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Original Research: Pulmonary Vascular Disease |

Physical Activity Limitation as Measured by Accelerometry in Pulmonary Arterial HypertensionActivity in Pulmonary Arterial Hypertension

Meredith E. Pugh, MD; Maciej S. Buchowski, PhD; Ivan M. Robbins, MD; John H. Newman, MD; Anna R. Hemnes, MD
Author and Funding Information

From the Division of Allergy, Pulmonary and Critical Care Medicine (Drs Pugh, Robbins, Newman, and Hemnes) and Division of Gastroenterology (Dr Buchowski), Vanderbilt University Medical Center, Nashville, TN.

Correspondence to: Meredith E. Pugh, MD, Division of Allergy, Pulmonary and Critical Care, Vanderbilt University Medical Center, T1218 Medical Center N, 1161 21st Ave S, Nashville, TN 37232; e-mail: meredith.e.pugh@vanderbilt.edu


Funding/Support: This work was supported by the National Institutes of Health [supported in part by the Vanderbilt Clinical and Translational Science Awards grant UL1 RR024975 (to Dr Pugh), 5 T32 HL087738-05 (to Dr Pugh), and 5 K08 HL093363 (to Dr Hemnes) and by Vanderbilt Diabetes Research and Training Center grant DK069465 (to Dr Buchowski)].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(6):1391-1398. doi:10.1378/chest.12-0150
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Background:  The 6-min walk test, commonly used to assess exercise capacity and response to therapy in pulmonary arterial hypertension (PAH), has many well-described limitations. Sedentary time is associated with adverse cardiovascular outcomes and reduced quality of life, and measuring sedentary time and physical activity using accelerometry is another potential way to quantify exercise capacity in PAH. Whether sedentary time is different in patients with PAH vs control subjects is unknown.

Methods:  Physical activity was measured in 20 patients with PAH and 30 matched healthy control subjects using accelerometry for 7 consecutive days. Patients with PAH completed standard 6-min walk testing, and baseline demographics were recorded for all study participants. Total daily activity counts, sedentary time, and proportion of time at various activity levels were compared between groups.

Results:  Sedentary time was significantly higher in patients with PAH (mean, 92.1% daily activity; 95% CI, 89.5-94.8%) than in control subjects (mean, 79.9% daily activity; 95% CI, 76.4%-83.5%; P < .001), and all levels of physical activity were reduced in the PAH group compared with the control group (P < .01 for all). Daily moderate to vigorous physical activity was reduced in the PAH group (7.5 min; 95% CI; 0.8-15.6 min) compared with the control group (mean, 64.7 min; 95% CI, 51.1-78.2 min; P < .001). Activity counts correlated with 6-min walk distance in the PAH group (Spearman rank correlation = 0.72, P < .001).

Conclusions:  Sedentary time is increased in patients with PAH and may lead to increased risk for metabolic and cardiovascular morbidity. Quantitation of daily activity and sedentary time using accelerometry may be a novel end point for PAH management and clinical trials.

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