Heart rate and oxygen uptake kinetics obtained from continuous measurements with wearable devices during outdoor walks of patients with COPD

Journal article

Buekers, Joren, Arbillaga-Etxarri, Ane, Gimeno-Santos, Elena, Donaire Gonzalez, David, Chevance, Guillaume, Aerts, Jean-Marie and Garcia-Aymerich, Judith. (2023). Heart rate and oxygen uptake kinetics obtained from continuous measurements with wearable devices during outdoor walks of patients with COPD. Digital Health. 9, pp. 1-13. https://doi.org/10.1177/20552076231162989
AuthorsBuekers, Joren, Arbillaga-Etxarri, Ane, Gimeno-Santos, Elena, Donaire Gonzalez, David, Chevance, Guillaume, Aerts, Jean-Marie and Garcia-Aymerich, Judith
Abstract

Objective
Continuous physiological measurements during a laboratory-based exercise test can provide physiological biomarkers, such as heart rate (HR) and oxygen uptake (V̇O2) kinetics, that carry clinically relevant information. In contrast, it is not clear how continuous data generated by wearable devices during daily-life routines could provide meaningful biomarkers. We aimed to determine whether valid HR and V̇O2 kinetics can be obtained from measurements with wearable devices during outdoor walks in patients with chronic obstructive pulmonary disease (COPD).

Methods
HR (Polar Belt) and V̇O2(METAMAX3B) were measured during 93 physical activity transitions performed by eight patients with COPD during three different outdoor walks (ntr = 77) and a 6-minute walk test (ntr = 16). HR and V̇O2 kinetics were calculated every time a participant started a walk, finished a walk or walked upstairs. HR and V̇O2 kinetics were considered valid if the response magnitude and model fit were adequate, and model parameters were reliable.

Results
Continuous measurements with wearable devices provided valid HR kinetics when COPD patients started or finished (range 63%–100%) the different outdoor walks and valid V̇O2 kinetics when they finished (range 63%–100%) an outdoor walk. The amount of valid kinetics and kinetic model performance was comparable between outdoor walks and a laboratory-based exercise test (p > .05).

Conclusion
We envision that the presented approach could improve telemonitoring applications of patients with COPD by providing regular, unsupervised assessments of HR kinetics during daily-life routines. This could allow to early identify a decline in the patients’ dynamic physiological functioning, physical fitness and/or health status.

Keywordsrespiratory medicine; wearables personalised medicine; mhealth physiology; remote patient monitoring personalised medicine; exercise lifestyle; telehealth general
Year2023
JournalDigital Health
Journal citation9, pp. 1-13
PublisherSAGE Publications
ISSN2055-2076
Digital Object Identifier (DOI)https://doi.org/10.1177/20552076231162989
PubMed ID36937691
Scopus EID2-s2.0-85150609349
PubMed Central IDPMC10017947
Open accessPublished as ‘gold’ (paid) open access
Page range1-13
FunderEuropean Respiratory Society
Spanish Ministry of Science and Innovation (MICINN)
Agency for the Research Centres of Catalonia (CERCA) Programme, Generalitat de Catalunya
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online14 Mar 2023
Publication process dates
Accepted23 Feb 2023
Deposited07 May 2025
Grant IDCEX2018-000806-S
Additional information

© The Author(s) 2023.

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

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Physical activity patterns and clusters in 1001 patients with COPD
Mesquita, Rafael, Spina, Gabriele, Pitta, Fabio, Donaire-Gonzalez, David, Deering, Brenda M., Patel, Mehul S., Mitchell, Katy E., Alison, Jennifer, van Gestel, Arnoldus J. R., Zogg, Stefanie, Gagnon, Philippe, Abascal-Bolado, Beatriz, Vagaggini, Barbara, Garcia-Aymerich, Judith, Jenkins, Sue C., Romme, Elisabeth A. P. M., Kon, Samantha S. C., Albert, Paul S., Waschki, Benjamin, ... Spruit, Martijn A.. (2017). Physical activity patterns and clusters in 1001 patients with COPD. Chronic Respiratory Disease. 14(3), pp. 256 - 269. https://doi.org/10.1177/1479972316687207
The relationship between bicycle commuting and perceived stress: a cross-sectional study
Avila-Palencia, Ione, de Nazelle, Audrey, Cole-Hunter, Tom, Donaire-Gonzalez, D., Jerrett, Michael, Rodríguez, Daniel A. and Nieuwenhuijsen, Mark. (2017). The relationship between bicycle commuting and perceived stress: a cross-sectional study. BMJ Open. 7(6), pp. 1 - 11. https://doi.org/10.1136/bmjopen-2016-013542
Private and public modes of bicycle commuting: A perspective on attitude and perception
Curto, A., de Nazelle, Audrey, Donaire-Gonzalez, David, Cole-Hunter, Tom, Garcia-Aymerich, J., Martínez, David, Anaya, Esther, Rodríguez, Daniel A., Jerrett, Michael and Nieuwenhuijsen, Mark J.. (2016). Private and public modes of bicycle commuting: A perspective on attitude and perception. European Journal of Public Health. 26(4), pp. 717 - 723. https://doi.org/10.1093/eurpub/ckv235
Acute respiratory response to traffic-related air pollution during physical activity performance
Matt, Florian, Cole-Hunter, Tom, Donaire-Gonzalez, David, Kubesch, Nadine, Martínez, David, Carrasco-Turigas, Glòria and Nieuwenhuijsen, Mark. (2016). Acute respiratory response to traffic-related air pollution during physical activity performance. Environment International. 97, pp. 45 - 55. https://doi.org/10.1016/j.envint.2016.10.011
Spatiotemporally resolved black carbon concentration, schoolchildren's exposure and dose in Barcelona
Rivas, Ioar, Donaire-Gonzalez, David, Bouso, L., Esnaola, Mikel, Pandolfi, M., de Castro, Montserrat, Viana, M., Alvarez-Pedrerol, Mar, Nieuwenhuijsen, Mark J., Alastuey, A., Sunyer, Jordi and Querol, Xavier. (2016). Spatiotemporally resolved black carbon concentration, schoolchildren's exposure and dose in Barcelona. Indoor Air. 26(3), pp. 391 - 402. https://doi.org/10.1111/ina.12214
Short-term planning and policy interventions to promote cycling in urban centers: Findings from a commute mode choice analysis in Barcelona, Spain
Braun, Lindsay M., Rodríguez, Daniel A., Cole-Hunter, Tom, Ambros, Albert, Donaire-Gonzalez, David, Jerrett, Michael, Mendez, Michelle A., Nieuwenhuijsen, Mark J. and de Nazelle, Audrey. (2016). Short-term planning and policy interventions to promote cycling in urban centers: Findings from a commute mode choice analysis in Barcelona, Spain. Transportation Research Part A. 89, pp. 164 - 183. https://doi.org/10.1016/j.tra.2016.05.007
Inspiratory capacity-to-total lung capacity ratio and dyspnoea predict exercise capacity decline in COPD
Ramon, Maria A., Ferrer, Jaume, Gimeno-Santos, Elena, Donaire-Gonzalez, David, Rodríguez, Esther, Balcells, Eva, de Batlle, Jordi, Benet, Marta, Guerra, Stefano, Sauleda, Jaume, Ferrer, Antoni, Farrero, Eva, Gea, Joaquim, Barberà, Joan A., Agustí, Àlvar, Rodriguez-Roisin, Robert, Antó, Josep M. and Garcia-Aymerich, Judith. (2016). Inspiratory capacity-to-total lung capacity ratio and dyspnoea predict exercise capacity decline in COPD. Respirology. 21(3), pp. 476 - 482. https://doi.org/10.1111/resp.12723
Characterisation and prognosis of undiagnosed chronic obstructive pulmonary disease patients at their first hospitalisation
Balcells, Eva, Gimeno-Santos, Elena, de Batlle, Jordi, Ramon, Maria Antonia, Rodríguez, Esther, Benet, Marta, Farrero, Eva, Ferrer, Antoni, Guerra, Stefano, Ferrer, Jaume, Sauleda, Jaume, Barberà, Joan A., Agustí, Àlvar, Rodriguez-Roisin, Robert, Gea, Joaquim, Antó, Josep M., Garcia-Aymerich, Judith, the, P. A. C. Copd Study Group and Donaire Gonzalez, David. (2015). Characterisation and prognosis of undiagnosed chronic obstructive pulmonary disease patients at their first hospitalisation. BMC Pulmonary Medicine. 15(1), p. Article 4. https://doi.org/10.1186/1471-2466-15-4
The added benefit of bicycle commuting on the regular amount of physical activity performed
Donaire-Gonzalez, David, de Nazelle, Audrey, Cole-Hunter, Tom, Curto, Ariadna, Rodríguez, Daniel A., Mendez, Michelle A., Garcia-Aymerich, Judith, Basagaña, Xavier, Ambros, Albert, Jerrett, Michael and Nieuwenhuijsen, Mark J.. (2015). The added benefit of bicycle commuting on the regular amount of physical activity performed. American Journal of Preventive Medicine. 49(6), pp. 842 - 849. https://doi.org/10.1016/j.amepre.2015.03.036
Objective correlates and determinants of bicycle commuting propensity in an urban environment
Cole-Hunter, Tom, Donaire-Gonzalez, David, Curto, A., Ambros, Albert, Valentín, Antònia, Garcia-Aymerich, J., Martínez, David, Braun, Lindsay M., Mendez, Michelle, Jerrett, Michael, Rodríguez, Daniel A., de Nazelle, Audrey and Nieuwenhuijsen, Mark J.. (2015). Objective correlates and determinants of bicycle commuting propensity in an urban environment. Transportation Research Part D. 40, pp. 132 - 143. https://doi.org/10.1016/j.trd.2015.07.004
Benefits of physical activity on COPD hospitalisation depend on intensity
Donaire-Gonzalez, David, Gimeno-Santos, Elena, Balcells, Eva, De Batlle, Jordi, Ramon, Maria A., Rodriguez, Esther, Farrero, Eva, Benet, Marta, Guerra, Stefano, Sauleda, Jaume, Ferrer, Antoni, Barberà, Joan A., Rodriguez-Roisin, Robert, Gea, Joaquim, Agusti, Alvar, Antó, Josep M., Garcia-Aymerich, Judith, PAC-COPD Study Group, , Ferrer, Jaume and PAC-COPD Study Group. (2015). Benefits of physical activity on COPD hospitalisation depend on intensity. European Respiratory Journal. 46(5), pp. 1281 - 1289. https://doi.org/10.1183/13993003.01699-2014
Positive health effects of the natural outdoor environment in typical populations in different regions in Europe (PHENOTYPE): A study programme protocol
Nieuwenhuijsen, Mark J., Kruize, Hanneke, Gidlow, Christopher, Andrusaityte, Sandra, Antó, Josep M., Basagaña, Xavier, Cirach, Marta, Dadvand, Payam, Danileviciute, Asta, Donaire-Gonzalez, David, Garcia, Judith, Jerrett, Michael, Jones, Marc V., Julvez, Jordi, van Kempen, Elise, van Kamp, Irene, Maas, Jolanda, Seto, Edmund, Smith, Graham, ... Gražulevičienė, Regina. (2014). Positive health effects of the natural outdoor environment in typical populations in different regions in Europe (PHENOTYPE): A study programme protocol. BMJ Open. 4(4), pp. 1 - 11. https://doi.org/10.1136/bmjopen-2014-004951
Lifetime occupational exposure to dusts, gases and fumes is associated with bronchitis symptoms and higher diffusion capacity in COPD patients
Rodríguez, Esther, Ferrer, Jaume, Zock, Jan-Paul, Serra, Ignasi, Antó, Josep M., De Batlle, Jordi, Kromhout, Hans, Vermeulen, Roel, Donaire-Gonzalez, David, Benet, Marta, Balcells, Eva, Monso, Eduard, Gayete, Angel, Garcia-Aymerich, J., Guerra, Stefano, Gea, Joaquim, Orozco-Levi, Mauricio, Vollmer, Ivan, Barberà, Joan A., ... Belda, José. (2014). Lifetime occupational exposure to dusts, gases and fumes is associated with bronchitis symptoms and higher diffusion capacity in COPD patients. PLoS ONE. 9(2), pp. 1 - 7. https://doi.org/10.1371/journal.pone.0088426
Using personal sensors to assess the exposome and acute health effects
Nieuwenhuijsen, Mark J., Donaire-Gonzalez, David, Foraster, Maria, Martínez, David and Cisneros, Andres. (2014). Using personal sensors to assess the exposome and acute health effects. International Journal of Environmental Research and Public Health. 11(8), pp. 7805 - 7819. https://doi.org/10.3390/ijerph110807805
Physical activity in COPD patients : Patterns and bouts
Donaire-Gonzalez, David, Gimeno-Santos, Elena, Balcells, Eva, Rodríguez, Diego A., Farrero, Eva, de Batlle, Jordi, Benet, Marta, Ferrer, Antoni, Barberà, Joan A., Gea, Joaquim, Rodriguez-Roisin, Robert, Antó, Josep M. and Garcia-Aymerich, Judith. (2013). Physical activity in COPD patients : Patterns and bouts. European Respiratory Journal. 42(4), pp. 993-1002. https://doi.org/10.1183/09031936.00101512
Comparison of physical activity measures using mobile phone-based calfit and actigraph
Donaire-Gonzalez, David, de Nazelle, Audrey, Seto, Edmund, Mendez, Michelle, Nieuwenhuijsen, Mark J. and Jerrett, Michael. (2013). Comparison of physical activity measures using mobile phone-based calfit and actigraph. Journal of Medical Internet Research. 15(6), p. e111. https://doi.org/10.2196/jmir.2470
Improving estimates of air pollution exposure through ubiquitous sensing technologies
de Nazelle, Audrey, Seto, Edmund, Donaire-Gonzalez, David, Mendez, Michelle, Matamala, Jaume, Nieuwenhuijsen, Mark J. and Jerrett, Michael. (2013). Improving estimates of air pollution exposure through ubiquitous sensing technologies. Environmental Pollution. 176, pp. 92 - 99. https://doi.org/10.1016/j.envpol.2012.12.032
Effect of bronchial colonisation on airway and systemic inflammation in stable COPD
Marin, Alicia, Garcia-Aymerich, Judith, Sauleda, Jaume, Belda, Jose, Millares, Laura, García-Núñez, Marian, Serra, Ignasi, Benet, Marta, Agustí, Alvar, Antó, Josep M., Monsó, Eduard, PAC-COPD Study Group and Donaire-Gonzalez, David. (2012). Effect of bronchial colonisation on airway and systemic inflammation in stable COPD. COPD. 9(2), pp. 121-130. https://doi.org/10.3109/15412555.2011.636407
Cured meat consumption increases risk of readmission in COPD patients
Jordi de Batlle, Mendez, Michelle, Romieu, Isabelle, Balcells, Eva, Benet, Marta, Donaire-Gonzalez, David, Ferrer, Jaume J., Orozco-Levi, Mauricio, Antó, Josep M., Garcia-Aymerich, Judith and PAC-COPD Study Group. (2012). Cured meat consumption increases risk of readmission in COPD patients. European Respiratory Journal. 40(3), pp. 555-560. https://doi.org/10.1183/09031936.00116911
Specific IgA and metalloproteinase activity in bronchial secretions from stable chronic obstructive pulmonary disease patients colonized by Haemophilus influenzae
Millares, Laura, Marin, Alicia, Garcia-Aymerich, J., Sauleda, Jaume, Belda, José, Monso, Eduard, Antó, Josep M., Benet, Marta, De Batlle, Jordi, Serra, Ignasi, Donaire Gonzalez, David, Guerra, Stefano, Gea, Joaquim, Balcells, Eva, Gayete, ADavidngel, Orozco-Levi, Mauricio, Vollmer, Ivan, Barberà, Joan A., Gomez, Federico P., ... Pallissa, Esther. (2012). Specific IgA and metalloproteinase activity in bronchial secretions from stable chronic obstructive pulmonary disease patients colonized by Haemophilus influenzae. Respiratory Research. 13(1). https://doi.org/10.1186/1465-9921-13-113
Validation of the Yale Physical Activity Survey in Chronic Obstructive Pulmonary Disease Patients
Donaire-Gonzalez, David, Gimeno-Santos, Elena, Serra, Ignasi, Roca, Josep, Balcells, Eva, Rodríguez, Esther, Farrero, Eva, Antó, Josep M. and Garcia-Aymerich, Judith. (2011). Validation of the Yale Physical Activity Survey in Chronic Obstructive Pulmonary Disease Patients. Archivos de Bronconeumología. 47(11), pp. 552-560.