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Measurement of Physical Activity by Actigraphy in Infants and Young Children with Pulmonary Arterial Hypertension
Catherine M Avitabile1, Delphine Yung2, Stephanie Handler3
1Division of Cardiology, Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Insights
Wearable devices are feasible for measuring physical activity in children with pulmonary arterial hypertension (PAH). Children with PAH showed less activity than healthy peers, highlighting the need for further research into disease impact.
Area of Science:
- Pediatric cardiology
- Biomedical engineering
- Clinical research
Background:
- Pulmonary arterial hypertension (PAH) in children impacts physical activity and overall health.
- Objective assessment of activity levels in pediatric PAH is crucial for understanding disease burden.
- Wearable actigraphy offers a promising non-invasive method for monitoring activity in this population.
Purpose of the Study:
- To assess the feasibility, tolerability, and adherence of using wearable actigraphy devices in infants and children with PAH.
- To compare physical activity metrics between children with and without PAH.
- To identify potential challenges and benefits of actigraphy in pediatric PAH research.
Main Methods:
- A multicenter, prospective, observational study involving 47 children (0-6 years) with and without PAH.
- Participants wore ActiGraph and FitBit devices for 14 days to collect data on steps, activity intensity, and heart rate.
- Comparison of activity data and device adherence between the PAH group and a healthy control group.
Main Results:
- Actigraphy device use was feasible and demonstrated good adherence in children with PAH.
- PAH participants exhibited significantly lower steps, reduced activity intensity, and increased sedentary time compared to controls.
- No significant differences in heart rate variability were observed between the groups.
Conclusions:
- Wearable actigraphy is a feasible tool for measuring physical activity in young children with pulmonary arterial hypertension (PAH).
- Findings suggest reduced physical activity in pediatric PAH, warranting further investigation.
- Larger studies are needed to correlate physical activity with disease severity and establish pediatric clinical trial endpoints.
Objective:
To evaluate the feasibility, tolerability, and adherence with wearable actigraphy devices among infants and children with pulmonary arterial hypertension (PAH).
Study Design:
This multicenter, prospective, observational study included children ages 0-6 years with and without PAH. Participants wore the ActiGraph wGT3X-BT on the hip and FitBit Inspire on the wrist during waking hours for 14 days. Steps, vector magnitude counts per minute, activity intensity, heart rate, and heart rate variability were compared between groups.
Results:
Forty-seven participants (18 PAH, 29 control) were enrolled from 10 North American sites. PAH patients were mostly functional class II (n = 16, 89%) and treated with oral medications at the time of enrollment. The number of wear days was not significantly different between the groups (ActiGraph: 10 [95% CI: 5.5, 12.2] in PAH vs 8 [4, 12] in control, P = .20; FitBit 13 [10, 13.8] in PAH vs 12 [8, 14] in control, P = .87). Complete data were obtained in 81% of eligible ActiGraph participants and 72% of FitBit participants. PAH participants demonstrated fewer steps, lower vector magnitude counts per minute, more sedentary activity, and less intense physical activity at all levels compared with control participants. No statistically significant differences in heart rate variability were demonstrated between the 2 groups.
Conclusions:
Measurement of physical activity and other end points using wearable actigraphy devices was feasible in young children with PAH. Larger studies should determine associations between physical activity and disease severity in young patients with PAH to identify relevant end points for pediatric clinical trials.
