Matura Lea Ann, Shou Haochang, Fritz Jason S, Smith K Akaya, Vaidya Anjali, Pinder Diane, Archer-Chicko Christine, Dubow Danielle, Palevsky Harold I, Sommers Marilyn S, Kawut Steven M
University of Pennsylvania School of Nursing, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA.
Department of Biostatistics and Epidemiology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA.
Chest. 2016 Jul;150(1):46-56. doi: 10.1016/j.chest.2016.02.633. Epub 2016 Feb 15.
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.
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.
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.
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.
疲劳是肺动脉高压（PAH）患者的常见症状；然而，疲劳对PAH患者日常身体活动的影响尚不清楚。加速度计是评估身体活动的有效指标。我们假设，报告疲劳程度较高的PAH患者通过加速度计测量的日常身体活动水平较低。
我们对15名PAH女性患者进行了一项前瞻性队列研究。在第1天，受试者完成多维疲劳量表（MFI）、美国剑桥肺动脉高压结局评估（US CAMPHOR）和6分钟步行试验。受试者将加速度计佩戴在优势髋部，并完成7天的活动日记。在第15天，受试者重复MFI和US CAMPHOR，然后再次佩戴加速度计并完成另外7天的活动日记。所有多变量分析均对年龄、体重指数和PAH类型进行了校正。
平均年龄为50.5岁，53%的患者患有特发性或遗传性PAH。在这2周内，受试者大部分时间处于久坐状态（85%的时间），尽管其中10%的时间用于进行低水平活动。平均每日计数较低与自我报告的能量水平较差相关，而日常身体活动变异性较小与更多自我报告的精神疲劳、身体疲劳和总活动量相关。活动发作的百分比越高也与能量较差相关。
PAH女性患者可能大部分时间处于久坐状态，自我报告的能量水平较低与日常活动较少相关。改善疲劳等症状的干预措施也可能增加PAH患者的身体活动水平。
