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Original Research: Pulmonary Vascular Disease |

Physical Activity and Symptoms in Pulmonary Arterial Hypertension

Lea Ann Matura, PhD; Haochang Shou, PhD; Jason S. Fritz, MD; K. Akaya Smith, MD; Anjali Vaidya, MD; Diane Pinder, BS; Christine Archer-Chicko, MSN, CRNP; Danielle Dubow, MSN, CRNP; Harold I. Palevsky, MD; Marilyn S. Sommers, PhD; Steven M. Kawut, MD
Author and Funding Information

FUNDING/SUPPORT: This study was partially funded by the National Institutes of Health [grants K23 NR014885 and K24 HL103844], University Research Foundation, University of Pennsylvania, and by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health [grant UL1TR000003].

aUniversity of Pennsylvania School of Nursing, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA

bDepartment of Biostatistics and Epidemiology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA

cDepartment of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA

dCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA

CORRESPONDENCE TO: Lea Ann Matura, PhD, University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(1):46-56. doi:10.1016/j.chest.2016.02.633
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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-min 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 and 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, BMI, and PAH type.

Results  The mean age was 50.5 years, and 53% had idiopathic or heritable PAH. During the 2 weeks, subjects were mostly sedentary (85% of the time), although 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 of their 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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