Accelerometry In Patients Research Articles

A Cross-Sectional Study Evaluating the Association of Brachial Artery Flow Mediated Vasodilation with Physical Activity Measured by Accelerometry in Patients with the Overlap of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Overlap Syndrome (OS), the co-occurrence of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease. Clustering of patients in subgroups with similar pre-clinical manifestations (ie, endothelial dysfunction) may identify relevant therapeutic phenotype categories for patients with OS who are at high risk of CVD. We therefore conducted a cross-sectional pilot study of endothelial function in 7 patients with OS (Forced Expiratory Volume in 1 second/Forced Vital Capacity < 0.7) on continuous positive airway pressure therapy (n = 7) to assess the relationship between FMD and physical activity. We found a strong association between FMD and step counts (rho = 0.77, p = 0.04); and FMD and moderate physical activity (rho = 0.9, p = 0.005). Further, larger studies are needed to confirm that FMD may identify patients with OS at high risk of CVD who benefit from increased physical activity.

Ultradian rhythms in accelerometric and autonomic data vary based on seizure occurrence in paediatric epilepsy patients.

Ultradian rhythms are physiological oscillations that resonate with period lengths shorter than 24 hours. This study examined the expression of ultradian rhythms in patients with epilepsy, a disease defined by an enduring seizure risk that may vary cyclically. Using a wearable device, we recorded heart rate, body temperature, electrodermal activity and limb accelerometry in patients admitted to the paediatric epilepsy monitoring unit. In our case-control design, we included recordings from 29 patients with tonic-clonic seizures and 29 non-seizing controls. We spectrally decomposed each signal to identify cycle lengths of interest and compared average spectral power- and period-related markers between groups. Additionally, we related seizure occurrence to the phase of ultradian rhythm in patients with recorded seizures. We observed prominent 2- and 4-hour-long ultradian rhythms of accelerometry, as well as 4-hour-long oscillations in heart rate. Patients with seizures displayed a higher peak power in the 2-hour accelerometry rhythm (U = 287, P = 0.038) and a period-lengthened 4-hour heart rate rhythm (U = 291.5, P = 0.037). Those that seized also displayed greater mean rhythmic electrodermal activity (U = 261; P = 0.013). Most seizures occurred during the falling-to-trough quarter phase of accelerometric rhythms (13 out of 27, χ2 = 8.41, P = 0.038). Fluctuations in seizure risk or the occurrence of seizures may interrelate with ultradian rhythms of movement and autonomic function. Longitudinal assessments of ultradian patterns in larger patient samples may enable us to understand how such rhythms may improve the temporal precision of seizure forecasting models.

Analysis of heart rate variability and accelerometry in patients following surgery for the treatment of gastrointestinal cancer

Analysis of heart rate variability and accelerometry in patients following surgery for the treatment of gastrointestinal cancer

Rationale and study design of OUTSTEP-HF: a randomised controlled study to assess the effect of sacubitril/valsartan and enalapril on physical activity measured by accelerometry in patients with heart failure with reduced ejection fraction.

In PARADIGM-HF, sacubitril/valsartan demonstrated superiority to enalapril in reducing mortality and morbidity in patients with heart failure (HF) with reduced ejection fraction (HFrEF). Several patient-centred outcomes like improved physical activity and quality of life have been emphasised as important treatment goals in HF management. OUTSTEP-HF has been designed to evaluate the effect of sacubitril/valsartan compared with enalapril on non-sedentary daytime physical activity in patients with HFrEF. OUTSTEP-HF is a randomised, actively controlled, double-blind, double-dummy study that plans to enrol 600 ambulatory patients with symptomatic HFrEF in 19 European countries. Patients will be randomised 1:1 to receive sacubitril/valsartan 97/103 mg bid or enalapril 10mg bid. The primary objective of the study is to assess changes from baseline (Week 0) to Week 12 in exercise capacity measured by the 6-min walk test and in daily non-sedentary daytime activity. Physical activity and objective sleep parameters will be measured by accelerometry using a wrist-worn device, worn continuously from screening (Week -2) until the end of study (Week 12). As a co-primary outcome, changes from baseline in sub-maximal exercise capacity will be assessed by the 6-min walk test. Patient- and physician-reported questionnaires will be used to assess quality of life, changes in signs and symptoms of HF and sleep parameters. OUTSTEP-HF will be the largest randomised trial in HF to date to use non-invasive accelerometry to assess whether treatment with sacubitril/valsartan improves patients' daily physical activity and exercise capacity compared with enalapril.

Evaluation of balance during the gait using trunk acceleration from a tri-axial accelerometry in patients with chronic obstructive pulmonary disease

Evaluation of balance during the gait using trunk acceleration from a tri-axial accelerometry in patients with chronic obstructive pulmonary disease

Perspective on cystic fibrosis and physical activity: Is there a difference compared to healthy individuals?

The aim of this study was to compare habitual physical activity between cystic fibrosis (CF) patients and healthy controls and to investigate possible predictors for reduced physical activity in CF patients. Sixty-six patients with CF (3-44 years) and 65 healthy controls (3-55 years) were asked to wear an accelerometer (Actigraph GT1M) for 9 days (at least 10 hr/day). Physical activity was classified in five categories from very low to very strenuous. In general, there was no difference in physical activity between CF patients and healthy controls. However, young school-aged 6-13 years old children with CF spent less time with strenuous and very strenuous activity than healthy controls (adjusted difference in activity -0.43 (-0.69, -0.17)). Patients with very low lung function were significantly less active, but other CF-associated conditions did not affect physical activity. While we found similar levels of physical activity measured by accelerometry in patients with CF compared to healthy controls in general, young school-aged children showed less engagement in strenuous activities than their healthy counterparts. As the reduced physical activity in young school children was not likely to be explained by the disease state, strenuous physical activity may be enhanced by advocating exercise and sport. Pediatr Pulmonol. 2016;51:1020-1030. © 2016 Wiley Periodicals, Inc.

Comparison of Physical Activity Using Questionnaires (Leisure Time Physical Activity Instrument and Physical Activity at Home and Work Instrument) and Accelerometry in Fibromyalgia Patients: The Al-Ándalus Project

ObjectiveTo compare the levels of physical activity (PA) assessed with questionnaires (Leisure Time Physical Activity Instrument [LTPAI], Physical Activity at Home and Work Instrument [PAHWI]) and accelerometry in patients with fibromyalgia; and to analyze the test-retest reliability of these questionnaires. DesignCross-sectional study. SettingLocal fibromyalgia association. ParticipantsParticipants (N=99; 5 men) with fibromyalgia with a mean age of 50.2±9.5 years. InterventionsNot applicable. Main Outcome MeasuresParticipants carried an accelerometer for 1 week and completed the LTPAI and PAHWI twice (separated by a 1-wk interval). The LTPAI and PAHWI were summed to obtain overall values of PA. ResultsTime spent in total, moderate, and moderate-vigorous PA was higher (P<.01) when assessed by the LTPAI and PAHWI compared with accelerometry. The Bland-Altman method showed an absence of agreement between the LTPAI and PAHWI and the accelerometer for moderate, moderate-vigorous, and total PA. The test-retest reliability for the workplace subscale and total score of the PAHWI showed high and moderate intraclass correlation coefficients (ICCs), respectively, but also manifested high SE of measurements (up to 179min/d). The LTPAI showed low to moderate ICCs and high SE of measurements (up to 79min/d). For the LTPAI and PAHWI, the ICCs for total activity across the population were low to moderate, and the Bland-Altman method confirmed this lack of agreement. ConclusionsThe LTPAI and PAHWI and the accelerometer differ greatly when assessing PA. Furthermore, the LTPAI and PAHWI did not show good levels of test-retest reliability. Therefore, the self-administered LTPAI and PAHWI show questionable usefulness to assess PA in populations with fibromyalgia.

Comparison of physical activity estimates using International Physical Activity Questionnaire (IPAQ) and accelerometry in fibromyalgia patients: The Al-Andalus study

The International Physical Activity Questionnaire (IPAQ) has been widely used to assess physical activity in healthy populations. The present study compared physical activity assessed by the long, self-administrated version of the International Physical Activity Questionnaire with physical activity assessed by accelerometry in patients with fibromyalgia. A total of 99 (five men) participants with fibromyalgia completed the International Physical Activity Questionnaire and wore an accelerometer for nine consecutive days. We analysed the correlations of physical activity expressed as min · day−1 of light, moderate, vigorous, and moderate to vigorous (MVPA) intensity, as well as time spent sitting, by the International Physical Activity Questionnaire and accelerometry by Spearman correlations. Bland and Altman plots were performed to verify the agreements between both instruments. The results showed weak yet significant correlations (Rs = 0.15–0.39, all P < 0.05) in all physical activity intensities between the two instruments, except for sedentary time. The highest correlations were observed for physical activity at home or in garden (Rs = 0.297, P < 0.01). The results suggest that the long self-administrated International Physical Activity Questionnaire is a questionable instrument to assess physical activity in patients with fibromyalgia. Therefore, physical activity measurement in fibromyalgia patients should not be limited solely to self-reported measures.

The clinical utility of accelerometry in patients with rheumatoid arthritis

To assess habitual physical activity levels in patients with RA compared with healthy control participants and to compare these measures with health-related quality of life and disease activity in the RA patients. METHODS. Fifty RA patients [age 48 (13) years] and 22 BMI, sex and geographically matched control participants were recruited. Habitual physical activity was measured using an Actical accelerometer worn on the hip for 2 consecutive weeks. Patients completed the Short Form-36 (SF-36) and modified Health Assessment Questionnaires (HAQ-DI). Disease activity was assessed using the Simplified Disease Activity Index (SDAI). RA patients were further categorized as more physically active (n = 25) and less physically active (n = 25) according to their average activity counts. The RA group spent more time in sedentary activity than the control group (71% vs 62% of the day respectively, P = 0.002) and had bimodal decreases in diurnal physical activity compared with the control group in the morning (P < 0.001) and late afternoon (P < 0.001). HAQ-DI, when adjusted for age and disease duration, was negatively correlated with physical activity in the RA group (r = -0.343, P = 0.026). The more physically active patients scored better than the less physically active patients on every component of the SF-36. Patients with RA lead a significantly more sedentary lifestyle than healthy controls and show diurnal differences in physical activity due to morning stiffness and fatigue. Higher levels of habitual physical activity may be protective of functional capacity and are highly associated with improved health-related quality of life in RA patients.

Tremor in neurodegenerative ataxias, Huntington disease and tic disorder

IntroductionTremor is the most prevalent movement disorder, defined as rhythmic oscillations of a body part, caused by alternating or synchronic contractions of agonistic or antagonistic muscles. The aim of the study was to assess prevalence and to characterize parameters of tremor accompanying degenerative ataxias, Huntington disease (HD) and tic disorders in comparison with a control group. Material and methodsForty-three patients with degenerative ataxias, 28 with HD and 26 with tic disorders together with 51 healthy controls were included in the study. For each participant, clinical and instrumental assessment (accelerometer, electromyography [EMG], graphic tablet) of hand tremor was performed. Frequency and severity of tremor were assessed in three positions: at rest (rest tremor), with hands extended (postural tremor), during the ‘finger-to-nose’ test and during Archimedes spiral drawing (kinetic tremor). Based on the mass load test, the type of tremor was determined as essential tremor type or enhanced physiological tremor type. ResultsThe incidence of tremor in the accelerometry in patients with degenerative ataxia (50%) significantly differs from controls (10%) (p = 0.001). The dominant tremor was postural, low-intense, with 7-Hz frequency, essential tremor (23%) or other tremor type (23%), while enhanced physiological tremor was the least frequent (2%). Tremor in patients with HD and tic disorders was found in 10% and 20% of patients, respectively, similarly to the control group. Tremor was mild, postural and of essential tremor type, less frequently of enhanced physiological tremor type. No correlation between severity of tremor and severity of disease was found. ConclusionsThe prevalence of tremor is considerably higher among patients with degenerative ataxias compared with HD, tic disorder and the control group. The most common type of tremor accompanying ataxias, HD and tic disorders is essential tremor type.

Assessment of Arm Activity Using Triaxial Accelerometry in Patients With a Stroke

van der Pas SC, Verbunt JA, Breukelaar DE, van Woerden R, Seelen HA. Assessment of arm activity using triaxial accelerometry in patients with a stroke. Objective To study the validity of accelerometry in the assessment of arm activity of patients with impaired arm function after stroke. Design Cross-sectional concurrent validity study. Setting Rehabilitation center. Participants Patients (N=45) at different stages after stroke. Interventions Not applicable. Main Outcome Measures All patients wore 2 triaxial accelerometers around their wrists during 3 consecutive days. Arm activity was assessed, based on unilateral (activity of the affected arm) and bilateral accelerometry (ratio between the activity of the affected and nonaffected arm). The Motor Activity Log-26 (MAL-26) Amount of Use (AOU) scale was used as the main external criterion to test the concurrent validity of arm accelerometry. In addition, the MAL-26 Quality of Movement (QOM) scale and the Stroke Impact Scale (SIS) subscale Hand Function were used. To test the divergent validity, the SIS subscale Mobility was used. Spearman correlation coefficients were calculated. In an additional regression analysis, the hypothesized confounding influence of spasm, therapy intensity, and interobserver differences was studied. Results Both unilateral (ρ=.58, P<.001) and bilateral (ρ=.60, P<.001) accelerometry were significantly related to the MAL-AOU scale. Associations of both unilateral and bilateral accelerometry with the MAL-QOM and SIS subscale Hand Function corroborated these findings. The SIS subscale Mobility was not significantly associated with unilateral accelerometry (ρ=.41, P=.01) or bilateral accelerometry (ρ=.23, P=.11). None of the hypothesized confounders influenced these associations significantly. Conclusions Based on the results, both the concurrent and divergent validity of unilateral and bilateral arm accelerometry for measuring arm activity after stroke are good.

Daily Physical Activity Levels as Measured by Self-Report and Accelerometry in Patients with Heart Failure

Daily Physical Activity Levels as Measured by Self-Report and Accelerometry in Patients with Heart Failure