Abstract
BackgroundMeasurements of Energy Expenditure (EE) at rest (REE) and during physical activities are increasing in interest in chronic patients. In this study we aimed at evaluating the validity/reliability of the SenseWear®Armband (SWA) device in terms of REE and EE during assisted walking in Chronic Respiratory Failure (CRF) patients receiving long-term oxygen therapy (LTOT).Methodology/Principal FindingsIn a two-phase prospective protocol we studied 40 severe patients and 35 age-matched healthy controls. In phase-1 we determined the validity and repeatability of REE measured by SWA (REEa) in comparison with standard calorimetry (REEc). In phase-2 we then assessed EE and Metabolic Equivalents-METs by SWA during the 6-minute walking test while breathing oxygen in both assisted (Aid) or unassisted (No-Aid) modalities. When compared with REEc, REEa was slightly lower in patients (1351±169 vs 1413±194 kcal/day respectively, p<0.05), and less repeatable than in healthy controls (0.14 and 0.43 coefficient respectively). COPD patients with CRF patients reported a significant gain with Aid as compared with No-Aid modality in terms of meters walked, perceived symptoms and EE.Conclusions/SignificanceSWA provides a feasible and valid method to assess the energy expenditure in CRF patients on LTOT, and it shows that aided walking results in a substantial energy saving in this population.
Highlights
It is not yet proved that SWA is feasible to assess EE during walking in those chronic obstructive pulmonary disease (COPD) patients suffering from Chronic Respiratory Failure (CRF) and requiring long-term oxygen therapy (LTOT)
COPD patients were in advanced stage of the disease with hypoxemia on ambient air at rest, but corrected with adequate oxygen supplement which approximates the severity of their CRF
Body mass index (BMI) were similar by definition between groups, body circumferences and FFMI in male (1762 and 1961 kg/m2, respectively) were lower in patients than in controls
Summary
Among new methods to objectively assess Energy Expenditure (EE) both at rest (REE) or during activity, the SenseWearHArmband (SWA) device has been validated in healthy normal-weight [1,2,3,4,5] or obese [6] individuals and in chronic patients with heart failure [7] or diabetes [8].This is a multisensor device applied and carried by humans that allows to continuously measure active movements and to derive energy expenditure throughout; a specific software is associated for this calculation.EE measurement by SWA has been shown to have elevated reliability during standard walked distance (6MWT) even in patients with chronic obstructive pulmonary disease (COPD) [9,10]. Among new methods to objectively assess Energy Expenditure (EE) both at rest (REE) or during activity, the SenseWearHArmband (SWA) device has been validated in healthy normal-weight [1,2,3,4,5] or obese [6] individuals and in chronic patients with heart failure [7] or diabetes [8]. It is not yet proved that SWA is feasible to assess EE during walking in those COPD patients suffering from Chronic Respiratory Failure (CRF) and requiring long-term oxygen therapy (LTOT) These patients generally suffer from progressive physical disability and muscles de-conditioning which often cause restriction in daily activities (such as self-directed walking) [11]. In this study we aimed at evaluating the validity/reliability of the SenseWearHArmband (SWA) device in terms of REE and EE during assisted walking in Chronic Respiratory Failure (CRF) patients receiving long-term oxygen therapy (LTOT)
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