Hammond-Haley Matthew, Allen Christopher, Han Jennie, Patterson Tiffany, Marber Michael, Redwood Simon
British Heart Foundation Centre of Research Excellence, King's College London, Rayne Institute, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EP, UK.
Department of Cardiology, Guys' and St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, UK.
Eur Heart J Digit Health. 2021 May 6;2(2):231-243. doi: 10.1093/ehjdh/ztab035. eCollection 2021 Jun.
Physical activity (PA) plays an important role in primary and secondary prevention of cardiovascular disease (CVD), functioning as a marker of disease progression and response to therapy. Real-world measurement of habitual PA is now possible through wearable activity monitors, however, their use in cardiovascular patients is not well described.
We performed a systematic review to summarize how wearable activity monitors have been used to measure PA in patients with CVD, with 11 464 patients included across 108 studies. Activity monitors were primarily used in the setting of cardiac rehabilitation (46, 43%). Most often, triaxial accelerometers (70, 65%) were instructed to be worn at the hip (58, 54%) for 7 days ( = 54, 50%). Thirty-nine different activity monitors were used, with a range of accelerometer specific settings for collection and reporting of activity data. Activity was reported most commonly as time spent in metabolic equivalent-defined activity levels (49, 45%), while non-wear time was defined in just 16 (15%) studies.
The collecting, processing, and reporting of accelerometer-related outcomes were highly heterogeneous. Most validation studies are limited to healthy young adults, while the paucity of methodological information disclosed renders interpretation of results and cross-study comparison challenging. While accelerometers are promising tools to measure real-world PA, we highlight current challenges facing their use in elderly multimorbid cardiology patients. We suggest recommendations to guide investigators using these devices in cardiovascular research. Future work is required to determine optimal methodology and consensus-based development of meaningful outcomes using raw acceleration data.
身体活动（PA）在心血管疾病（CVD）的一级和二级预防中起着重要作用，可作为疾病进展和治疗反应的标志物。现在通过可穿戴活动监测器可以对习惯性PA进行实际测量，然而，其在心血管疾病患者中的应用尚未得到充分描述。
我们进行了一项系统综述，以总结可穿戴活动监测器如何用于测量CVD患者的PA，108项研究共纳入11464例患者。活动监测器主要用于心脏康复（46项，43%）。最常使用的是三轴加速度计（70项，65%），要求佩戴在髋部（58项，54%），持续7天（n = 54项，50%）。使用了39种不同的活动监测器，在收集和报告活动数据方面有一系列加速度计特定设置。活动最常报告为在代谢当量定义的活动水平上花费的时间（49项，45%），而只有16项（15%）研究定义了非佩戴时间。
加速度计相关结果的收集、处理和报告高度异质。大多数验证研究仅限于健康的年轻人，而公开的方法学信息匮乏使得结果解释和跨研究比较具有挑战性。虽然加速度计是测量实际PA的有前景的工具，但我们强调了其在老年多病的心脏病患者中使用面临的当前挑战。我们提出了一些建议，以指导研究人员在心血管研究中使用这些设备。未来需要开展工作来确定最佳方法，并基于共识利用原始加速度数据开发有意义的结果。
