Actigraphy informs distinct patient-centered outcomes in Pre-COPD,Respiratory Medicine

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Actigraphy informs distinct patient-centered outcomes in Pre-COPD
Respiratory Medicine ( IF 3.5 ) Pub Date : 2021-07-30 , DOI: 10.1016/j.rmed.2021.106543
Jianhong Chen ₁ , Lemlem Weldemichael ₁ , Siyang Zeng ₂ , Brian Giang ₃ , Jeroen Geerts ₄ , Wendy Czerina Ching ₁ , Melissa Nishihama ₁ , Warren M Gold ₅ , Mehrdad Arjomandi ₁

Affiliation

Background

Actigraphy can provide useful patient-centered outcomes for quantification of physical activity in the “real-world” setting.

Methods

To characterize the relationship of actigraphy outputs with “in-laboratory” measures of cardiopulmonary function and respiratory symptoms in pre-COPD, we obtained actigraphy data for 8 h/day for 5 consecutive days a week before in-laboratory administration of respiratory questionnaires, PFT, and CPET to a subgroup of subjects participating in the larger study of the health effects of exposure to secondhand tobacco smoke who had air trapping but no spirometric obstruction (pre-COPD). Using machine learning approaches, we identified the most relevant actigraphy predictors and examined their associations with symptoms, lung function, and exercise outcomes.

Results

Sixty-one subjects (age = 66±7 years; BMI = 24±3 kg/m²; FEV₁/FVC = 0.75 ± 0.05; FEV₁ = 103 ± 17 %predicted) completed the nested study. In the hierarchical cluster analysis, the activity, distance, and energy domains of actigraphy, including moderate to vigorous physical activity, were closely correlated with each other, but were only loosely associated with spirometric and peak exercise measures of oxygen consumption, ventilation, oxygen-pulse, and anaerobic threshold (VO_2AT), and were divergent from symptom measures. Conversely, the sedentary domain clustered with respiratory symptoms, air trapping, airflow indices, and ventilatory efficiency. In Regression modeling, sedentary domain was inversely associated with baseline lung volumes and tidal breathing at peak exercise, while the activity domains were associated with VO_2AT. Respiratory symptoms and PFT data were not associated with actigraphy outcomes.

Discussion

Outpatient actigraphy can provide information for “real-world” patient-centered outcomes that are not captured by standardized respiratory questionnaires, lung function, or exercise testing. Actigraphy activity and sedentary domains inform of distinct outcomes.

中文翻译：

Actigraphy 为 COPD 前患者提供不同的以患者为中心的结果

背景

Actigraphy 可以提供有用的以患者为中心的结果，用于量化“现实世界”环境中的身体活动。

方法

为了描述活动图输出与 COPD 前心肺功能和呼吸系统症状的“实验室”测量值之间的关系，我们在实验室管理呼吸问卷、PFT 之前每周连续 5 天获得每天 8 小时的活动图数据, 和 CPET 对参与有关接触二手烟草烟雾对健康的影响的大型研究的受试者亚组进行了研究，这些受试者有空气滞留但没有肺功能阻塞（COPD 前）。使用机器学习方法，我们确定了最相关的活动记录预测因子，并检查了它们与症状、肺功能和运动结果的关联。

结果

61 名受试者（年龄 = 66±7 岁；BMI = 24±3 kg/m ²；FEV ₁ /FVC = 0.75 ± 0.05；FEV ₁ = 103 ± 17 % 预测）完成了嵌套研究。在层次聚类分析中，活动记录的活动、距离和能量域，包括中度到剧烈的身体活动，彼此密切相关，但仅与氧消耗、通气、氧耗的肺活量和运动峰值测量松散相关。脉搏和无氧阈（VO _2AT)，并且与症状测量不同。相反，久坐的领域与呼吸道症状、空气滞留、气流指数和通气效率聚集在一起。在回归模型中，久坐区域与运动高峰时的基线肺容量和潮汐呼吸呈负相关，而活动区域与 VO _2AT相关。呼吸系统症状和 PFT 数据与活动记录结果无关。