• Lea Ann Matura, Haochang Shou, Jason S Fritz, K Akaya Smith, Anjali Vaidya, Diane Pinder, Christine Archer-Chicko, Danielle Dubow, Harold I Palevsky, Marilyn S Sommers, and Steven M Kawut.
• University of Pennsylvania School of Nursing, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA. Electronic address: matura@nursing.upenn.edu.
• Chest. 2016 Jul 1; 150 (1): 46-56.

BackgroundFatigue is a common symptom in patients with pulmonary arterial hypertension (PAH); however, the impact of fatigue on daily physical activity in PAH is unknown. Accelerometry is a validated measure for assessing physical activity. We hypothesized that patients with PAH reporting higher levels of fatigue would have lower daily physical activity measured by accelerometry.MethodsWe performed a prospective cohort study of 15 women with PAH. On day 1, subjects completed the Multidimensional Fatigue Inventory (MFI), the United States Cambridge Pulmonary Hypertension Outcome Review (US CAMPHOR), and a 6-min walk test. Subjects wore the accelerometer on their dominant hip and completed an activity diary for 7 days. On day 15, subjects repeated the MFI and the US CAMPHOR, and then wore the accelerometer and completed an activity diary for an additional 7 days. All multivariate analyses were adjusted for age, BMI, and PAH type.ResultsThe mean age was 50.5 years, and 53% had idiopathic or heritable PAH. During the 2 weeks, subjects were mostly sedentary (85% of the time), although 10% of their time was spent performing low-level activity. Lower average daily counts were associated with worse self-reported energy levels, whereas less day-to-day physical activity variability was associated with more self-reported mental fatigue, physical fatigue, and total activity. Higher percentage of activity bouts was also associated with worse energy.ConclusionsWomen with PAH may spend most of their time being sedentary, and lower self-reported energy levels are associated with less daily activity. Interventions to improve symptoms such as fatigue may also increase physical activity levels in PAH.Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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