Abstract
Introduction: Higher levels of physical activity (PA) have been associated with better health-related quality of life (HRQoL). Whether this is true for patients counselled to restrict PA is unknown. Our aim was to examine the relationship between objective measures of PA and HRQoL in children with hypertrophic cardiomyopathy (HCM). Methods: A cross-sectional study of children with HCM, aged 10-18 yrs, enrolled from 10 Canadian sites (2016-23), who underwent cardiovascular screening including the PedsQL Quality of Life Inventory to measure HRQoL. PA measured via Fitbit occurred over 2 weeks. PA parameters included average daily heart rate, step-count, distance covered (Kms), stair flights, activity and sedentary time. Multiple linear regressions were performed to assess the relationship between PA and HRQoL. Covariate adjustments included: age/sex/BMI class at enrollment, cardiac arrest history, previous ICD implant and PA restriction. Correlation matrix was calculated for PA parameters. Results: Fifty-six patients were enrolled [71.4% male; median age 15.5 yrs (IQR 13.8-16.8), median BMI 23.3 Kg/m 2 (IQR 19.5-27.7)], including 11% with a cardiac arrest, 30.4% with an ICD implant and 75% PA restricted. The Fitbit was worn for a median of 14 days (IQR 13.3-14). Average daily steps were 7586 (IQR 5333-10324]) and median sedentary time 893 mins (IQR 735-1141). After adjustment, the average daily steps were associated with Physical HRQoL scores [mean difference (MD) of 2.0 [95% CI 0.3-3.0] per each 1000 steps increase (p=0.02)]. Similar effect sizes were seen for Physical HRQoL with average daily Kms, active time and stairs flights. These outcomes were highly correlated with daily steps (Spearman's ρ; 0.97, 0.81 and 0.6). Conversely, 100 mins of sedentary time decreased mean Physical HRQoL scores by 2 (MD = -2 [-4--0.4]; p=0.02). Only average daily stair flights (MD = 0.6 [0.1-1.1]; p=0.02) was associated with a higher Total HRQoL. Conclusions: Increasing PA in children with HCM, especially with flights of stairs, was associated with higher Physical/Total HRQoL, whereas sedentary time had a determinantal effect on Physical HRQoL. Efforts to decrease sedentary time and improve PA may improve the overall physical and total HRQoL of children with HCM.
Published Version
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