Average Step Research Articles

Comparison of Sleep and Physical Activity Metrics From Wrist-Worn ActiGraph wGT3X-BT and GT9X Accelerometers During Free-Living in Adults

Background: ActiGraph accelerometers can monitor sleep and physical activity (PA) during free-living, but there is a need to confirm agreement in outcomes between different models. Methods: Sleep and PA metrics from two ActiGraphs were compared after participants (N = 30) wore a GT9X and wGT3X-BT on their nondominant wrist for 7 days during free-living. PA metrics including total steps, counts, average acceleration—Euclidean Norm Minus One (ENMO) and Mean Amplitude Deviation, intensity gradient, the minimum acceleration value of the most active 10 and 30 min (M10, M30), time spent in activity intensities from vector magnitude (VM) counts, and ENMO cut points and sleep metrics (sleep period time window, sleep duration, sleep onset, and waking time) were compared. Results: Excellent agreement was evident for average acceleration-Mean Amplitude Deviation, counts, total steps, M10, and light PA (VM counts) with good agreement evident from the remaining PA metrics apart from moderate–vigorous PA (VM counts) which demonstrated moderate agreement. Mean bias for all PA metrics were low, as were the limits of agreement for the intensity gradient, average acceleration-Mean Amplitude Deviation, and inactive time (ENMO and VM counts). The limits of agreement for all other PA metrics were >10%. Excellent agreement, low mean bias, and narrow limits of agreement were evident for all sleep metrics. All sleep and PA metrics demonstrated equivalence (equivalence zone of ≤10%) apart from moderate–vigorous PA (ENMO) which needed an equivalence zone of 16%. Conclusions: Equivalent estimates of almost all PA and sleep metrics are provided from the GT9X and wGT3X-BT worn on the nondominant wrist.

Lifestyle and mood correlates of cardiometabolic risk in people with serious mental illness on second-generation antipsychotic medications.

Cardiovascular morbidity and mortality are high in people with serious mental illness (SMI). This problem is mediated, at least in part, by metabolic side effects of second-generation antipsychotics (SGAs) and by unhealthy lifestyle behaviors. We asked whether oral glucose tolerance testing (oGTT) or hemoglobin A1c (HbA1c) is superior in identifying people with SMI at high cardiometabolic risk and whether this risk is shaped by mood, cognition, or lifestyle habits. We evaluated 40 patients with schizophrenia, schizoaffective, or bipolar disorder receiving SGAs by oGTT, HbA1c, comprehensive metabolic and lipid panels, and CRP. Mood was assessed using the Patient Health Questionnaire (PHQ-9), and cognition was assessed using the Saint Louis University Mental Status examination. Diet was assessed using the UK Diabetes and Diet Questionnaire (UKDDQ), and physical activity was assessed using daily step counts. Most patients had prediabetes (preDM) or diabetes mellitus (DM), 72.5% by oGTT, and 52.5% by HbA1c criteria. Pulse rates and insulin resistance indices (Homeostatic Model Assessment of Insulin Resistance, HOMA IR; Matsuda) were significantly different between patients classified as normal or with preDM/DM, using either oGTT or HbA1c criteria. Patients with preDM/DM by HbA1c but not oGTT criteria also had higher waist/hip ratios, triglyceride, and CRP levels (p<0.05). A strong negative correlation was found between average daily step counts and CRP levels (rho = -0.62, p<0.001). Higher UKDDQ scores, or unhealthier diet habits, were associated with higher fasting plasma glucose (rho = 0.28, p = 0.08), triglyceride levels (rho = 0.31, p = 0.05), and insulin resistance (HOMA IR: rho = 0.31, p = 0.06). Higher PHQ-9 scores correlated with lower 2h-oGTT glucose levels (rho = -0.37, p<0.05). OGTT screening is superior to HbA1c screening in detecting preDM and DM early. Patients identified with preDM/DM by oGTT or HbA1c screening are insulin-resistant and have higher pulse rates. Abdominal obesity, unfavorable lipid profiles, and higher CRP levels were noted in patients screened by HbA1c, but not by oGTT. Low physical activity, low depression scores, and unhealthy diet habits were associated with higher CRP and higher glucose and triglyceride levels, respectively. Future studies should assess the impact of specifically tailored individual lifestyle counseling and medical management interventions in this high-risk population.

Characteristics of walking techniques with different pelvic height and pelvic rotation: effect on muscle activation and energy consumption.

Purpose: Previous studies have proven that modifications in the natural walking technique alter muscle activation and energy consumption. This research aimed to determine the differences in muscle activation, energy consumption, kinematic characteristics, perceived muscular exertion and perceived cardio-respiratory fatigue between natural and modified walking techniques with altered pelvic height and rotation. Methods: Nine physically active, non-injured males walked on a treadmill. Modified walking techniques assumed maintenance of constant pelvic height and application of maximal pelvic rotation. Walking speed was subtransit - 0.4 km/h less than the transit. Sampled variables were: average normalized maximal activation during contact and swing phase relativized to maximal voluntary activation, average submaximal oxygen consumption relativized to body mass and subtransit speed, average step length and frequency, rating of perceived muscular exertion and perceived cardio-respiratory fatigue. Muscle activation, energy consumption and kinematic characteristics were assessed throughout each walking session. Perceived muscular exertion and perceived cardio-respiratory fatigue were evaluated post-session. Electromyographic activity was assessed for rectus femoris, gluteus maximus, vastus medialis, biceps femoris, tibialis anterior and gastrocnemius lateralis. Results: The most significant changes in muscle activation were observed during the contact phase. A decrease in pelvic height increased muscle activation of rectus femoris, vastus medialis and gastrocnemius lateralis. An increase in pelvic rotation increased muscle activation of all monitored muscles except for gluteus maximus. Both modifications increased energy consumption, perceived muscular exertion and perceived cardio-respiratory fatigue, and altered kinematic characteristics. Conclusions: Modifications in pelvic height and rotation at the same walking speed alter muscle activation, energy consumption, kinematic characteristics, perceived exertion and fatigue.

Association of Daily Physical Activity With Motivation in Prefrail and Frail Older Adults Living in Retirement Communities.

Older adults living in retirement communities are an understudied population, and the association between their motivation and daily physical activity is unknown. We recruited participants (n = 173) living in a retirement community who completed the Behavioral Regulation in Exercise Questionnaire-2 and wore an activPAL accelerometer to evaluate this relationship. Participants had a median age of 81years and demonstrated low levels of daily activity with an average step count of 3,637 (±1,965)steps per day and 52 (±25)min of daily stepping time. External motivation was negatively associated with the square root of daily step count (β = -4.57; p < .001) and square root of daily stepping time (β = -0.49; p < .001). Older adults living in retirement communities demonstrated low levels of daily activity, with a negative association between external motivation and daily activity. Strategies are needed to make an active lifestyle supportive and enticing for older adults in these communities.

Magnetic field-assisted manufacturing of groove-structured flexible actuators with enhanced performance

Magnetic flexible actuators with hard-magnetic particles (NdFeB) as inlays have attracted widespread attention due to their small size, wireless control capability, and diverse transformation modes. The manufacturing method of these actuators plays a crucial role in their functionality. Here we propose a magnetic field-assisted manufacturing method based on vat photopolymerization (VPP) to produce hard-magnetic flexible actuators with 3D architecture in both geometry structure and magnetization arrangements. The assisting magnetic field enables alignment of hard magnetic particles during manufacturing process, thus obtaining a magnetization arrangement. The VPP method offers the ability to manufacture fine structures and selective curing but has a limitation on the magnetic particle content. To deal with the lack of driving force due to the low available content of magnetic particles, we construct groove structure to enhance the actuators' deformation, which is confirmed by both theoretical and experimental analyses. Flexible actuators with a low magnetic particle content (10 wt%) can be fabricated and fulfill intended functionality. We demonstrate the effectiveness of our method by manufacturing multi-arm grippers, showcasing their transportation capabilities. Moreover, we construct a 2-DOF joint for a crawling robot, significantly improving its motion performance and increasing the average step length to 6.8 times. Finally, we design and manufacture a magnetic diaphragm with complex structure and 3D magnetization arrangements, which is applied to a micro pump, demonstrating its pumping process with a rate of about 3.6 mL/min. These results highlight the potential of the proposed method in designing complex structures and magnetization arrangements of flexible actuators, expanding their functional boundaries.

Path planning optimization for swine manure‐cleaning robots through enhanced slime mold algorithm with cellular automata

AbstractOne of the primary challenges for robotic manure cleaners in pig farming is to plan the shortest path to designated cleaning points under specified conditions with minimal processing cost and time, while avoiding collisions. However, pigs are randomly distributed in actual pig farms, which obstructs the robots' movement and complicates the rapid determination of optimal solutions. To address these issues, this study introduces the concept of interaction among cellular automaton cell neighborhoods and proposes the Cellular Automata Slime Mold Algorithm (CASMA). This enhanced slime mold algorithm accelerates convergence speed and improves search accuracy. To validate its effectiveness, CASMA was compared with four metaheuristic algorithms (ACO, FA, PSO, and WPA) through performance tests and simulated experiments. Results demonstrate that in complex pigsty environments with varying numbers of pigs, CASMA reduces average step consumption by 8.03%, 1.61%, 0.99%, and 4.26% compared with these algorithms and saves processing time by averages of 13.20%, 20.11%, 10.86%, and 6.4%, respectively. In addition, in dynamic obstacle experiments, CASMA achieved average time savings of 48.27% and 56.28% compared with A* and TS, respectively, while reducing step consumption. Overall, CASMA enhances the efficiency of manure‐cleaning robots in pig farms, thereby improving animal welfare.

Promoting Physical Activity in the Diabetic and Pre-Diabetic Low Socioeconomic Population: Case Study

Introduction: Movement and exercise play a vital role in health maintenance and preventing complications with diabetes. Type 2 diabetes can be reversed or/and managed with lifestyle modifications. The lifestyle modification of focus in this study is increasing daily steps with a goal of 10,000 a day. Methods: This is a case study n=1 including participants that were diagnosed with type 2 diabetes. The focus of the study is to identify any increase in activity level (steps) by giving a patient a pedometer and setting a daily step goal. The patient documented their steps in the activity log every day for 3 months. Their weight and hemoglobin A1C were measured at the beginning and end of the study. A questionnaire was completed at the beginning of the study and at the completion of the study. At the end of the study the patient completed a questionnaire of their perception of increased activity with the pedometer. Results: On the posttest questionnaire, the participant said it did increase the motivation level and compliance. Having a goal did help to increase activity level. The first day steps recorded were 3,357. The daily step goal was set at 10,000 steps. It was met and exceeded 77% of the time over the 3-month period with an average daily step being 14,695. Conclusions: More research needs to be conducted due to a small sample size.

Plan Prototype Microcontroller based 30 Meter Running Speed Test Equipment

This research aims to produce a 30 meter running speed equipment product athlete North Sumatra which is microcontroller based. It is hoped that this research will be able to overcome the difficulties faced by testers which have so far been carried out manually so that they are effective and effective objectivity The results of this test still cannot be categorized as accurate. This research uses an approach of research and development with the Borg and Gall model which is divided into three stages. The research stages are; (1) Pre-development stage, which one At this stage, a needs analysis is carried out through survey level of tool requirements for users, preparation instrument and consultation to experts. (2) Development stage develop products running speed 30 meters starting from developing initial product manuscripts (manual books), designing digital tools, trials small group, stage I improvement, trials large group, phase II improvement, mass production. (3) Evaluation stage implementation of product results and dissemination product. The results of the analysis from the trial I obtained an average value implementation of Microcontroller-Based 30 Meter Running Speed ​​Test Equipment based on data obtained for the answer "Yes" with a percentage of 81.38% and "No" with a percentage of 18.62%. The results of the analysis of trial II obtained an average value implementation plan prototype digital step frequency measuring test tool based on data obtained for the answer "Yes" with a percentage of 86.08% and "No" with a percentage of 13.92%. The conclusion in this research is that the test tool developed is valid because the calculation uses a digital system.

Functional Connectivity, Physical Activity, and Behavioral Abnormality in Patients with Vascular Cognitive Impairment

Purpose of the research: Neuropsychiatric Symptoms (NPSs) can negatively impact the survival and quality of life in Vascular Cognitive Impairment (VCI) patients. Physical Activity (PA) has been shown to reduce NPSs in dementia patients, possibly by influencing synaptic plasticity. This study investigates the relationship between NPSs, Default Mode Network (DMN), and PA in patients with VCI. Methods: The study included 42 VCI patients. Functional Connectivity (FC) within the DMN and neurobehavioral performance was assessed. NPSs were categorized. The severity of Hyperactivity and Behavioral Symptoms (HBS) was quantified using a Hyperactivity and Behavioral Composite Score (HBCS). Patients’ PA levels were measured using Fitbit Charge 2. Principal results: After accounting for disease severity, increased FC between the left Posterior Cingulate Cortex (PCC) seed and the right inferior parietal gyrus was linked to more severe HBS. There was an inverse correlation between HBCS and average step counts per day (steps/d) as well as average distance per day (km/d). This suggests that higher levels of PA were associated with less severe HBS. HBCS was also inversely correlated with steps/d and km/d, reinforcing the idea that increased PA was linked to reduced symptom severity. Major conclusions: The study concludes that increased FC within the DMN is associated with more severe HBS in VCI patients. Greater levels of PA (measured by step counts and distance) were associated with a reduction in the severity of HBS. This suggests that FC within the DMN may play a role in the modulation of HBS by PA in VCI patients.

Movement response of small mammals to burn severity reveals importance of microhabitat features

Abstract Disturbance events are increasing at a global scale, with cascading impacts to ecosystems and residents therein that include fragmentation and altered vegetation structure and composition. Such changes may disproportionately impact small mammal movements, risk perception, and community dynamics as smaller species perceive such changes at finer spatial scales. We examined movement response to burn severity, vegetation structure, and composition in Mexican woodrats (Neotoma mexicana), a common but understudied small mammal species. The study was conducted on Mt. Graham in southeastern Arizona, United States, following a fire that burned over 19,400 ha. We measured path tortuosity of woodrats translocated over patches of different burn severity. Tortuosity can indicate microhabitat selection, foraging behavior, and perceived predation risk—features affecting population-level processes that changes in community composition alone cannot fully demonstrate. We captured woodrats, released them 50 m away from their midden, and used fluorescent powder to track woodrat movement paths through areas of low–severe burn severity. We analyzed features of the resulting powder trails including straightness, average step length, fractal dimension, and squared displacement. We also compared used versus expected vegetation structure and composition along movement paths across burn severities. Analyses indicated shorter step length with increased bare ground, as well as higher squared displacement in areas with more logs. Vegetation analyses likewise showed that logs were heavily used in low-burned areas, whereas dense vegetation was avoided in highly burned areas. Burn severity alone did not have a direct effect on movement parameters, rather its influence on vegetative composition and structure appears to be most important. Selection for logs and avoidance of dense vegetation may be attributed to auditory concealment and ease of travel. With projected increases in wildfire extent and severity, this work represents an understudied approach to understanding these disturbances and their effects on ecological communities.

THE LIVED EXPERIENCE OF COPD AND EMOTIONAL DISTRESS IN US VETERANS: A MIXED-METHOD STUDY

Abstract Behavioral interventions targeting low physical activity (PA) and comorbid emotional distress are critically needed to address gaps in the management of chronic obstructive pulmonary disease (COPD). A mixed-methods study was conducted to guide the development of Step-Cognitive Behavioral Therapy (Step-CBT), a virtual behavioral intervention under study integrating PA promotion with CBT for those with COPD. Semi-structured interviews with U.S. Veterans with COPD at the VA Boston Healthcare System explored the lived experience of COPD and emotional distress. Participants completed the Patient Health Questionnaire-9 [PHQ-9], Beck Anxiety Inventory [BAI]), and wore an accelerometer (ActiGraph wGT3X-BT) for 14 days to measure objective PA. Thematic analysis was used to code responses and identify themes. Participants (n=22; 90.9% male, age 68.0±6.0 years; 96% White) were assessed. PHQ-9 indicated moderate depression severity (M=11.3± 5.3) and BAI scores indicated moderate anxiety severity (M=26.5±9.4). Average daily step count was (M=6,611±4,799). In response to questions eliciting participants’ experience of emotional distress, participants described Emotions, Behaviors, and Cognitions associated with distress that interacted with COPD and PA (e.g., “I’ve gotta catch my breath where before I could just do up the yard with no problem… so that gets me depressed”). When asked about engaging in daily PA in the context of emotional distress, three themes emerged: Emotion Regulation and Coping (e.g., healthy behavioral coping, maladaptive coping, etc.), Factors that Motivate (i.e., routine/schedule, etc.), and Social Context. Findings illuminate linkages between emotional distress and PA that will guide the creation of vignette-based treatment modules in the development of Step-CBT.

The effect of mandatory post-call relief on sleep and wellness in ophthalmology residents

BackgroundMultiple duty hour reforms have been implemented to optimize resident wellness through increasing opportunities for sleep recovery, but few studies have recorded objectively measured sleep or shown direct sleep and wellness benefits from such interventions. This study seeks to determine whether mandatory post-call relief policies with a partial night float system improved resident sleep, activity, and burnout among ophthalmology residents taking home call.MethodsWe conducted a two group cohort study of ophthalmology residents at the University Washington comparing post graduate year-2 (PGY-2) resident sleep, activity, and burnout between the optional post-call relief group from July 1, 2017 to June 30, 2019 to the mandatory post-call relief group from July 1, 2019 to June 30, 2021.ResultsOf twenty total residents participating in the survey portion, 18 residents participated in the sleep and activity tracking portion of the study, 9 in in the optional post-call relief cohort, and 9 in the mandatory post-call relief cohort. The mandatory post-call relief group recorded longer total sleep on call than the optional post-call relief group (p < 0.001). There was no difference in overnight sleep recorded on call (median 3.4 h), but residents recorded more time napping in the mandatory post-call relief cohort (p < 0.001). There was no significant difference between cohorts in amount of sleep while not on call. Residents in the mandatory post-call relief cohort recorded higher average daily steps, higher exercise time, and lower sedentary time than residents in the optional post-call relief cohort (p < 0.001). They also recorded lower median emotional exhaustion on the Maslach Burnout Inventory and lower stress in the Depression and Anxiety Stress Scale in the mandatory post-call relief cohort (p = 0.008).ConclusionsImplementation of mandatory post-call relief policies with a partial night-float system among PGY-2 residents was associated with more post-call naps with more overall physical activity, lower emotional exhaustion scores, and lower stress scores, despite no changes to overnight sleep on call or total sleep. Although sample size limits interpretation of data, implementation of mandatory post call relief could be considered to improve post-call sleep in programs with home call.

The Role of Daily Steps in the Treatment of Major Depressive Disorder: Secondary Analysis of a Randomized Controlled Trial of a 6-Month Internet-Based, Mindfulness-Based Cognitive Behavioral Therapy Intervention for Youth.

Current evidence supports physical activity (PA) as an adjunctive treatment for major depressive disorder (MDD). Few studies, however, have examined the relationship between objectively measured PA and MDD treatment outcomes using prospective data. This study is a secondary analysis of data from a 24-week internet-based, mindfulness-based cognitive behavioral therapy program for MDD. The purpose of this analysis was twofold: (1) to examine average daily step counts in relation to MDD symptom improvement, and whether pain moderated this relationship; and (2) to examine whether changes in step activity (ie, step trajectories) during treatment were associated with baseline symptoms and symptom improvement. Patients from the Centre for Addiction and Mental Health were part of a randomized controlled trial evaluating the effects of internet-based, mindfulness-based cognitive behavioral therapy for young adults (aged 18-30 years old) with MDD. Data from 20 participants who had completed the intervention were analyzed. PA, in the form of objectively measured steps, was measured using the Fitbit-HR Charge 2 (Fitbit Inc), and self-reported depression severity was measured with the Beck Depression Inventory-II (BDI-II). Linear regression analysis was used to test PA's relationship with depression improvement and the moderating effect of pain severity and pain interference. Growth curve and multivariable regression models were used to test longitudinal associations. Participants walked an average of 8269 steps per day, and each additional +1000-step difference between participants was significantly associated with a 2.66-point greater improvement (reduction) in BDI-II, controlling for anxiety, pain interference, and adherence to Fitbit monitoring (P=.02). Pain severity appeared to moderate (reduce) the positive effect of average daily steps on BDI-II improvement (P=.03). Higher baseline depression and anxiety symptoms predicted less positive step trajectories throughout treatment (Ps≤.001), and more positive step trajectories early in the trial predicted greater MDD improvement at the end of the trial (Ps<.04). However, step trajectories across the full duration of the trial did not significantly predict MDD improvement (Ps=.40). This study used objective measurements to demonstrate positive associations between PA and depression improvement in the context of cognitive behavioral treatment. Pain appeared to moderate this relationship, and baseline symptoms of anxiety and depression predicted PA trajectories. The findings inform future interventions for major depression. Future research with larger samples should consider additional moderators of PA-related treatment success and the extent to which outcomes are related to PA change in multimodal interventions. Clinical Trials.gov NCT03406052; https://www.clinicaltrials.gov/ct2/show/NCT03406052. RR2-10.2196/11591.

SMART System in the Assessment of Exercise Tolerance in Adults.

Health-oriented physical activity should meet two key criteria: safety and an optimal level of exercise. The system of monitoring and rationalization of training (SMART) was designed to meet them. SMART integrates a custom-configured inertial measurement unit (IMU) and a sensor with real-time heart rate measurement (HR) using a proprietary computer application. SMART was used to evaluate the safety and exercise load with 115 study participants: 51 women (44.35%) and 64 men (55.65%) aged 19 to 65 years. The exercise test was the 6MWT test. In 35% of the participants, the mean HR exceeded the recognized safe limit of HR 75% max. Ongoing monitoring of HR allows for optimal exercise and its safety. Step count data were collected from the SMART system. The average step length was calculated by dividing the distance by the number of steps. The aim of the present study was to assess the risk of excessive cardiovascular stress during the 6MWT test using the SMART system.

Use of Apple Watch to Acquire Baseline Wearable Biometric Data for Patients with Sickle Cell Disease and Correlations to Symptoms Such As Pain and Fatigue

Background: Sickle cell disease (SCD) is an inherited blood disorder that impacts the structure of red blood cells. The most common complication of SCD are vaso-occlusive crises (VOCs), commonly called pain crisis. Frequency and intensity of VOCs can differ among individuals. The unpredictable nature of VOCs increases risk of further complications, limits daily activities, affects mental well-being, and decreases health related quality of life. The use of mHealth and wearables for those living with SCD allows the opportunity to better understand pain and general wellbeing through real time data and analysis. Objectives: We aimed to: 1) Establish a comprehensive baseline health profile for individuals with SCD; and 2) determine potential relationships between patient reported symptoms and biometric data. Methods: Following IRB approval, patients entering the SCD clinic or the SCD Day Hospital at Duke University were approached, consented, and provided with the Nanbar Health app. Participants were instructed to make entries at least once daily and wear an Apple Watch throughout the day for 6 months. If a participant did not have Apple devices, an iOS Apple smartphone and/or Apple Watch series SE were provided. Self-reported general symptoms were recorded in the Nanbar Health app on scales from 0 (none) to 10 (most severe). General wellbeing was rated on an emoji scale, converted to 1 (worst/'frowny face') to 5 (best/'smiley face'). The biometric data from wearable collected included heart rate, step count, heart rate variability (HRV), resting heart rate (RHR), respiratory rate, and O2 saturation. For participants that had their own Apple Watch, 3 months of retroactive data was acquired. Statistical and network analysis was performed to analyze the correlations between symptoms, biometric data, and the general wellbeing of the participant. Results: Over 3 months, 18 participants were enrolled in the study. Median age of participant was 25 (IQR 21-33), 10 females, all Black/African American, and most either HgbSS (72%) or HgbSC (16%). Participants logged symptoms in the app 597 times over 93 days with a median of 0.33 entries/day/patient (IQR 0.22-0.44). The average pain score participants reported was 5.9 (SD 2.4, n=220). The three most reported symptoms, besides pain, were tiredness (22.1%), headache (5.2%), and priapism (5%). The patient-reported general feeling average was 3.3 (n=597, SD 1.6). Heart rate (n=74646), HRV (n=1277), and step count (n=1566) were the most recorded biometrics from the wearables. The average heart rate, HRV, and step count were 105.1 bpm (SD 26.8), 31.9 ms (SD 13.3), and 4100 steps/day (SD 5960), respectively. Significant expected correlations include between pain and priapism (r=0.85, p&amp;lt;0.01), aching and pain (r=0.78, p&amp;lt;0.01), and feeling bad and aching (r= -0.74, p&amp;lt;0.01). We also found feeling well correlated positively to back pain and tired correlated negatively with aching (see Table 1). Using network analysis of biometrics, RHR and HRV had a higher expected influence on patient feeling compared to the other biometrics collected. Conclusion: Baseline biometric characteristics for patients were similar to other diseases with chronic pain and as expected, pain is the most common symptom reported. Our data reflected lower HRV compared to healthy individuals and consistent with other disorders characterized by chronic pain. However, compared to other chronic pain disorders, patients with SCD appeared to have lower HRV values. There was no strong correlation (&amp;gt;0.7) between biometrics obtained by the watch and SCD patient-reported pain scores. Our study found a strong significant correlation between priapism and feeling cold. The strongest correlation was between feeling tired and feeling cold, however, tired/fatigue was also significantly correlated with priapism and feeling cold, although negatively correlated with aching. Limitations to conducting comprehensive analyses and making direct comparisons with other conditions include discrepancies in biometrics due to high variability and participant adherence. These limitations underscore the need to enroll more patients and improve patient adherence to improve the reliability of biometric data in future studies. Future efforts will compare the use of other mHealth devices besides the Apple Watch and expand to patients outside our institution.

Patients with knee osteoarthritis have altered gait and gaze patterns compared to age-matched controls: A pilot study.

Although knee Osteoarthritis (KOA) sufferers are at an increased risk of falls, possibly due to impaired gait function, the associated gaze behaviour in patients with KOA are largely unknown. Thus, we compared gait and gaze behaviours characteristics between KOA patients and asymptomatic age-matched controls. For Timed Up and Go (TUG) and stair climb tasks, the KOA group demonstrated longer periods of gaze fixations with less frequency of fixations compared to the control group. Conversely, for the Timed up and Go Agility (TUGA) test shorter fixation and frequency patterns were observed. The KOA group presented a shorter final stride length prior to the initiation of the first step in the Stair climb assessment. In addition, for the 30m walk and dual task assessments, the average step length was significantly shorter in the KOA group compared to controls. Overall, we found altered gait and gaze behaviours are evident in KOA patients which could relate to their increased falls risk.

Associations of pedometer-measured ambulatory activity with incidence of atherosclerotic cardiovascular diseases: Strong heart family study

ObjectiveCoronary heart disease has several risk factors that require a multifactorial community intervention approach in prevention efforts. Prevalence of coronary heart disease and its risk factors have been disproportionately high among American Indians. The objective of this study is to evaluate the impact of ambulatory activity levels on the development of coronary heart disease in this population. MethodsUsing pedometer data and other lifestyle and clinical factors from 2492 participants in the Strong Heart Family Study, we examined the associations of average daily step counts with incident coronary heart disease during an 18 to 20 year follow-up. ResultsAfter adjusting for potential confounders, participants with daily step counts in the 4th quartile (>7282 steps per day) had significantly lower odds of developing coronary heart disease compared to those in the 1st quartile (<3010 steps per day) (p = 0.035). ConclusionsHigher daily step count (over 7282 steps per day) is significantly associated with lower incidence of coronary heart disease among American Indian participants of the Strong Heart Family Study in a 20-year follow-up period.

Associations between glycemic variability, sleep quality, and daily steps in subjects without diabetes using wearable devices

BackgroundSince there are limited studies on the associations between glycemic variability (GV) and sleep quality or physical activity in subjects without diabetes, we evaluated the associations between GV, as assessed by continuous glucose monitoring (CGM), and both sleep quality and daily steps using wearable devices in healthy individuals. MethodsForty participants without diabetes were monitored by both an intermittently scanned CGM and a smartwatch-type activity tracker for 2 weeks. The standard deviation (SD) and coefficient of variation (CV) of glucose were evaluated as indices of GV. The activity tracker was used to calculate each participant's average step count per day. We also calculated sleep duration, sleep efficiency, and sleep latency based on data from the activity tracker. Spearman's correlation coefficient was used to assess the association between GV and sleep indices or daily steps. For each participant, periods were divided into quartiles according to step counts throughout the day. We compared mean parameter differences between the periods of lowest quartile and highest quartile (lower 25% and upper 25%). ResultsSD glucose was significantly positively correlated with sleep latency (R = 0.23, P < 0.05). There were no significant correlations among other indices in GV and sleep quality (P > 0.05). SD glucose and CV glucose levels in the upper 25% period of daily steps were lower than those in the lower 25% period in each participant (both, P < 0.01). ConclusionIn subjects without diabetes, GV evaluated by intermittently scanned CGM was positively associated with the time to fall asleep. Furthermore, GV in the days of larger daily steps was decreased compared to the days of smaller daily steps in each participant.

Abstract 15700: What Role Does Physical Activity Play in Health-Related Quality of Life (HRQoL) of Children With Hypertrophic Cardiomyopathy (HCM)?

Introduction: Higher levels of physical activity (PA) have been associated with better health-related quality of life (HRQoL). Whether this is true for patients counselled to restrict PA is unknown. Our aim was to examine the relationship between objective measures of PA and HRQoL in children with hypertrophic cardiomyopathy (HCM). Methods: A cross-sectional study of children with HCM, aged 10-18 yrs, enrolled from 10 Canadian sites (2016-23), who underwent cardiovascular screening including the PedsQL Quality of Life Inventory to measure HRQoL. PA measured via Fitbit occurred over 2 weeks. PA parameters included average daily heart rate, step-count, distance covered (Kms), stair flights, activity and sedentary time. Multiple linear regressions were performed to assess the relationship between PA and HRQoL. Covariate adjustments included: age/sex/BMI class at enrollment, cardiac arrest history, previous ICD implant and PA restriction. Correlation matrix was calculated for PA parameters. Results: Fifty-six patients were enrolled [71.4% male; median age 15.5 yrs (IQR 13.8-16.8), median BMI 23.3 Kg/m 2 (IQR 19.5-27.7)], including 11% with a cardiac arrest, 30.4% with an ICD implant and 75% PA restricted. The Fitbit was worn for a median of 14 days (IQR 13.3-14). Average daily steps were 7586 (IQR 5333-10324]) and median sedentary time 893 mins (IQR 735-1141). After adjustment, the average daily steps were associated with Physical HRQoL scores [mean difference (MD) of 2.0 [95% CI 0.3-3.0] per each 1000 steps increase (p=0.02)]. Similar effect sizes were seen for Physical HRQoL with average daily Kms, active time and stairs flights. These outcomes were highly correlated with daily steps (Spearman's ρ; 0.97, 0.81 and 0.6). Conversely, 100 mins of sedentary time decreased mean Physical HRQoL scores by 2 (MD = -2 [-4--0.4]; p=0.02). Only average daily stair flights (MD = 0.6 [0.1-1.1]; p=0.02) was associated with a higher Total HRQoL. Conclusions: Increasing PA in children with HCM, especially with flights of stairs, was associated with higher Physical/Total HRQoL, whereas sedentary time had a determinantal effect on Physical HRQoL. Efforts to decrease sedentary time and improve PA may improve the overall physical and total HRQoL of children with HCM.

Four Days Are Enough to Provide a Reliable Daily Step Count in Mild to Moderate Parkinson’s Disease through a Commercial Smartwatch

Daily steps could be a valuable indicator of real-world ambulation in Parkinson’s disease (PD). Nonetheless, no study to date has investigated the minimum number of days required to reliably estimate the average daily steps through commercial smartwatches in people with PD. Fifty-six patients were monitored through a commercial smartwatch for 5 consecutive days. The total daily steps for each day was recorded and the average daily steps was calculated as well as the working and weekend days average steps. The intraclass correlation coefficient (ICC) (3,k), standard error of measurement (SEM), Bland–Altman statistics, and minimum detectable change (MDC) were used to evaluate the reliability of the step count for every combination of 2–5 days. The threshold for acceptability was set at an ICC ≥ 0.8 with a lower bound of CI 95% ≥ 0.75 and a SAM &lt; 10%. ANOVA and Mann–Whitney tests were used to compare steps across the days and between the working and weekend days, respectively. Four days were needed to achieve an acceptable reliability (ICC range: 0.84–0.90; SAM range: 7.8–9.4%). In addition, daily steps did not significantly differ across the days and between the working and weekend days. These findings could support the use of step count as a walking activity index and could be relevant to developing monitoring, preventive, and rehabilitation strategies for people with PD.