背景:在“现实世界”环境中,活动描记术可以为量化身体活动提供有用的以患者为中心的结果。
方法:为了表征COPD前期的“实验室内”心肺功能和呼吸道症状测量值与活动记录输出的关系,在实验室给予呼吸问卷前,我们每周连续5天获得8小时/天的活动记录数据,PFT,和CPET,一组受试者参与了接触二手烟对健康影响的更大研究,这些研究有空气滞留但没有肺活量测定阻塞(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的关系,肺功能,和锻炼结果。
结果:61名受试者(年龄=66±7岁;BMI=24±3kg/m2;FEV1/FVC=0.75±0.05;FEV1=103±17%预测)完成了嵌套研究。在层次聚类分析中,活动,距离,和活动记录的能量域,包括中等到剧烈的体力活动,彼此密切相关,但仅与肺活量测定和峰值运动耗氧量相关,通风,氧脉冲,和无氧阈值(VO2AT),与症状测量不同。相反,久坐的区域聚集有呼吸道症状,空气捕集,气流指数,和通气效率。在回归建模中,久坐域与基线肺容量和峰值运动时的潮气呼吸呈负相关,而活性结构域与VO2AT相关。呼吸道症状和PFT数据与活动记录结果无关。
结论:门诊活动记录可以为“真实世界”以患者为中心的结果提供信息,而标准化的呼吸问卷无法捕获这些信息,肺功能,或运动测试。活动活动和久坐域告知不同的结果。
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 (VO2AT), 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 VO2AT. Respiratory symptoms and PFT data were not associated with actigraphy outcomes.
CONCLUSIONS: 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.