Wrist sensors reveal physical activity gaps for children with PH in study
Findings may help in developing metrics for use in clinical trials with kids
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Children with pulmonary hypertension (PH) engage in fewer and shorter bouts of intense physical activity than their peers, according to a new study that measured data from sensors worn on the wrist.
Moreover, kids with more severe PH generally had “worse physical testing,” as well as “a steeper decline in … intensity” when exercising, the researchers noted. Their study involved more than two dozen children with PH along with youngsters without the progressive disease, who served as controls; the team used research-grade devices to track physical activity among the participants over a two-week period.
According to the researchers, their findings may help provide a foundation for developing metrics that can be used in clinical trials of potential treatments for pediatric PH.
“This is the first study to process raw acceleration data from a research-grade wrist sensor to derive estimates of [physical activity] in pediatric PH patients and demonstrate deficits in [physical activity] levels compared to healthy peers and in relation to PH disease severity,” the scientists wrote.
The study, “Physical Activity Traits From Wrist Sensors Correlate With Clinical Status in Pediatric Pulmonary Hypertension,” was published in the journal Pulmonary Circulation.
PH is marked by elevated pressure in the vessels that carry blood from the heart through the lungs. Several treatments are approved for adults with PH, but far fewer are available for children. This is in part due to a lack of clinical trials testing treatments in pediatric patients.
One of the reasons it’s hard to run trials in kids with PH is that there aren’t well-established measures that can be used to track functional status in this young patient population. Measures that are standard for adults — such as the six-minute walk distance (6MWD) — are just not practical for younger children.
“One of the limitations to clinical trials in pediatric PH is the lack of non-invasive, easily accessible endpoints reflective of functional status in children of all ages,” the researchers wrote.
Physical activity measures for adults don’t work for children
In this study, a team of U.S. scientists set out to assess whether sensors worn on the wrist like a watch might be able to provide information that could be used in clinical trials for pediatric PH. The study enrolled 30 young people with PH, ages 8 to 18, and 29 participants without PH. For 14 days, the participants wore a wrist sensor that tracked their physical activity.
The results showed that overall physical activity was similar in the children with and without PH. However, differences were evident when the researchers looked at the intensity of physical activity.
Specifically, the data indicated that children with PH had significantly fewer and shorter bouts of moderate to vigorous physical activity lasting at least 10 minutes. Children with PH also spent more of their active time doing low-intensity activity than their peers. These differences were generally most pronounced among children with more severe PH, statistical analyses showed.
With further research, these traits may reveal important endurance deficits in this population and could be potential targets for clinical trials [in pediatric PH].
The researchers noted that looking only at long bouts of vigorous activity — rather than just looking at the average amount of vigorous activity — can help limit erroneous findings.
For example, it allowed the team to identify brief arm movements being taken as actual physical activity. As such, the team suggested that this type of so-called bouting may be a useful endpoint for future clinical trials in pediatric PH. The researchers called for further work to validate and expand on this finding.
“PH participants engaged in less [physical activity] compared to healthy controls as indicated by fewer and shorter [moderate-to-vigorous physical activity] bouts [lasting at least] 10 [minutes]. … With further research, these traits may reveal important endurance deficits in this population and could be potential targets for clinical trials,” the scientists concluded.
