Activity Monitoring for Assessment of Physical Activities in Daily Life in Patients With Chronic Obstructive Pulmonary Disease

Abstract

Pitta F, Troosters T, Spruit MA, Decramer M, Gosselink R. Activity monitoring for assessment of physical activities in daily life in patients with chronic obstructive pulmonary disease. Objective To investigate the degree of agreement between different methods of assessing physical activities in daily life in patients with chronic obstructive pulmonary disease (COPD): video recordings (criterion standard), the DynaPort Activity Monitor (DAM), and patient self-report. Design Study A: outcomes from video recordings were compared with DAM outcomes and with patient estimation of time spent on each activity after a 1-hour protocol including walking, cycling, standing, sitting, and lying. Study B: DAM outcomes and patient self-report were compared during 1 day in real life. Setting Outpatient clinic in a university hospital. Participants Study A: 10 patients with COPD (mean age, 62±6y; forced expiratory volume in the first second [FEV 1]=40%±16% of predicted). Study B: 13 patients with COPD (mean age, 61±8y; FEV 1=33%±10% of predicted). Interventions Not applicable. Main Outcome Measures Time spent on different activities and movement intensity during walking and cycling. Results Study A: time estimated by the patients in the sitting position was significantly lower than the time showed by the video recordings and the DAM (both P<.001). For the other variables, there were no statistically significant differences (all P>.05). However, Bland and Altman plots and intraclass correlation coefficients showed large disagreement between video recordings and patients’ estimations, in contrast to the high degree of agreement between video recordings and DAM. Changes in walking speed correlated highly to changes in DAM movement intensity ( r=.81, P<.01). Study B: patients significantly overestimated walking time (22±47min, P=.04) and underestimated standing time (–45±71min, P=.04). Conclusions The DAM showed high accuracy in objectively assessing time spent on different activities and changes in walking speed in patients with COPD. Patients’ estimations of time spent on physical activities in daily life disagreed with objective assessment.