Pacemaker detected active minutes are superior to pedometer-based step counts in measuring the response to physical activity counseling in sedentary older adults.
Accelerometer
Cardiology
Geriatrics
Pacemaker
Physical activity
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
06 05 2020
06 05 2020
Historique:
received:
12
09
2019
accepted:
14
04
2020
entrez:
8
5
2020
pubmed:
8
5
2020
medline:
22
12
2020
Statut:
epublish
Résumé
In patients with permanent pacemakers (PPM), physical activity (PA) can be monitored using embedded accelerometers to measure pacemaker detected active hours (PDAH), a strong predictor of mortality. We examined the impact of a PA Counseling (PAC) intervention on increasing activity as measured by PDAH and daily step counts. Thirteen patients (average age 80 ± 6 years, 84.6% women) with implanted Medtronic PPMs with a ≤ 2 PDAH daily average were included in this study. Patients were randomized to Usual Care (UC, N = 6) or a Physical Activity Counseling Intervention (PACI, N = 7) groups. Step count and PDAH data were obtained at baseline, following a 12-week intervention, then 12 weeks after intervention completion. Data were analyzed using independent t-tests, Pearson's r, chi-square, and general linear models for repeated measures. PDAH significantly differed by time point for all subject combined (P = 0.01) but not by study group. Subjects with baseline gait speeds of > 0.8 m/sec were responsible for the increases in PDAH observed. Step counts did not differ over time in the entire cohort or by study group. Step count and PDAH significantly correlated at baseline (r = 0.60, P = 0.03). This correlation disappeared by week 12. PDAH can be used to monitor PA and PA interventions and may be superior to hip-worn pedometers in detecting activity. A significant increase in PA, regardless of treatment group, suggests that patient awareness of the ability to monitor PA through a PPM increases PA in these patients, particularly in patients with gait speeds of < 0.8 m/sec. ClincalTrials.gov NCT03052829. Date of Registration: 2/14/2017.
Sections du résumé
BACKGROUND
In patients with permanent pacemakers (PPM), physical activity (PA) can be monitored using embedded accelerometers to measure pacemaker detected active hours (PDAH), a strong predictor of mortality. We examined the impact of a PA Counseling (PAC) intervention on increasing activity as measured by PDAH and daily step counts.
METHODS
Thirteen patients (average age 80 ± 6 years, 84.6% women) with implanted Medtronic PPMs with a ≤ 2 PDAH daily average were included in this study. Patients were randomized to Usual Care (UC, N = 6) or a Physical Activity Counseling Intervention (PACI, N = 7) groups. Step count and PDAH data were obtained at baseline, following a 12-week intervention, then 12 weeks after intervention completion. Data were analyzed using independent t-tests, Pearson's r, chi-square, and general linear models for repeated measures.
RESULTS
PDAH significantly differed by time point for all subject combined (P = 0.01) but not by study group. Subjects with baseline gait speeds of > 0.8 m/sec were responsible for the increases in PDAH observed. Step counts did not differ over time in the entire cohort or by study group. Step count and PDAH significantly correlated at baseline (r = 0.60, P = 0.03). This correlation disappeared by week 12.
CONCLUSION(S)
PDAH can be used to monitor PA and PA interventions and may be superior to hip-worn pedometers in detecting activity. A significant increase in PA, regardless of treatment group, suggests that patient awareness of the ability to monitor PA through a PPM increases PA in these patients, particularly in patients with gait speeds of < 0.8 m/sec.
TRIAL REGISTRATION
ClincalTrials.gov NCT03052829. Date of Registration: 2/14/2017.
Identifiants
pubmed: 32375676
doi: 10.1186/s12877-020-01559-y
pii: 10.1186/s12877-020-01559-y
pmc: PMC7201960
doi:
Banques de données
ClinicalTrials.gov
['NCT03052829']
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
162Subventions
Organisme : NICHD NIH HHS
ID : R21 HD094565
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL144098
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL128240
Pays : United States
Organisme : NHLBI NIH HHS
ID : K24 HL152143
Pays : United States
Organisme : NIGMS NIH HHS
ID : T32 GM089586
Pays : United States
Organisme : NHLBI NIH HHS
ID : R38 HL167238
Pays : United States
Organisme : NHLBI NIH HHS
ID : R38 HL143561
Pays : United States
Références
Diabetes. 2007 Nov;56(11):2655-67
pubmed: 17827399
Indian Heart J. 2016 Dec;68 Suppl 3:S21-S25
pubmed: 28038720
Lancet. 2012 Jul 21;380(9838):219-29
pubmed: 22818936
Open Heart. 2014 Dec 10;1(1):e000177
pubmed: 25512875
Gait Posture. 2011 May;34(1):111-8
pubmed: 21531139
Am J Health Promot. 1998 Jan-Feb;12(3):154-61
pubmed: 10176088
Eur J Appl Physiol. 2012 Jan;112(1):49-57
pubmed: 21479653
Circulation. 2000 Sep 12;102(11):1270-5
pubmed: 10982542
Prev Chronic Dis. 2018 Mar 29;15:E38
pubmed: 29602315
Arch Phys Med Rehabil. 2017 Feb;98(2):295-302
pubmed: 27666157
Med Klin (Munich). 2008 Dec 15;103(12):827-30
pubmed: 19099211
Circulation. 2010 Jul 27;122(4):406-41
pubmed: 20625115
JAMA. 2003 Apr 9;289(14):1785-91
pubmed: 12684356
Med Sci Monit. 2012 Dec;18(12):RA173-80
pubmed: 23197245
Am J Cardiol. 1988 Mar 1;61(8):628-32
pubmed: 3344690
Telemed J E Health. 2016 May;22(5):441-9
pubmed: 26451900
Indian Pacing Electrophysiol J. 2004 Jul 01;4(3):137-45
pubmed: 16943981
J Nutr Health Aging. 2009 Dec;13(10):881-9
pubmed: 19924348
Diabetologia. 2012 Nov;55(11):2895-905
pubmed: 22890825
CA Cancer J Clin. 2017 May 6;67(3):233-244
pubmed: 28198998
J Am Coll Cardiol. 2015 Aug 11;66(6):754-5
pubmed: 26248996
Am J Physiol Heart Circ Physiol. 2007 Nov;293(5):H3159-64
pubmed: 17766475
Am J Physiol Heart Circ Physiol. 2010 Aug;299(2):H243-4
pubmed: 20511408
Sleep Health. 2018 Apr;4(2):209-216
pubmed: 29555136
Eur Heart J. 2011 Mar;32(5):590-7
pubmed: 21224291
Health Psychol. 2007 May;26(3):375-80
pubmed: 17500625
Sleep. 2003 May 1;26(3):342-92
pubmed: 12749557
J Am Heart Assoc. 2017 Feb 10;6(2):
pubmed: 28188253
J Gen Intern Med. 2008 Jan;23 Suppl 1:13-9
pubmed: 18095038
Diabetes. 2009 Aug;58(8):1776-9
pubmed: 19470610
J Am Heart Assoc. 2018 May 17;7(11):
pubmed: 29773575
Neuropsychiatr Dis Treat. 2020 Jan 08;16:55-70
pubmed: 32021199
Int J Obes (Lond). 2018 Dec;42(12):2062-2063
pubmed: 30301965
JAMA. 2011 Jun 15;305(23):2448-55
pubmed: 21673296
Chronobiol Int. 2018 Sep;35(9):1185-1197
pubmed: 29953265
Prog Cardiovasc Dis. 2015 Jan-Feb;57(4):315-23
pubmed: 25559060
JAMA. 2011 Jan 5;305(1):50-8
pubmed: 21205966
Am J Prev Med. 2002 May;22(4):267-84
pubmed: 11988383
J Clin Densitom. 2015 Oct-Dec;18(4):488-92
pubmed: 26071171
Vital Health Stat 10. 2009 Dec;(242):1-157
pubmed: 20821903
Metabolism. 2006 Oct;55(10):1382-7
pubmed: 16979410
Circulation. 2000 Sep 19;102(12):1351-7
pubmed: 10993851
J Am Heart Assoc. 2014 Feb 26;3(1):e000702
pubmed: 24572255
Scand J Med Sci Sports. 2015 Dec;25 Suppl 3:1-72
pubmed: 26606383
Med Sci Sports Exerc. 2009 May;41(5):998-1005
pubmed: 19346988
Control Clin Trials. 2000 Oct;21(5 Suppl):212S-7S
pubmed: 11018578