PDF(Pubmed)
Abstract：
Children with pulmonary hypertension (PH) often demonstrate limited exercise capacity. Data support exercise as an effective nonpharmacologic intervention among adults with PH. However, data on exercise training in children and adolescents are limited, and characteristics of the optimal exercise program in pediatric PH have not been identified. Exercise programs may have multiple targets, including muscle deficits which are associated with exercise limitations in both adult and pediatric PH. Wearable accelerometer sensors measure physical activity volume and intensity in the naturalistic setting and can facilitate near continuous data transfer and bidirectional communication between patients and the study team when paired with informatics tools during exercise interventions. To address the knowledge gaps in exercise training in pediatric PH, we designed a prospective, single arm, nonrandomized pilot study to determine feasibility and preliminary estimates of efficacy of a 16-week home exercise intervention, targeting lower extremity muscle mass and enriched by wearable mobile health technology. The exercIse Training in pulmONary hypertEnsion (iTONE) trial includes (1) semistructured exercise prescriptions tailored to the participant\'s baseline level of activity and access to resources; (2) interval goal setting fostering self-efficacy; (3) real time monitoring of activity via wearable devices; (4) a digital platform enabling communication and feedback between participant and study team; (5) multiple avenues to assess participant safety. This pilot intervention will provide information on the digital infrastructure needed to conduct home-based exercise interventions in PH and will generate important preliminary data on the effect of exercise interventions in youth with chronic cardiorespiratory conditions to power larger studies in the future.
摘要：
患有肺动脉高压（PH）的儿童通常表现出有限的运动能力。数据支持运动作为成人PH患者的有效非药物干预措施。然而,关于儿童和青少年运动训练的数据有限，尚未确定小儿PH的最佳运动计划的特征。锻炼计划可能有多个目标，包括与成人和儿童PH的运动限制相关的肌肉缺陷。可穿戴加速度计传感器在自然环境中测量身体活动量和强度，并且在运动干预期间与信息学工具配对时，可以促进患者与研究团队之间的近连续数据传输和双向通信。为了解决儿科PH运动训练中的知识空白，我们设计了一个潜在的，单臂,非随机试点研究，以确定16周家庭运动干预的可行性和疗效的初步估计，针对下肢肌肉质量，并通过可穿戴移动健康技术丰富。脉搏过度训练（iTONE）试验包括（1）针对参与者的基线活动水平和资源访问量身定做的半结构化运动处方；（2）间隔目标设定，促进自我效能；（3）通过可穿戴设备实时监测活动；（4）使参与者与研究团队之间能够进行交流和反馈的数字平台；（5）评估参与者安全的多种途径。这项试点干预措施将提供有关在PH中进行基于家庭的运动干预所需的数字基础设施的信息，并将产生有关运动干预对患有慢性心肺疾病的年轻人的影响的重要初步数据，以推动未来的更大研究。
