Participant Discomfort Research Articles

Investigating the effect of different smells in the indoor built environment (office) on human emotions using a mixed-method approach

Despite numerous studies highlighting the impact of smells on humans, there has been a notable lack of attention to ambient smell within the discipline of architecture. To address the gaps, a systematic methodology was designed to investigate the impact of the indoor-built environment's smell on human emotions. In this experiment, 14 adults (7 women and 7 men) are exposed to the smell of jasmine and rotten orange peel in two identical rooms. The EEG analysis revealed increased theta band power in frontal regions and increased alpha power in frontal and occipital areas when participants were exposed to the jasmine scent. Gamma activity in the frontal regions increases with exposure to the smell of rotten orange peel. Participants reported that the smell of jasmine was pleasant, leading to pleasant emotions, interest, enjoyment and a sleepy state. However, the smell of rotten orange peel led to unpleasant emotions, discomfort and annoyance for participants.

Use of Esmarch bandage does not increase peripheral vein size in healthy volunteers: A randomized clinical trial

IntroductionUltrasound is used for peripheral intravenous (PIV) cannulation in patients with difficult landmark-guided IV access in the Emergency Department. Distal-to-proximal application of an Esmarch bandage on the target limb has been suggested as a method for increasing vein size and ease of cannulation. MethodsThis study was a single-blinded crossover randomized controlled trial comparing basilic vein size under ultrasound with use of an Esmarch bandage in addition to standard IV tourniquet (“tourniquet + Esmarch”) compared to use of a standard IV tourniquet alone. Participant discomfort with the tourniquet + Esmarch was also compared to that with standard IV tourniquet alone. ResultsTwenty-two healthy volunteers were used to measure basilic vein size with and without the Esmarch bandage. There was no difference in basilic vein size between the two groups, with a mean diameter of 6.0 ± 1.5 mm in the tourniquet + Esmarch group and 6.0 ± 1.4 mm in the control group, p = 0.89. Discomfort score (from 0 to 10) was different between the groups, with a mean discomfort score of 2.1 in the tourniquet + Esmarch group and 1.1 in the standard IV tourniquet alone group (p < 0.001). ConclusionsThis study showed that the use of an Esmarch bandage does not increase basilic vein size in healthy volunteers but is associated with a mild increase in discomfort.

Influential Signs of Dry Eye-Related Ocular Symptoms in Participants With Unstable Tear Film.

The aim of this study was to investigate the factors influencing dry eye disease (DED)-related ocular symptoms in participants with short fluorescein tear break-up time (FTBUT). This cross-sectional study included 82 participants with short FTBUT (<10 seconds). Examinations included Ocular Surface Disease Index (OSDI), FTBUT, average noninvasive tear break-up time (NIBUTave), lid wiper epitheliopathy, lipid layer thickness, blink rate, partial blink, tear meniscus height, and meibomian gland (MG) evaluation which included ratio of residual MG area (RMGA) and MG grade in tarsal plates. One-way analysis of variance was used to detect differences between symptomatic tear film instability group (FTBUT <5 s, OSDI ≥13), asymptomatic tear film instability group (FTBUT <5 s, OSDI <13), and control group (FTBUT ≥5 s, OSDI <13). A bivariate correlation, partial correlation, and multiple linear regression analyses were used to identify major factors. Only the right eye was included. Among the participants with FTBUT <5 seconds, symptomatic group showed less upper RMGA ( P < 0.001) and NIBUTave ( P = 0.010). OSDI was negatively associated with upper RMGA ( r = -0.450, P < 0.001) and NIBUTave ( r = -0.414, P = 0.001), and positively associated with upper MG grade ( r = 0.277, P = 0.027). Linear regression analysis showed that the upper RMGA significantly affected OSDI (B = -41.895, P = 0.001), while not significantly correlated with age, upper MG grade, and NIBUTave. The upper RMGA might be the main factor affecting DED-related discomfort in participants with unstable tear film, indicating an early ocular change in DED.

A novel test for hyposalivation using a sugar cube.

Hyposalivation is a highly prevalent condition in old persons. The aim of this study was to assess a novel tool for the diagnosis of hyposalivation using a sugar cube and to compare its reliability to other validated test methods. Five tests were performed: unstimulated salivary flow test by draining method (USFT), oral moisture device Mucus® (MCS), sugar cube test (SCT), stimulated salivary flow test by chewing gum (CG) and Saxon test (SX). The sugar cube test consisted in measuring the time needed to disintegrate a standard-sized sugar cube N°4 (5.6 g) placed beneath the tongue. Bivariate correlation analyses were performed. ROC curve analysis and the Youden Index were used to determine the cut-off value. Sensitivity and specificity were calculated according to the determined cut-off point. A total of 121 participants were recruited, with an average age of 49.8 ± 18.2 years. The USFT was best correlated with the SCT. No correlation was found between SCT and the stimulated saliva tests (CG, SX) as well as the MCS test. According to the Youden index, 140 s is appropriate to diagnose hyposalivation. Sensitivity of .64 and specificity of .91 were found for SCT using USFT as gold standard. The mean subjective evaluation score of the SCT was 3.1 ± 1, significantly higher than USFT 2.6 ± 1.1 (p < .05). The sugar cube test proved to be a useful method for assessing unstimulated salivation, reducing test execution time and causing less participant discomfort than the gold standard unstimulated salivary flow test.

Toward Trauma-Informed Research Practices with Youth in HCI: Caring for Participants and Research Assistants When Studying Sensitive Topics

Research involving sensitive data often leads to valuable human-centered insights. Yet, the effects of participating in and conducting research about sensitive data with youth are poorly understood. We conducted meta-level research to improve our understanding of these effects. We did the following: (i) asked youth (aged 13-21) to share their private Instagram Direct Messages (DMs) and flag their unsafe DMs; (ii) interviewed 30 participants about the experience of reflecting on this sensitive data; (iii) interviewed research assistants (RAs, n=12) about their experience analyzing youth's data. We found that reflecting about DMs brought discomfort for participants and RAs, although both benefited from increasing their awareness about online risks, their behavior, and privacy and social media practices. Participants had high expectations for safeguarding their private data while their concerns were mitigated by the potential to improve online safety. We provide implications for ethical research practices and the development of reflective practices among participants and RAs through applying trauma-informed principles to HCI research.

Acceptability and anklet user experience with the SCRAM-CAM transdermal alcohol concentration sensor in regularly drinking young adults' natural environments.

Recent developments in wearable technologies have allowed for device-based capture of alcohol concentration among participants in their natural environments. Currently, the Continuous Alcohol Monitor from SCRAM systems (SCRAM-CAM) is the most extensively studied and validated transdermal alcohol concentration (TAC) sensor. However, there has been relatively little work focusing on its acceptability from the participants' perspective. In the current study, we assess the user experience of the SCRAM-CAM anklet in a sample of 222 regularly heavy drinking young adults (mean age=22.3) who wore the anklet in their natural environments for five 24-h periods spanning 6 consecutive days. Differences in the anklet user experience were measured along a number of dimensions, and differences were tested by sex at birth, white/non-white racial/ethnic group membership, and alcohol use disorder (AUD) risk (measured through Alcohol Use Disorder Identification Test [AUDIT] scores). Males and females differed significantly on six of the eight acceptability items, with males showing more positive responses toward the anklet than females. No differences were found by white/non-white racial/ethnic groups nor AUD risk. Results suggest positive levels of acceptability toward the device overall while in natural environments, further validating the usage of the device in studies that measure alcohol consumption among different groups, including those with high levels of alcohol consumption. Researchers should take into consideration the different levels of burden or discomfort in male versus female participants when using the device.

Effects of aircraft tray table height and neck posture on passenger comfort: A study of the economy class cabin.

The tray table in economy class air travel may cause excessive neck flexion and discomfort in passengers. The purpose of this study is to examine the influence of different tray table heights on the neck posture and discomfort perception of passengers. A passenger experience survey was used to determine the passengers' view that the tray table was not high enough, and that most passengers were dissatisfied with the overall comfort evaluation of the tray table, especially passengers with obesity. Three head-neck angles and discomfort perceptions of six body parts in 58 participants were recorded by neck posture 3D scanning and perceived level of discomfort assessment, respectively. Tray tables at the original height (68 cm) caused unnatural neck posture and discomfort in participants. Raising the tray table can improve the neck posture of participants and reduce discomfort. However, raising the tray table too high will cause more shoulder discomfort in participants. Based on the results, 78 (±2) cm is suggested as the suitable thresholds range of tray tables for economy class air travel. The results and findings of this study could provide a theoretical base for the optimization of tray table design.

Manipulating device-to-body forces in passive exosuit: An experimental investigation on the effect of moment arm orientation using passive back-assist exosuit emulator.

Passive exosuits have been vastly researched in the past decade for lifting tasks to alleviate the mechanical loading on the spine and reduce the lower back muscle activities in lifting tasks. Despite promising advantages of exosuits, factors such as comfort directly influence the user's acceptability of such body-worn devices. Exosuits' routing/anchoring points, which transmit device-to-body forces, remain the leading cause of discomfort among users. In the present study, we sought to investigate the effect of the routing element, that is, the "moment arm," in altering the device-to-body forces and perceived discomfort. We first presented a simplified human-exosuit model to establish insight into the effect of the moment arm on the device-to-body forces acting at the shoulder (FS) and waist (FW). Further, an experimental investigation was conducted on 10 participants with six different exosuit moment arm configurations (C1, C2, C3, C4, C5, and C6) to investigate their effect on the device-to-body forces, perceived discomfort, and muscle activity using a passive back-assist exosuit emulator in a lifting/lowering task. Configuration C4 was found to be most beneficial in reducing device-to-body forces at the shoulder and waist by up to 44.6 and 22.2%, respectively, during lifting. Subjective scores also comprehended with the device-to-body forces, indicating that C4 produces significantly less discomfort for participants. The outcome of the study illustrates the importance of selecting an appropriate moment arm configuration for passive back support exosuits in alleviating the device-to-body forces and perceived discomfort.

Combined Exercise and Game-Based Cognitive Training Intervention: Correlative Pilot Study of Neurotrophic and Inflammatory Biomarkers for Women With Breast Cancer.

Interventions that increase neuroprotective factors and/or decrease inflammatory biomarkers may be effective in improving cognitive function for cancer survivors. Concurrent investigation of potential mechanism(s) to fully understand and refine effective interventions is needed. This correlative prospective substudy was conducted to investigate biomarkers related to potential mechanism(s) for a combined exercise and game-based brain training intervention designed to improve cognitive function in breast cancer survivors. Fingerstick bloodspot samples were collected at 3 time points during the randomized, wait-list controlled interventional parent study. Samples were analyzed for neuroprotective factors and inflammatory biomarker levels. Insulinlike growth factor 1 (IGF-1) levels significantly increased (P < .01) for the intervention group from baseline to 4 and 16 weeks postintervention. Insulinlike growth factor 1 levels correlated with neurocognitive test performace improvement for Trail Making Test B (r = 0.31, P = .02). This association was not significant in the mixed model. No significant correlation was seen between IGF-1 levels and changes in self-report of cognitive function, activity level, or intervention dose. Further investigation of IGF-1 levels is warranted as related to potential mechanisms for the Combined Exercise and Game-based Cognitive Training intervention. Future investigations should involve a larger sample cohort and incorporate objective measures of physical activity and prescribed sampling time in relationship to the most recent performance of the intervention. Fingerstick bloodspot sample collection is feasible, acceptable, and effective for conducting biomarker research. This methodology minimizes participant burden and discomfort; increases clinical trial access for home, off-site, or rural settings; and facilitates research efforts during times of pandemic restrictions.

Impact of Biometric Patient Data, Probiotic Supplementation, and Selected Gut Microorganisms on Calprotectin, Zonulin, and sIgA Concentrations in the Stool of Adults Aged 18-74 Years.

Alterations to the intestinal barrier may be involved in the pathogenesis of various chronic diseases. The diagnosis of mucosal barrier disruption has become a new therapeutic target for disease prevention. The aim of this study was to determine whether various patient demographic and biometric data, often not included in diagnostic analyses, may affect calprotectin, zonulin, and sIgA biomarker values. Stool markers' levels in 160 samples were measured colorimetrically. The analysis of twenty key bacteria (15 genera and 5 species) was carried out on the basis of diagnostic tests, including cultures and molecular tests. The concentrations of selected markers were within reference ranges for most patients. The sIgA level was significantly lower in participants declaring probiotics supplementation (p = 0.0464). We did not observe differences in gastrointestinal discomfort in participants. We found significant differences in the sIgA level between the 29-55 years and >55 years age-related intervals groups (p = 0.0191), together with a significant decreasing trend (p = 0.0337) in age-dependent sIgA concentration. We observed complex interdependencies and relationships between their microbiota and the analyzed biomarkers. For correct clinical application, standardized values of calprotectin and sIgA should be determined, especially in elderly patients. We observed a correlation between the composition of the gut community and biomarker levels, although it requires further in-depth analysis.

Comparison of Ultrasound and Electrical Stimulation Guidance for Onabotulinum Toxin-A Injections: A Randomized Crossover Study.

Botulinum neurotoxin (BoNT) injection is an established therapy for limb spasticity and focal limb dystonia. Comparative benefits of injection guidance procedures have not been rigorously studied. We compared 2 targeting techniques for onabotulinumtoxin-A (onabotA) injection for the treatment of focal hand dystonia and upper limb spasticity: electrophysiologic guidance using electrical stimulation (E-stim) and ultrasound (US). This was a 2-center, randomized, crossover, assessor-blinded trial. Participants with focal hand dystonia or upper limb spasticity, on stable onabotA therapy for at least 2 previous injection cycles, were randomly assigned to either E-stim or US with crossover at 3 months. The primary outcome was improvement in dystonia or spasticity severity on a visual analog scale (VAS; 0-100) measured 1 month after each injection. The secondary outcome was participant discomfort assessed on a VAS. Repeated-measures analysis of covariance was used with linear mixed-model covariate selection. A total of 19 participants (13 men) completed the study, 10 with upper limb spasticity and 9 with dystonia. Benefit was equivalent between the 2 techniques (VAS least-square mean [LSmean] 51.5 mm with US and 53.1 with E-stim). E-stim was perceived as more uncomfortable by participants (VAS LSmean 34.5 vs. 19.9 for E-stim and US, respectively). Procedure duration was similar with the 2 procedures. There were no serious adverse events related to either approach. US and E-Stim localization guidance techniques provide equivalent efficacy in onabotA injections for spasticity and dystonia. US guidance injections are more comfortable for participants. Both techniques are effective guidance methods, with US potentially preferable based on participant comfort.

Examining the Impact of Rotated Neck and Trunk Postures on Vertical Seat-to-Head Vibration Transmissibility and Self-Reported Discomfort

Adopting non-neutral sitting postures while exposed to whole-body vibration (WBV) can put heavy equipment operators at an increased risk for lower back pain and may cause damage to the spinal tissue. A laboratory experiment involving 11 participants (5 females, 6 males) completing four 45-min test sessions incorporating different seated conditions (vibration versus no vibration, and rotation versus no rotation) was used to assess seat-to-head transmissibility (STHT) and self-reported discomfort while in four rotated neck and trunk postures. The vibration exposure profile was a constant vertical sinusoidal signal with a frequency of 3 Hz and 0.7 m/s2 acceleration. Vibration measured at the head was greater than at the seat under all conditions, with a statistically significant effect of time (F1,10 = 101.73, p &lt; 0.001, Eta2 = 0.910) and posture (F3,8 = 5.64, p = 0.023, Eta2 = 0.679). Mean self-reported discomfort ratings revealed increased participant discomfort in rotated neck and trunk positions in both vibration and non-vibration conditions. Increasing time also had a significant (F(1,10) = 15.53, p = 0.003) impact on higher rates of participant discomfort. Overall, it was found that increasing the degree of rotated neck and trunk position from neutral amplified the STHT and self-reported discomfort.

Comparing amplitudes of transcranial direct current stimulation (tDCS) to the sensorimotor cortex during swallowing.

Transcranial direct current stimulation (tDCS) can alter cortical excitability, making it a useful tool for promoting neuroplasticity in dysphagia rehabilitation. Clinical trials show functional improvements in swallowing following anodal tDCS despite varying dosing parameters and outcomes. The aim of the current study was to determine the most effective amplitude criterion (e.g., 0mA [sham/control], 1mA, 2mA) of anodal tDCS for upregulating the swallowing sensorimotor cortex. As a novel paradigm, tDCS, functional near-infrared spectroscopy (fNIRS), and surface electromyography (sEMG) were simultaneously administered while participants completed a swallowing task. This allowed for measurement of the cortical hemodynamic response and submental muscle contraction before, during, and after tDCS. At the conclusion of the study, participants were asked to rate their level of discomfort associated with tDCS using a visual analog scale. There was no significant difference in the hemodynamic response by time or amplitude. However, post-hoc analyses indicated that in the post-stimulation period, changes to the hemodynamic response in the left (stimulated) hemisphere were significantly different for the groups receiving 1mA and 2mA of tDCS compared to baseline. Participants receiving 1mA of tDCS demonstrated reduced hemodynamic response. There was no significant difference in submental muscle contraction during or after tDCS regardless of amplitude. Anodal tDCS was well tolerated in healthy adults with no difference among participant discomfort scores across tDCS amplitude. During a swallowing task, healthy volunteers receiving 1mA of anodal tDCS demonstrated a suppressed hemodynamic response during and after stimulation whereas those receiving 2mA of anodal tDCS had an increase in the hemodynamic response. tDCS remains a promising tool in dysphagia rehabilitation, but dosing parameters require further clarification.

Prediction model for discomfort luminance levels of head‐mounted displays

AbstractTo predict the luminance threshold of head‐mounted displays (HMDs), which can cause discomfort due to excessive brightness, a psychophysical experiment was conducted with 20 participants through a yes/no task under a wide luminance range (2–284 cd/m2). The participants were asked to adapt to the luminance of the HMD and further answer whether the test luminance of the HMD caused discomfort. The discomfort threshold was determined for each individual at each adaptation luminance, and a prediction model was proposed based on the mean value of each participant's discomfort luminance level. The proposed model represents that individuals may experience discomfort using an HMD with a luminance of about 280 cd/m2, regardless of whether they are provided time to adapt to the luminance for 2 min.

Optimising the method for isolating ocular surface microRNA using impression cytology

AbstractPurposeConjunctival impression cytology is a reliable method to obtain epithelial cells from the ocular surface. Its application has broadened our knowledge of ocular surface disease, paving the way for a greater understanding of the pathogenesis of disease, new treatment options and personalised medicine. Herein we compare the most commonly used materials to optimise isolating microRNA (miR) from the conjunctiva.MethodsMiR yield of 12 mm PTFE and 13 mm PES in a free membrane semicircle form were compared (n = 3). Next a single 13 mm PES semicircle membrane and a single Eyeprim applicator were compared (n = 8). MiRs were isolated using miRNeasy kit (QIAGEN GmbH Hilden Germany) and concentration was determined on Nanodrop ND‐1000 Spectrophotometer (Thermo Fisher Scientific Wilmington DE). In the second experiment, subjective discomfort provoked by each technique was also determined using SANDE immediately and 2 min after sampling.ResultsPES had a significantly higher miR yield vs PTFE; 131.3 ng/µl±8.1 vs 32 ng/µl±9.9 ng/µl p = 0.0002. In the second experiment miR yield from PES was comparable to Eyeprim; 48.7 ng/µl±24.4 vs 46.9 ng/µl±19.2, p = 0.88. SANDE measured participant discomfort in this experiment. Regarding intensity PES was most tolerable at the point of sampling; 0.1± 0.3 vs 4.5±2.8 for Eyeprim, p = 0.0016. At 2 min, PES measured 0.1 ± 0.3 vs 3.3 ± 3.22 for Eyeprim, p = 0.03.ConclusionsOur results confirm that free PES membrane is greatly superior in its miR harvesting ability compared to free PTFE membrane which was previously optimised in studies using Millicell Biopore. Furthermore, miR yield from free PES membrane is comparable to the commercially designed Eyeprim while being better tolerated. We recommend the use of PES of 0.2 µm pore in 13 mm semicircle design to harvest and characterise miR expression from conjunctival epithelial cells. This simple, inexpensive method can easily be implemented in a clinical research setting to investigate ocular surface disease.

The implementation of forward chaining and certainty factor methods to examine the covid-19 vaccination eligibility

Screening for the COVID-19 vaccination is an important and mandatory step to ensure the eligibility status of each candidate for vaccination. The main obstacle experienced was the ineffective screening process (a long process) that resulted in the accumulation of patients. Sometimes it takes one to two hours from registration to receiving the vaccination paper. This situation certainly causes discomfort for both participants and vaccinators. Therefore, the presence of an expert system is needed to overcome these obstacles. The expert system plays a role in simplifying service flow and shortening service time. This article discusses the application of the Forward Chaining method to formulate screening parameters so that they can be used to accurately determine vaccination eligibility. Based on the results of interviews with experts (expert doctors who handle vaccination), 12 rules were obtained from the formulation of 20 historical parameters, which will then serve as a knowledge base for the Covid-19 vaccination screening expert system. The test is carried out by comparing the results of expert screening diagnoses with an expert system using 15 samples of test data. The test results using the Certainty Factor method show that the confidence level is 84% to 99%.

Using Wearable Cameras to Investigate Health-Related Daily Life Experiences: A Literature Review of Precautions and Risks in Empirical Studies.

Automated, wearable cameras can benefit health-related research by capturing accurate and objective information about individuals' daily experiences. However, wearable cameras present unique privacy- and confidentiality-related risks due to the possibility of the images capturing identifying or sensitive information from participants and third parties. Although best practice guidelines for ethical research with wearable cameras have been published, limited information exists on the risks of studies using wearable cameras. The aim of this literature review was to survey risks related to using wearable cameras, and precautions taken to reduce those risks, as reported in empirical research. Forty-five publications, comprising 36 independent studies, were reviewed, and findings revealed that participants' primary concerns with using wearable cameras included physical inconvenience and discomfort in certain situations (e.g., public settings). None of the studies reviewed reported any serious adverse events. Although it is possible that reported findings do not include all risks experienced by participants in research with wearable cameras, our findings suggest a low level of risk to participants. However, it is important that investigators adopt recommended precautions, which can promote autonomy and reduce risks, including participant discomfort.

The impact of cuff width on perceptual responses during and following blood flow restricted walking exercise.

An appropriate comparison of different cuff widths during blood flow restricted exercise requires that the cuffs are inflated to the same relative pressures. Narrow cuffs tend to be preferred and may reduce discomfort when applied during resistance exercise, but whether this is also true during walking exercise remains unknown. Individuals completed two identical walking trials, once with 12-cm wide cuffs and once with 17-cm wide cuffs. Five 2-min walking bouts were completed at a speed of 50m/min, with a 1-min rest period between sets. The restriction cuffs were inflated to 40% of the individuals' arterial occlusion pressure taken with each respective cuff. Individuals were asked to rate their discomfort, perceived exertion (RPE), and cuff preference. Twenty-seven individuals completed the study. The 12-cm cuff required a higher occlusion pressure which resulted in a higher absolute pressure applied (58 vs. 52mmHg; BF10 =19331.897). Whilst there was no difference in RPE values between cuffs (BF10 =0.474), individuals reported greater discomfort when using the wider cuffs (2.3 vs. 1.7; BF10 =252.786). The majority of individuals (63%) preferred to use the narrower cuff, whereas fewer preferred the wider cuff (26%) and even fewer did not have a preference (11%). Blood flow restricted walking exercise performed with narrower restriction cuffs appeared to reduce participant discomfort whilst also being preferred over that of wider cuffs. Future studies may wish to test the influence of different restrictive cuff widths on alterations in gait patterns during blood flow restricted walking exercise.

Risks and Benefits of Adolescent Girls' Participation in Online Sexting Survey Research.

The increasingly ubiquitous use of sexting among adolescent girls underscores the importance of empirical data on their sexting behaviors, motivations, and outcomes. To date, the majority of sexting studies have been conducted online; however, little is known about the extent to which responding to such socially sensitive questions may cause participant discomfort or distress. Research on this question is critical since in the absence of empirical data, institutional review boards (IRBs) may permit or place restrictions on online sexting studies based on an under- or overestimation of adolescent participation risk. The current online study asked 210 girls (aged 14-18years, 55% non-Hispanic White, with sexting experience in the past 12months) who previously registered to take online surveys on (1) their anticipated comfort in responding to a sexting survey include items on sexting motivations, positive and negative sexting consequences, and related sexual behaviors; (2) their perceptions of sexting research benefits/harms; and (3) comfort discussing similar topics in everyday life and with health professionals. Overall, participants were comfortable responding to sexting survey questions, rated sexting research as high benefits and low risks, and felt about the same as or more comfortable completing a sexting survey than discussing similar topics with peers, parents, or healthcare professionals. Findings suggest that anonymous online sexting studies can be classified as minimal risk research for adolescent girls and provide empirical support for IRB decisions to waive guardian permission for participation in such studies.

Heart Rate Monitor Agreement In Breast Cancer Survivors In A Community-based Exercise Program

Appropriate exercise intensity, often expressed as target heart rate (HR), is critical to effecting change in symptom burden in breast cancer survivors (BCS). Traditional chest-worn monitors, despite their well-documented validity, may be inconvenient in unsupervised settings due to necessary receivers and participant discomfort. Commercially-available wearable sensors may represent an accessible alternative to HR monitoring in community-based exercise settings. PURPOSE: To examine the agreement between the Fitbit Inspire HR and Polar chest monitor for HR measurement in BCS at different stages of exercise in a community-based program. METHODS: BCS (N = 9; aged 38-72 years) were randomized to a 12-week moderate intensity (45-75% HR reserve) pilot aerobic exercise program. HR was concurrently measured using a Polar chest strap monitor and wrist-worn Fitbit Inspire HR in 5 stages: pre-exercise seated rest; midpoint of a 5-minute warmup; midpoint of moderate intensity exercise; midpoint of a 5-minute cool-down; after a 5-minute seated recovery. Agreement between HR measurements was assessed using Lin’s concordance correlation coefficient (rc). Relative error rates were calculated to indicate differences across exercise session stages. RESULTS: Across sessions (n = 187), HR ranged from 55 to 139 beats per minute. Agreement between the Polar monitor and Fitbit Inspire HR was highest during seated rest (pre-exercise, rc = 0.74, 95%CI [0.67, 0.80]; post-exercise, rc = 0.90, 95%CI [0.86, 0.92]) followed by the midpoint of moderate intensity exercise (rc = 0.63, 95%CI [0.54, 0.70]). Agreement was lowest during “transitionary” periods—i.e., warmup (rc = 0.37, 95% [0.25, 0.49]) and cool-down (rc = 0.43, 95% [0.32, 0.53]). Mean relative error rates ranged from -4.30% to 3.27% and were greatest during the warmup stage (RER = -4.3 ± 12.06%). CONCLUSION: This study provides novel data on HR monitor agreement in a community-based exercise setting and in a clinical population. Results indicate moderate agreement between Fitbit Inspire HR and Polar HR monitors during steady-state, moderate intensity aerobic exercise. While Fitbit alone may provide an estimate of exercise HR, it is likely not precise enough for accurate HR monitoring in exercise prescription.