A Mobile Health Intervention to Increase Physical Activity in Pulmonary Arterial Hypertension.

Background: Supervised exercise training improves outcomes in patients with pulmonary arterial hypertension (PAH). The effect of an unsupervised activity intervention has not been tested.Research Question: Can a text-based mobile health intervention increase step counts in patients with PAH?Study De...

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Publicado en:CHEST Vol. 160; no. 3; pp. 1042 - 1053
Autores principales: Hemnes, Anna R., Silverman-Lloyd, Luke G., Huang, Shi, MacKinnon, Grant, Annis, Jeffrey, Whitmore, Carolyn S., Mallugari, Ravinder, Oggs, Rashundra N., Hekmat, Rezzan, Shan, Rongzi, Huynh, Pauline P., Yu, Chang, Martin, Seth S., Blaha, Michael J., Brittain, Evan L., Silverman-Loyd, Luke
Formato: research randomized controlled trial Journal Article
Publicado: American College of Chest Physicians Sep2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2021
      vid: 160
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      pub: American College of Chest Physicians
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        10.1016/j.chest.2021.04.012
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        atl: A Mobile Health Intervention to Increase Physical Activity in Pulmonary Arterial Hypertension.
      aug:
        au:
          Hemnes, Anna R.
          Silverman-Lloyd, Luke G.
          Huang, Shi
          MacKinnon, Grant
          Annis, Jeffrey
          Whitmore, Carolyn S.
          Mallugari, Ravinder
          Oggs, Rashundra N.
          Hekmat, Rezzan
          Shan, Rongzi
          Huynh, Pauline P.
          Yu, Chang
          Martin, Seth S.
          Blaha, Michael J.
          Brittain, Evan L.
          Silverman-Loyd, Luke
        affil: Division of Allergy Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN
      sug:
        subj:
          Telemetry Methods
          Adipose Tissue Pathology
          Quality of Life
          Telemedicine Methods
          Exercise
          Telemedicine Equipment and Supplies
          Ventricular Function, Right
          Telemetry Equipment and Supplies
          Single-Blind Studies
          Female
          Body Weights and Measures
          Male
          Middle Age
          Text Messaging
          Echocardiography Methods
          Human
          Comparative Studies
          Multicenter Studies
          Randomized Controlled Trials
          Evaluation Research
          Validation Studies
          Clinical Assessment Tools
          Scales
          Ferrans and Powers Quality of Life Index
          Exercise of Self-Care Agency Scale
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Supervised exercise training improves outcomes in patients with pulmonary arterial hypertension (PAH). The effect of an unsupervised activity intervention has not been tested.Research Question: Can a text-based mobile health intervention increase step counts in patients with PAH?Study Design and Methods: We performed a randomized, parallel arm, single-blind clinical trial. We randomized patients to usual care or a text message-based intervention for 12 weeks. The intervention arm received three automated text messages per day with real-time step count updates and encouraging messages rooted in behavioral change theory. Individual step targets increased by 20% every 4 weeks. The primary end point was mean week 12 step counts. Secondary end points included the 6-min walk test, quality of life, right ventricular function, and body composition.Results: Among 42 randomized participants, the change in raw steps between baseline and week 12 was higher in the intervention group (1,409 steps [interquartile range, -32 to 2,220] vs -149 steps [interquartile range, -1,010 to 735]; P = .02), which persisted after adjustment for age, sex, baseline step counts, and functional class (model estimated difference, 1,250 steps; P = .03). The intervention arm took a higher average number of steps on all days between days 9 and 84 (P < .05, all days). There was no difference in week 12 six-minute walk distance. Analysis of secondary end points suggested improvements in the emPHasis-10 score (adjusted change, -4.2; P = .046), a reduction in visceral fat volume (adjusted change, -170 mL; P = .023), and nearly significant improvement in tricuspid annular plane systolic excursion (model estimated difference, 1.2 mm; P = .051).Interpretation: This study demonstrated the feasibility of an automated text message-based intervention to increase physical activity in patients with PAH. Additional studies are warranted to examine the effect of the intervention on clinical outcomes.Clinical Trial Registration: ClinicalTrials.gov; No. NCT03069716; URL: www.clinicaltrials.gov.
      pubtype: Academic Journal
      doctype:
        research
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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