Use of accelerometers to characterize physical activity patterns with COPD exacerbations.

Purpose: To determine the feasibility of using an accelerometer to characterize physical activity patterns (PA) surrounding chronic obstructive pulmonary disease (COPD) exacerbations (AECOPD) in patients with COPD for 16 weeks.

Methods: Patients with COPD (n = 8) wore the RT3, a triaxial accelerometer (Stayhealthy, Monrovia, CA) during waking hours and kept daily symptom diaries. The mean vector magnitude unit (VMU) per minute was calculated by dividing the total VMU for the day by the number of minutes the device was worn. Descriptive statistics were used and plots were made showing PA for each subject with AECOPD markers based on symptom diaries and health resource utilization.

Results: Sample characteristics were: age 71 +/- 4; 5 Females; forced expiratory volume in one second (FEV1)% predicted: 40% +/- 16%; FEV1/forced vital capacity: 45 +/- 7; and Medical Research Council dyspnea scale: 2.3 +/- 0.9. Overall adherence to the monitoring protocol was 97.6% (Range 92%-100%) while adherence to wearing the device for at least 10 hours per day was 91.5% (Range 75%-99%). Mean vector magnitude units per minute was 117.8 +/- 47 (Range 61.4-184.1). Seven exacerbations were captured over a total of 896 person-days of monitoring. There were substantial intra-individual fluctuations in daily PA during both the stable state and with outpatient treated exacerbations.

Conclusions: Patients with COPD were able to adhere to a 16-week activity monitoring protocol and reported a willingness to wear such a device for an extended period of time if the data yield important and useful information for themselves and their health provider. Future work will need to focus first, on validating other promising devices that produce higher quality PA data and second, replicate this monitoring protocol with a larger sample of COPD patients over a longer period.