Lung Fibrosis Service, Department of General Respiratory Medicine and Lung Transplantation, Alfred Hospital, Melbourne, Victoria, Australia.
Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Respirology. 2021 Dec;26(12):1152-1159. doi: 10.1111/resp.14137. Epub 2021 Aug 26.
Patients with idiopathic pulmonary fibrosis (IPF) have reduced levels of daily physical activity (DPA); however, little is known about how DPA changes as disease progresses. We aimed to (i) describe change in DPA over 12 months, (ii) analyse its association with conventional markers of disease severity and quality of life and (iii) assess DPA as a prognostic tool.
A total of 54 patients with IPF had DPA monitored at baseline and at 6 and 12 months with a SenseWear armband for 7 consecutive days. Participants completed the Hospital Anxiety and Depression scale, St George's Respiratory Questionnaire and Leicester Cough Questionnaire at each time point and provided clinical data including forced vital capacity (FVC), diffusion capacity of carbon monoxide and 6-min walk distance (6MWD).
Baseline and 12-month daily step count (DSC) were 3887 (395) and 3326 (419), respectively. A significant reduction in DSC (mean = 645 [260], p = 0.02) and total energy expenditure (mean = 486 kJ [188], p = 0.01) was demonstrated at 12 months. The decline in DSC over 12 months was proportionally larger than decline in lung function. Annual change in DPA had weak to moderate correlation with annual change in FVC % predicted and 6MWD (range r = 0.34-0.45). Change in physical activity was not associated with long-term survival.
In IPF, decline in DPA over 12 months is significant and disproportionate to decline in pulmonary physiology and may be a useful tool for assessment of disease progression.
特发性肺纤维化（IPF）患者的日常体力活动（DPA）水平降低；然而，对于疾病进展过程中 DPA 的变化知之甚少。我们旨在：（i）描述 12 个月内 DPA 的变化；（ii）分析其与疾病严重程度和生活质量的常规标志物的相关性；（iii）评估 DPA 作为预后工具的作用。
共有 54 名 IPF 患者使用 SenseWear 臂带连续 7 天监测基线以及 6 个月和 12 个月的 DPA。参与者在每个时间点完成医院焦虑和抑郁量表、圣乔治呼吸问卷和莱斯特咳嗽问卷，并提供包括用力肺活量（FVC）、一氧化碳弥散量和 6 分钟步行距离（6MWD）在内的临床数据。
基线和 12 个月的每日步数（DSC）分别为 3887（395）和 3326（419）。在 12 个月时，DPA 和总能量消耗（mean=645[260]，p=0.02）均显著下降。12 个月内 DSC 的下降幅度（mean=645[260]，p=0.02）大于肺功能的下降幅度。DPA 在 12 个月内的变化与 FVC%预计值和 6MWD 的年变化呈弱至中度相关（范围 r=0.34-0.45）。体力活动的变化与长期生存无关。
在特发性肺纤维化中，12 个月内 DPA 的下降显著且与肺生理功能的下降不成比例，可能是评估疾病进展的有用工具。
