# Physical Activity in Pulmonary Arterial Hypertension (ACTiPH)

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2021 · $1,123,529

## Abstract

Pulmonary arterial hypertension (PAH) is characterized by limitation of physical activity even with current
effect treatments. Most observational studies, clinical trials, and outpatient clinical assessments of patients with
PAH focus on exercise capacity (the maximal effort a person can achieve under controlled circumstances),
measured by cardiopulmonary exercise or six minute walk testing. However, these artificial tests do not
capture the intensity, frequency, duration, context, and pattern of physical activity throughout the day or week
in the patient’s life. Such an activity “signature” or phenotype may more accurately reflect an individual’s
function and perceived health-related quality of life (HRQOL) by providing insight into multisystem function,
side effects, and treatment benefits and burdens. A physical activity intervention which is personalized for a
PAH patient could lead to improvements in psychosocial function, symptoms, HRQOL, fitness, and even
survival. Unfortunately, there have been very few published studies of physical activity in PAH patients, none of
which have assessed multidimensionality in a large multicenter cohort. We have performed preliminary studies
using traditional accelerometry which have shown that patients with PAH cluster into low, medium, and high
activity phenotypes which show differences in six minute walk distance and HRQOL. Functional principal
components analysis has identified “signatures” of physical activity patterns throughout the day in PAH. Novel
biosensors which continuously capture multiple streams of data in real time (including accelerometry) would
provide an innovative approach to remote clinical monitoring and may increase the efficiency and pertinence of
clinical trials in PAH.
 The Pulmonary Hypertension Association Registry (PHAR) has been prospectively collecting data from
adult and pediatric PAH patients from centers throughout the United States since 2015. The PHAR has
enrolled 1400 patients with 2000 patient-years of follow-up at 52 centers, representing one of the largest
multicenter registries of patients with PAH. We propose to measure accelerometry for one week periods
biannually for > 1400 patients over four years (~7000 assessments) in the PHAR with high efficiency and low
patient burden. We aim to determine the predictors of physical activity phenotype and whether physical activity
patterns are associated with health-related quality of life, emergency department visits, hospitalizations, and
time to lung transplantation or death in PAH. We will estimate the “minimally important difference” in physical
activity which could be used as an end point in clinical trials in PAH. We will incorporate a novel wearable
biosensor which could be used to advance these models of physical activity in PAH.

## Key facts

- **NIH application ID:** 10317293
- **Project number:** 1R01HL159997-01
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Steven M Kawut
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $1,123,529
- **Award type:** 1
- **Project period:** 2021-08-20 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10317293

## Citation

> US National Institutes of Health, RePORTER application 10317293, Physical Activity in Pulmonary Arterial Hypertension (ACTiPH) (1R01HL159997-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10317293. Licensed CC0.

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