Cystic fibrosis fitness during inpatient treatment

ABSTRACT

Purpose of Study Cystic Fibrosis (CF) is a progressive, genetic disease that affects over 30,000 individuals across the nation and results in decreased functionality of the lungs. Physical activity has a positive impact on the symptoms of CF and works to slow the decline in lung function. Additionally, activities with moderate intensity have been shown to improve sputum expectoration and oxygen saturation in children with CF. This study assessed whether using fitness trackers and providing a daily step goal would increase physical activity in hospitalized children and young adults with CF. Methods Used This prospective study included participants 6- 21 years of age who were admitted to the hospital for a pulmonary exacerbation of CF between October 2020-May 2021. Study enrollment occurred no more than 48 hours after hospital admission. Garmin vivosmart® 4 wrist-based activity trackers were issued and baseline data were tracked and analyzed for the first 2 study days. Pre-goal steps were defined as the average of steps taken on those 2 days. On study day 3, a step goal and menu of activities designed to increase physical activity were shared with the participant. Steps after goal setting were defined as the average of steps taken on study day 3 and beyond, excluding day of discharge. Data were collected from the electronic medical record and the activity tracker web-based profile and included the following daily oxygen requirement, daily step count, sleep duration, overnight pulse oximetry levels, resting heart rate, calories expended, and intensity minutes. The primary outcome of change in daily steps and attainment of step goals was analyzed using descriptive statistical testing, means and standard deviations. Summary of Results Six patients, aged 6-18 years, completed the study. Mean baseline FEV1for study participants was 66% predicted (range 38 to 92%). Hospital length of stay ranged from 4-14 days. Participants took an average of 1772 ± 1011 steps before goal setting. This increased to an average of 3741 ± 1780 steps after goal setting. Overall, step goals were met 52% (Range 0-100%) of the time. Conclusions This intervention shows promise, as daily steps doubled from baseline during the intervention period. There was great variability among the participants, suggesting the device may help some people much more than others. Enrollment was initially planned for 20 patients;however, the SARS-CoV-2 pandemic and consequent changes to CF therapy drastically reduced hospitalizations during the study period. Though our results show a positive impact of increased physical activity following goal implementation, further research is needed to determine the effect such an intervention would have on a larger scale. Future directions of research include having a larger sample size, conducting a multi-center study to increase population diversity, and implementing a longer follow- up period to better assess long term benefits of intervention.