Physical Activity Measurement and Impact in Heart Failure Management

Physical activity has emerged as a pivotal marker of health status and prognosis in patients with heart failure. Objective quantification of movement through wearables and implantable sensors offers a continuous and granular view of daily function, complementing traditional assessments such as exercise tests and symptom questionnaires. External accelerometers and actigraphy devices capture step counts, intensity profiles and sedentary periods, while implantable cardioverter-defibrillators and cardiac resynchronisation devices register internal motion signals to infer activity levels. These technologies facilitate remote monitoring, enabling early detection of clinical deterioration and personalised adjustment of therapy. Moreover, longitudinal activity trends can serve as surrogate end points in clinical trials, reflecting response to pharmacological or rehabilitative interventions. Despite clear prognostic associations—where lower activity predicts higher rates of hospitalisation and mortality—widespread implementation faces challenges in standardising data collection, ensuring device accuracy across populations and interpreting diverse metrics within routine care pathways. Ongoing efforts aim to harmonise methodology, validate clinically meaningful thresholds and integrate activity feedback into self-management programmes. The global burden of heart failure and the rising adoption of digital health tools underscore the importance of physical activity measurement in improving outcomes, optimising resource allocation and empowering patients to participate actively in their own care.

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Physical Activity Measurement and Impact in Heart Failure Management publication trend

The graph below shows the total number of articles in physical activity measurement and impact in heart failure management across all publications each year (not limited to Nature Index journals).

Technical terms

Accelerometer: A sensor that measures acceleration forces to quantify movement intensity, frequency and duration.

Actigraphy: The continuous recording of movement patterns using wearable accelerometers to infer sleep–wake cycles and physical activity.

Six-minute walk distance (6MWD): A standard field test measuring the distance a patient can walk in six minutes as an index of functional capacity.

Left ventricular ejection fraction (LVEF): The percentage of blood ejected from the left ventricle during each heartbeat, indicating pump efficiency.

Kansas City Cardiomyopathy Questionnaire (KCCQ): A validated patient-reported outcome measure assessing symptoms, physical limitations and quality of life in heart failure.

Remote monitoring: The transmission of physiological or behavioural data from patients to clinicians via digital networks for ongoing assessment and management.

References

1. A scoping review on advancements in noninvasive wearable technology for heart failure management. npj Digital Medicine (2024).
2. Wearable Accelerometer-Derived Measures of Physical Activity in Heart Failure: Insights From the DETERMINE trials. Journal of Cardiac Failure (2024).
3. Accelerometer-measured physical activity in patients with heart failure and reduced ejection fraction: Determinants and relationship with patient-reported health status. American Heart Journal (2024).
4. Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity Study. Journal of the American Heart Association (2015).
5. Variability in Physical Activity Assessed with Accelerometer Is an Independent Predictor of Mortality in CHF Patients. PLOS ONE (2016).
6. Comparative Analysis of Physical Activity Detected via an External Accelerometer and Cardiac Implantable Electronic Devices. Frontiers in Cardiovascular Medicine (2022).