Measurement of Physical Activity by Actigraphy in Infants and Young Children with Pulmonary Arterial Hypertension

• Published in: The Journal of pediatrics 2023-11, Vol.262, p.113639-113639, Article 113639
• Main Authors: Avitabile, Catherine M., Yung, Delphine, Handler, Stephanie, Hopper, Rachel K., Fineman, Jeff, Freire, Grace, Varghese, Nidhy, Mullen, Mary, Krishnan, Usha S., Austin, Eric, Silveira, Lori, Ivy, D. Dunbar
• Format: Article
• Language: English
• Subjects: 6-minute walk test; Actigraphy; Child; Child, Preschool; clinical trials; Exercise - physiology; Familial Primary Pulmonary Hypertension; Humans; Infant; Prospective Studies; Pulmonary Arterial Hypertension; wearables
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2023.113639

To evaluate the feasibility, tolerability, and adherence with wearable actigraphy devices among infants and children with pulmonary arterial hypertension (PAH). This multi-center, prospective, observational study included children ages 0-6 years with and without PAH. Participants wore the ActiGraph wGT3X-BT on the hip and FitBit Inspire on the wrist during waking hours for 14 days. Steps, vector magnitude counts per minute (CPM), activity intensity, heart rate, and heart rate variability (HRV) were compared between groups. Forty-seven participants (18 PAH, 29 control) were enrolled from 10 North American sites. PAH patients were mostly functional class II (n=16, 89%) and treated with oral medications at the time of enrollment. The number of wear days was not significantly different between the groups (ActiGraph: 10 [95% CI 5.5, 12.2] in PAH vs. 8 [4, 12] in control, p=0.20; FitBit 13 [10, 13.8] in PAH vs. 12 [8, 14] in control, p=0.87). Complete data were obtained in 81% of eligible ActiGraph participants and 72% of FitBit participants. PAH participants demonstrated fewer steps, lower vector magnitude CPM, more sedentary activity, and less intense physical activity at all levels compared with control participants. No statistically significant differences in HRV were demonstrated between the two groups. Measurement of physical activity and other endpoints using wearable actigraphy devices was feasible in young children with PAH. Larger studies should determine associations between physical activity and disease severity in young PAH patients to identify relevant endpoints for pediatric clinical trials.