms such as fatigue may also increase physical activity levels in PAH.

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