设备评估留置胸膜导管患者的活动行为：澳大利亚恶性胸腔积液（AMPLE）-2随机试验的一项子研究。

Device assessed activity behaviours in patients with indwelling pleural catheter: A sub-study of the Australasian Malignant PLeural Effusion (AMPLE)-2 randomized trial.

作者信息

Peddle-McIntyre Carolyn J, Muruganandan Sanjeevan, McVeigh Joanne, Fitzgerald Deirdre B, Straker Leon, Newton Robert U, Murray Kevin, Lee Yun Chor Gary

机构信息

Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia.

School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.

出版信息

Respirology. 2023 Jun;28(6):561-570. doi: 10.1111/resp.14451. Epub 2023 Jan 15.

DOI:10.1111/resp.14451

PMID:36642702

Abstract

BACKGROUND AND OBJECTIVE

Device-assessed activity behaviours are a novel measure for comparing intervention outcomes in patients with malignant pleural effusion (MPE). Australasian Malignant PLeural Effusion (AMPLE)-2 was a multi-centre clinical trial where participants with MPE treated with an indwelling pleural catheter were randomized to daily (DD) or symptom-guided (SGD) drainage for 60-days. Our aim was to describe activity behaviour patterns in MPE patients, explore the impact of drainage regimen on activity behaviours and examine associations between activity behaviours and quality of life (QoL).

METHODS

Following randomization to DD or SGD, participants enrolled at the lead site (Perth) completed accelerometry assessment. This was repeated monthly for 5-months. Activity behaviour outcomes were calculated as percent of daily waking-wear time and compared between groups (Mann-Whitney U test; Median [IQR]). Correlations between activity behaviour outcomes and QoL were examined.

RESULTS

Forty-one (91%) participants provided ≥1 valid accelerometry assessment (DDn = 20, SGD n = 21). Participants spent a large proportion of waking hours sedentary (72%-74% across timepoints), and very little time in moderate-to-vigorous physical activity (<1% across timepoints). Compared to SGD group, DD group had a more favourable sedentary-to-light ratio in the week following randomization (2.4 [2.0-3.4] vs. 3.2 [2.4-6.1]; p = 0.047) and at 60-days (2.0 [1.9-2.9] vs. 2.9 [2.8-6.0]; p = 0.016). Sedentary-to-light ratio was correlated with multiple QoL domains at multiple timepoints.

CONCLUSION

Patients with MPE are largely sedentary. Preliminary results suggest that even modest differences in activity behaviours favouring the DD group could be meaningful for this clinical population. Accelerometry reflects QoL and is a useful outcome measure in MPE populations.

摘要

背景与目的

通过设备评估的活动行为是比较恶性胸腔积液（MPE）患者干预效果的一种新方法。澳大利亚恶性胸腔积液（AMPLE）-2是一项多中心临床试验，将接受留置胸腔导管治疗的MPE患者随机分为每日（DD）引流组或症状引导（SGD）引流组，为期60天。我们的目的是描述MPE患者的活动行为模式，探讨引流方案对活动行为的影响，并研究活动行为与生活质量（QoL）之间的关联。

方法

在随机分为DD组或SGD组后，主要研究地点（珀斯）招募的参与者完成了加速度计评估。在5个月内每月重复进行一次。活动行为结果以每日清醒佩戴时间的百分比计算，并在组间进行比较（曼-惠特尼U检验；中位数[四分位间距]）。研究了活动行为结果与QoL之间的相关性。

结果

41名（91%）参与者提供了≥1次有效的加速度计评估（DD组n = 20，SGD组n = 21）。参与者在清醒时间的大部分时间里久坐不动（各时间点均为72%-74%），而进行中度至剧烈体育活动的时间很少（各时间点均<1%）。与SGD组相比，DD组在随机分组后的一周内久坐与轻度活动的比例更有利（2.4[2.0-3.4]对3.2[2.4-6.1]；p = 0.047），在60天时也是如此（2.0[1.9-2.9]对2.9[2.8-6.0]；p = 0.016）。久坐与轻度活动的比例在多个时间点与多个QoL领域相关。