Novel Input for Designing Patient-Tailored Pulmonary Rehabilitation: Telemonitoring Physical Activity as a Vital Sign-SMARTREAB Study.

Catarina Duarte Santos,Cristina Bárbara,Cátia Caneiras,Rui César Das Neves,Ruy M Ribeiro,Martijn A Spruit,Fátima Rodrigues

doi:10.3390/jcm9082450

Abstract

Physical inactivity may be a consequence of chronic diseases but also a potential modifiable risk factor. Therefore, it should be clinically assessed as a vital sign of patients’ general physical condition prior to any exercise-based intervention. This cross-sectional study describes physical activity in the daily life of 100 chronic respiratory patients before pulmonary rehabilitation, comparing subjective and objective measures. The assessment combined the International Physical Activity Questionnaire (IPAQ) and 4-day accelerometer and oximeter telemonitoring with SMARTREAB technology, assessing heart rate, transcutaneous oxygen saturation and activity-related energy expenditure by metabolic equivalent of task (MET). According to IPAQ, 49% of patients had a moderate level of physical activity in daily life (PADL), a weekly mean level of 2844 ± 2925 MET.min/week, and a mean sedentary time of 5.8 ± 2.7 h/day. Alongside this, SMARTREAB telemonitoring assessed maximum activity ranging from 1.51 to 4.64 METs, with 99.6% daytime spent on PADL below 3 METs and 93% of patients with daily desaturation episodes. Regardless of the self-reported IPAQ, patients spend at least 70% of daytime on PADL below 2 METs. SMARTREAB was demonstrated to be an innovative methodology to measure PADL as a vital sign, combining oximetry with accelerometry, crossmatched with qualitative patient data, providing important input for designing patient-tailored pulmonary rehabilitation.

Highlights

Physical inactivity is the 4th worldwide risk factor for ill health with 1 million deaths and 8.3 million disability-adjusted life years lost per year [1]
Results show that patients with Chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), asthma and bronchiectasis spent about 80% of their daytime on activities below 2 metabolic equivalent of task (MET), including the International Physical Activity Questionnaire (IPAQ) reported sitting time
99.6% of their daytime was spent on activities below 3-fold their basal metabolism (3 METs)

Summary

Introduction

Physical inactivity is the 4th worldwide risk factor for ill health with 1 million deaths and 8.3 million disability-adjusted life years lost per year [1]. Chronic obstructive pulmonary disease (COPD) patients have less walking time at a slower walk pace [4,5], with a mean of almost 5000 steps/day [6,7] and associated increased risks for exacerbation-related hospitalization and premature mortality [8,9]. About 90% of bronchiectasis patients do not meet the recommended physical activity guidelines and have more than 10 h of daily sedentary behavior, walking an average of 6000 steps/day [12]. Physical activity is decreased on asthma patients with reported 8546 steps/day for mild/moderate asthma and 6560 steps/day for severe asthma [13]

Objectives

Results

Conclusion