Habitual physical activity in mitochondrial disease

Abstract

Purpose: Mitochondrial disease is the most common neuromuscular disease and has a profound impact upon daily life, disease and longevity. Exercise therapy has been shown to improve mitochondrial function in patients with mitochondrial disease. However, no information exists about the level of habitual physical activity of people with mitochondrial disease and its relationship with clinical phenotype.

Methods: Habitual physical activity, genotype and clinical presentations were assessed in 100 patients with mitochondrial disease. Comparisons were made with a control group individually matched by age, gender and BMI.

Results: Patients with mitochondrial disease had significantly lower levels of physical activity in comparison to matched people without mitochondrial disease (steps/day; 6883±3944 vs. 9924±4088, p = 0.001). 78% of the mitochondrial disease cohort did not achieve 10,000 steps per day and 48% were classified as overweight or obese. Mitochondrial disease was associated with less breaks in sedentary activity (Sedentary to Active Transitions, % per day; 13±0.03 vs. 14±0.03, p = 0.001) and an increase in sedentary bout duration (bout lengths/fraction of total sedentary time; 0.206±0.044 vs. 0.187±0.026, p = 0.001). After adjusting for covariates, higher physical activity was moderately associated with lower clinical disease burden (steps/day; r(s) = -0.49; 95% CI -0.33, -0.63, P<0.01). There were no systematic differences in physical activity between different genotypes mitochondrial disease.

Conclusions: These results demonstrate for the first time that low levels of physical activity are prominent in mitochondrial disease. Combined with a high prevalence of obesity, physical activity may constitute a significant and potentially modifiable risk factor in mitochondrial disease.

Figure 1. Scatter plot of the relationship between disease burden (total NMDAS score) and habitual physical activity (steps walked per day) (unadjusted regression line, R-Sq = 0.22, p<0.001).

The red zone represents under and green zone over 10,000steps per day; the advised level of physical activity by the World Health Organisation for health.

Figure 2. Power law analyses of the lengths of sedentary bouts of patients with mitochondrial disease [line] and controls [dashed] (Panel A).

Sedentary to Active Transitions, indicating transition from inactive to active periods, in patients with mitochondrial disease [grey] and controls [open] (Panel B). Data are Mean ± SD. *  =  significantly different from control p = 0.007.