Physical Activity Monitoring Research Articles

Implementing Remote Patient Monitoring of Physical Activity in Clinical Practice

Implementing Remote Patient Monitoring of Physical Activity in Clinical Practice

Prototipe Rekam Kesehatan Personal pada Pasien Diabetes Mellitus (Literature Review)

Personal Health Record (PHR) is a collection of health-related data that is archived and managed by an individual or parties associated with the PHR. Its purpose is to provide a comprehensive and accurate summary of a person's health history that can be accessed online. This research is a Literature Review study which aims to determine the features and implementation of Personal Health Records in Patients with Diabetes Mellitus. The method used is the Literature Review method from 7 journals which uses several methods including the prototype method, qualitative methods, heuristic evaluation methods, applied development methods, participatory action research methods, and randomized controlled trial methods with data collection techniques through google scholar, direct science and pubmed. The results of the research are seen in the features and implementation of the Personal Health Record. The Personal Health Record feature for diabetes mellitus with dialysis measures has 25 features on the main page, the PHR feature for diabetes mellitus has 7 main features. PHR implementation allows users to access their personal health records anytime and anywhere. Thus, the PHR system can increase accessibility and allow users to access PHR without time restrictions and also the Personal Health Record can assist in monitoring the health condition of Diabetes Mellitus patients. Research conclusion According to the journals analyzed, PHR is effective because it can encourage patient participation in individual health controls, and can access information about diabetes mellitus through monitoring physical activity, diet, weight, and glucose levels.

Efficacy of a Commercial Physical Activity Monitor in Longitudinal Tracking of Patients With Pulmonary Hypertension: A Pilot Study.

Patients with pulmonary arterial hypertension have quality-of-life limitations, decreased exercise capacity, and poor prognosis if the condition is left untreated. Standard exercise testing is routinely performed to evaluate patients with pulmonary arterial hypertension but may be limited in its ability to monitor activity levels in daily living. To evaluate the validity of the commercial Fitbit Charge HR as a tool to assess real-time exercise capacity as compared with standard exercise testing. Ambulatory pediatric and adult patients were enrolled and given a Fitbit with instructions to continuously wear the device during waking hours. Patients underwent a 6-minute walk test, cardiopulmonary exercise test, and a 36-Item Short Form Health Survey on the day of enrollment and follow-up. Twenty-seven ambulatory patients with pulmonary arterial hypertension were enrolled, and 21 had sufficient data for analyses (median age, 25 years [range, 13-59 years]; 14 female participants). Daily steps measured by the Fitbit had a positive correlation with 6-minute walk distance (r = 0.72, P = .03) and an inverse trend with World Health Organization functional class. On the 36-Item Short Form Health Survey, 77% of patients reported improvement in vitality (P = .055). At follow-up, there was a strong correlation between number of steps recorded by Fitbit and role limitations because of physical problems (r = 0.88, P = .02) and weaker correlations with other quality-of-life markers. The findings of this pilot study suggest activity monitors may have potential as a simple and novel method of assessing longitudinal exercise capacity and activity levels in patients with pulmonary hypertension. Further study in larger cohorts of patients is warranted to determine which accelerometer measures correlate best with outcomes.

An integrated personalized assistive devices approach to reduce the risk of foot ulcer recurrence in diabetes (DIASSIST): study protocol for a multicenter randomized controlled trial

BackgroundPreventing foot ulcers in people with diabetes can increase quality of life and reduce costs. Despite the availability of various interventions to prevent foot ulcers, recurrence rates remain high. We hypothesize that a multimodal treatment approach incorporating various footwear, self-management, and education interventions that matches an individual person’s needs can reduce the risk of ulcer recurrence with beneficial cost-utility. The aim of this study is to assess the effect on foot ulcer recurrence, footwear adherence, and cost-utility of an integrated personalized assistive devices approach in high-risk people with diabetes.MethodsIn a parallel-group multicenter randomized controlled trial, 126 adult participants with diabetes mellitus type 1 or 2, loss of protective sensation based on the presence of peripheral neuropathy, a healed plantar foot ulcer in the preceding 4 years, and possession of any type of custom-made footwear will be included. Participants will be randomly assigned to either enhanced therapy or usual care. Enhanced therapy consists of usual care and additionally a personalized treatment approach including pressure-optimized custom-made footwear, pressure-optimized custom-made footwear for indoor use, at-home daily foot temperature monitoring, and structured education, which includes motivational interviewing and personalized feedback on adherence and self-care. Participants will be followed for 12 months. Assessments include barefoot and in-shoe plantar pressure measurements; questionnaires concerning quality of life, costs, disease, and self-care knowledge; physical activity and footwear use monitoring; and clinical monitoring for foot ulcer outcomes. The study is powered for 3 primary outcomes: foot ulcer recurrence, footwear adherence, and cost-utility, the primary clinical, patient-related, and health-economic outcome respectively.DiscussionThis is the first study to integrate multiple interventions for ulcer prevention into a personalized state-of-the-art treatment approach and assess their combined efficacy in a randomized controlled trial in people with diabetes at high ulcer risk. Proven effectiveness, usability, and cost-utility will facilitate implementation in healthcare, improve the quality of life of high-risk people with diabetes, and reduce treatment costs.Trial registrationClinicalTrials.gov NCT05236660. Registered on 11 February 2022.

Preventing autonomy loss with multicomponent geriatric interventions: A resource-saving strategy? Evidence from the SPRINT-T study

BackgroundThe objective of healthy aging strategies is to support interventions targeting autonomy loss prevention, with the assumption that these interventions are likely to be efficient by simultaneously improving clinical outcomes and saving costs. MethodsWe compare the economic impact of two interventions targeting frailty prevention in older European populations: a multicomponent intervention including physical activity monitoring, nutrition management, information and communications technology use and a relatively simple healthy aging lifestyle education program based on a series of workshops. Our sample includes 1,519 male and female participants from 11 European countries aged 70 years or older. Our econometric model explores trends in several outcomes depending on intervention receipt and frailty status at baseline. ResultsImplementing a multicomponent intervention among frail older people does not lead to a lower use of care and do not prevent quality of life losses associated with aging. However, it impacts older people's sense of priorities and interest in the future. We find no statistically significant differences between the two interventions, suggesting that the implementation of a multicomponent intervention may not be the most efficient strategy. The impact of the interventions does not differ by frailty status at baseline. ConclusionsOur results show the need to implement healthy aging strategies that are more focused on people's interests.

Physical activity monitoring in Alzheimer's disease during sport interventions: a multi-methodological perspective.

Assessment methods for physical activity and fitness are of upmost importance due to the possible beneficial effect of physical conditioning on neurodegenerative diseases. The implementation of these methods can be challenging when examining elderly or cognitively impaired participants. In the presented study, we compared three different assessment methods for physical activity from the Dementia-MOVE trial, a 6-months intervention study on physical activity in Alzheimer's disease. The aim was to determine the comparability of physical activity assessments in elderly participants with cognitive impairment due to Alzheimer's disease. 38 participants (mean age 70 ± 7 years) with early-stage Alzheimer's disease (mean MoCA 18.84 ± 4.87) were assessed with (1) fitness trackers for an average of 12 (± 6) days, (2) a written diary on daily activities and (3) a questionnaire on physical activity at three intervention timepoints. For comparison purposes, we present a transformation and harmonization method of the physical assessment output parameters: Metabolic equivalent of task (MET) scores, activity intensity minutes, calorie expenditure and moderate-to-vigorous physical activity (MVPA) scores were derived from all three modalities. The resulting parameters were compared for absolute differences, correlation, and their influence by possible mediating factors such as cognitive state and markers from cerebrospinal fluid. Participants showed high acceptance and compliance to all three assessment methods. MET scores and MVPA from fitness trackers and diaries showed high overlap, whilst results from the questionnaire suggest that participants tended to overestimate their physical activity in the long-term retrospective assessment. All activity parameters were independent of the tested Alzheimer's disease parameters, showing that not only fitness trackers, but also diaries can be successfully applied for physical activity assessment in a sample affected by early-stage Alzheimer's disease. Our results show that fitness trackers and physical activity diaries have the highest robustness, leading to a highly comparable estimation of physical activity in people with Alzheimer's disease. As assessed parameters, it is recommendable to focus on MET, MVPA and on accelerometric sensor data such as step count, and less on activity calories and different activity intensities which are dependent on different variables and point to a lower reliability.

Updating national physical activity guidelines based on the global WHO guidelines: experiences and challenges from Switzerland

Physical activity guidelines are recognized as an important element of a national approach to promote physical activity. This publication summarizes the approach and process taken to update the Swiss Guidelines, presents a summary of the updated guidelines and discusses experiences and identifies challenges. The multistage project involved: 1) to summarize the scientific evidence underpinning the 2020-edition of the WHO guidelines; 2) to systematically analyze the existing Swiss guidelines for different target groups and to develop proposals for updates 3) a participatory process to gain consensus with the main interested groups 4) to finalize the guidelines. Updated guidelines were adopted for infants, pre-school children, children and young people, adults, older adults and pregnant and postpartum women, in most cases following the WHO guidelines. Children, young people and adults living with disability and adults and older adults with chronic conditions are specifically addressed in each of the general guidelines for healthy populations, rather than developing separate guidelines for each of these groups as done by the WHO. The systematic approach in identifying aspects to update, the participatory approach and a scientific consortium and project coordination group with different thematic backgrounds were key strengths in the process. Challenges included the large amount of feedback and finding scientifically sound compromises. The updated versions of the Swiss national guidelines provide an excellent basis to further promote physical activity in Switzerland. A remaining key task is to develop a range of communication tools and materials for different target groups beyond the circle of experts and interested groups, considering available evidence on optimal messaging and best outlet tools and channels. To track population prevalence, inform policy and evaluate physical activity promotion at national and sub-national level in a timely fashion, strengthening existing physical activity monitoring will be important.

Implementing Remote Patient Monitoring of Physical Activity in Clinical Practice.

Remote patient monitoring (RPM) is a tool for patients to share data collected outside of office visits. RPM uses technology and the digital transmission of data to inform clinician decision-making in patient care. Using RPM to track routine physical activity is feasible to operationalize, given contemporary consumer-grade devices that can sync to the electronic health record. Objective monitoring through RPM can be more reliable than patient self-reporting for physical activity. This article reports on four pilot studies that highlight the utility and practicality of RPM for physical activity monitoring in outpatient clinical care. Settings include endocrinology, cardiology, neurology, and pulmonology settings. The four pilot use cases discussed demonstrate how RPM is utilized to monitor physical activity, a shift that has broad implications for prediction, prevention, diagnosis, and management of chronic disease and rehabilitation progress. If RPM for physical activity is to be expanded, it will be important to consider that certain populations may face challenges when accessing digital health services. RPM technology provides an opportunity for clinicians to obtain objective feedback for monitoring progress of patients in rehabilitation settings. Nurses working in rehabilitation settings may need to provide additional patient education and support to improve uptake.

Examination of Physical Activity Patterns of Children, Reliability and Structural Validity Testing of the Hungarian Version of the PAQ-C Questionnaire.

Several studies report on the importance of physical activity (PA) in childhood, which influences attitudes towards health in adulthood. For monitoring PA, trustworthy measurement tools are needed. The study aimed to adapt the Physical Activity Questionnaire for Children (PAQ-C) to the Hungarian language and assess its validity, reliability, and factor structure. A total of 620 children (the average age was 10.62 (SD 2.36)) participated in the cross-sectional study. To assess physical activity, the PAQ-C questionnaire was used. The collected data were analysed using IBM SPSS version 28.0 and IBM SPSS AMOS 29.0 software. The internal consistency was acceptable (alpha = 0.729) and the test-retest reliability showed acceptable agreement (ICC = 0.772). The confirmatory factor favoured a one-factor structure of the questionnaire. The average PAQ-C score for girls was 2.87 (SD 1.07), and for boys it was 3.00 (SD 1.05), which showed a significant difference (p = 0.005). Based on our findings, our study tested the validity and reliability of the one-factor PAQ-C questionnaire, a valid and reliable measurement tool to test the physical activity patterns of primary school children in a Hungarian sample. Further research is needed to develop physical activity monitoring of Hungarian children.

Usability and ease of use of long-term remote monitoring of physical activity for individuals with acquired brain injury in community: a qualitative analysis.

Objective and continuous monitoring of physical activity over the long-term in the community is perhaps the most important step in the paradigm shift toward evidence-based practice and personalized therapy for successful community integration. With the advancement in technology, physical activity monitors have become the go-to tools for objective and continuous monitoring of everyday physical activity in the community. While these devices are widely used in many patient populations, their use in individuals with acquired brain injury is slowly gaining traction. The first step before using activity monitors in this population is to understand the patient perspective on usability and ease of use of physical activity monitors at different wear locations. However, there are no studies that have looked at the feasibility and patient perspectives on long-term utilization of activity monitors in individuals with acquired brain injury. This pilot study aims to fill this gap and understand patient-reported aspects of the feasibility of using physical activity monitors for long-term use in community-dwelling individuals with acquired brain injury. This pilot study found that patients with acquired brain injury faced challenges specific to their functional limitations and that the activity monitors worn on the waist or wrist may be better suited in this population. The unique wear location-specific challenges faced by individuals with ABI need to be taken into account when selecting wearable activity monitors for long term use in this population.

Effects of targeted clinical examination based on alerts from automated health monitoring systems on herd health and performance of lactating dairy cows

Our objectives were to compare the proportion of lactating dairy cows diagnosed with health disorders (HD) and herd performance when using a health monitoring program designed to rely primarily but not exclusively on alerts from automated health monitoring (AHM) systems or a health monitoring program based primarily on systematic clinical examinations, milk yield monitoring, and visual observation of cows. In a clinical trial, at ∼30 d before expected parturition, nulliparous and parous Holstein cows, stratified by parity and days in gestation, were randomly assigned to the high-intensity clinical monitoring (HIC-M; n = 625) or automated monitoring (AUT-M; n = 624) treatment. Cows were fitted with a neck-attached rumination and physical activity monitoring tag, and individual daily milk yield data were collected from parlor milk meters. For cows in HIC-M, clinical examination was conducted daily until 10 d in milk (DIM) and then in response to milk yield reduction alerts or visual observation of clinical signs of HD over the course of 21 DIM. For cows in AUT-M, clinical examination until 21 DIM was because of health index (HI) score alerts and reduced milk yield alerts. The HI score alerts used were generated based on the manufacturer's settings for the system for the last 2-h period before cows were selected for examination. Visual observation of clinical signs of HD was used for identifying cows potentially missed by automated alerts. Binomial and quantitative data were analyzed by logistic regression and ANOVA with repeated measures, respectively. The percentage of cows diagnosed with at least 1 HD during the experimental treatments risk period tended to be greater and the incidence rate ratio of HD diagnosed was greater in the HIC-M than in the AUT-M treatment. We found no difference between treatments for cows that exited the herd up to 60 or 150 DIM, but more cows tended to exit the herd from 61 to 150 DIM in the HIC-M than in the AUT-M treatment. No differences were detectable between treatments in daily or total milk yield to 21 DIM or in weekly mean milk yield and total milk yield to 150 DIM. More cows were inseminated in estrus for first service if in the HIC-M treatment and had no HD diagnosed than if in the HIC-M treatment but with HD diagnosed, or in the AUT-M treatment and had no HD diagnosed. Cows in the AUT-M treatment with HD diagnosed did not differ from other groups. No differences between treatments were observed in pregnancies per artificial insemination or pregnancy loss for first service. Despite a reduction in the risk of diagnosis of HD, no evidence indicated that a health monitoring program that relied on AHM system alerts to select cows for clinical examination reduced herd performance compared with a more intensive program that included systematic clinical examinations of all cows for the first 10 DIM, reduced milk yield alerts, and visual observation. However, to obtain the same herd performance as with the HIC-M treatment, the AUT-M treatment required use of visual observation. In conclusion, a health monitoring program designed to rely primarily on targeted clinical examination based on alerts from automated health monitoring systems might be a feasible alternative to programs that rely more on clinical examination, provided that visual observation is used to identify cows not detected by automated alerts.

Investigation of physical playfulness in physiotherapy students

BackgroundPhysiotherapists show a positive attitude towards playing games in order to be a role model for pediatric patients and to increase the success of therapy. The aim of the present study is to investigate the physical playfulness of physiotherapy students and the relationship of physical playfulness and individual and environmental factors.MethodsThe sociodemographic data, regular physical activity habits of the students were examined as well as their computer game playing status and duration. “Attitudes of 18–22 Age Adults for Playing Games That Contain Physical Activity” scale was used for assessing playfulness.ResultsA total of 268 students participated in the study. Among the game proneness scale subsections, the highest score was obtained in the Social Adjustment while the lowest scores were obtained in the “Desire to Play Game” and “To take pleasure from playing game” subsections. Male students scored higher in “Risk Taking and “To take pleasure from playing game” in comparison with the female students. There was a statistically significant difference between physical activity habits and “Game Compassion”, “Risk Taking”, “Social Adjustment” and “To take pleasure from playing game scores”.ConclusionPhysiotherapy students were found to be more playful, particularly in terms of social adaptation. Men take more risks in the plays and also play the games more enjoyable. Students with regular physical activity habits were more playful overall. The present study suggests that monitoring physical activity levels, computer games types might be beneficial for evaluating the playfulness.

Ecological monitoring of physical activity, emotions and daily life activities in schizophrenia: the DiAPAson study

BackgroundSchizophrenia spectrum disorders (SSD) compromise psychosocial functioning, including daily time use, emotional expression and physical activity (PA).ObjectiveWe performed a cohort study aimed at investigating: (1) the differences in PA, daily...

Operando monitoring of thermal runaway in commercial lithium-ion cells via advanced lab-on-fiber technologies

Operando monitoring of complex physical and chemical activities inside rechargeable lithium-ion batteries during thermal runaway is critical to understanding thermal runaway mechanisms and giving early warning of safety-related failure. However, most existing sensors cannot survive during such extremely hazardous thermal runaway processes (temperature up to 500 °C accompanied by fire and explosion). To address this, we develop a compact and multifunctional optical fiber sensor (12 mm in length and 125 µm in diameter) capable of insertion into commercial 18650 cells to continuously monitor internal temperature and pressure effects during cell thermal runaway. We observe a stable and reproducible correlation between the cell thermal runaway and the optical response. The sensor’s signal shows two internal pressure peaks corresponding to safety venting and initiation of thermal runaway. Further analysis reveals that a scalable solution for predicting imminent thermal runaway is the detection of the abrupt turning range of the differential curves of cell temperature and pressure, which corresponds to an internal transformation between the cell reversible and irreversible reactions. By raising an alert even before safety venting, this new operando measurement tool can provide crucial capabilities in cell safety assessment and warning of thermal runaway.

Development and validation of a sleep questionnaire, SNoRE 3.0, to evaluate sleep in companion dogs

Disturbances in the sleep–wake cycle are a debilitating, yet rather common condition not only in humans, but also in family dogs. While there is an emerging need for easy-to-use tools to document sleep alterations (in order to ultimately treat and/or prevent them), the veterinary tools which yield objective data (e.g. polysomnography, activity monitors) are both labor intensive and expensive. In this study, we developed a modified version of a previously used sleep questionnaire (SNoRE) and determined criterion validity in companion dogs against polysomnography and physical activity monitors (PAMs). Since a negative correlation between sleep time and cognitive performance in senior dogs has been demonstrated, we evaluated the correlation between the SNoRE scores and the Canine Dementia Scale (CADES, which includes a factor concerning sleep). There was a significant correlation between SNoRE 3.0 questionnaire scores and polysomnography data (latency to NREM sleep, ρ = 0.507, p < 0.001) as well as PAMs’ data (activity between 1:00 and 3:00 AM, p < 0.05). There was a moderate positive correlation between the SNoRE 3.0 scores and the CADES scores (ρ = 0.625, p < 0.001). Additionally, the questionnaire structure was validated by a confirmatory factor analysis, and it also showed an adequate test–retest reliability. In conclusion the present paper describes a valid and reliable questionnaire tool, that can be used as a cost-effective way to monitor dog sleep in clinical settings.

Enhancing Health Monitoring and Active Aging in the Elderly Population: A Study on Wearable Technology and Technology-Assisted Care

The constant monitoring of human physical activity, behaviour, and physiological signs has undergone a revolution thanks to wearable technology, which has provided invaluable insights into many facets of everyday life. Wearable technology has become a potent instrument for improving healthcare efficiency and lowering costs as the prevalence of an ageing population and the need for technology-assisted care increase. By analysing gait patterns and promoting a healthy lifestyle in age-friendly settings, this study aims to investigate how valid and trustworthy wearable devices, in conjunction with technology-assisted care, can facilitate the monitoring and improvement of the health of the elderly population. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 standards for data inclusion and exclusion are used in the study, which collects data from the Scopus database. The results show that wearable technology, which offers two main device categories—those intended for healthcare professionals and those aimed at consumers—plays a critical role in gait-pattern analysis. These gadgets offer robust data-collecting capabilities, allowing for precise evaluation and tracking of walking habits. Furthermore, the incorporation of wearable technology with eHealth solutions enhances the quality of life for the aged population by enabling them to live in settings that are age-friendly and successfully manage their health. The study also emphasises how critical it is to use reliable wearable technology to address the diversity of health issues and the occurrence of chronic diseases among the senior population. According to the study’s findings, wearable technologies have great promise for promoting the health and well-being of senior citizens. To meet the unique requirements and problems of the ageing population and to guarantee the successful integration of wearable devices into healthcare practices, more research and development are needed. In the end, wearable technology has enormous potential to revolutionise aged care and enhance health outcomes in ageing-friendly settings.

Reliability and validity of the Turkish version of the pregnancy exercise self-efficacy scale

ObjectiveThe aim of this study was to adapt the Pregnancy Exercise Self-Efficacy Scale (P-ESES) into Turkish, investigate its reliability and validity in Turkish pregnant women, and obtain a validated tool in order to assess the exercise self-efficacy during pregnancy. MethodsA total of 138 pregnant women participated in the present study. For the translation of the P-ESES into Turkish (P-ESES-T), a six-phase process was followed. The psychometric properties of the P-ESES-T were analyzed in respect of internal consistency, test–retest reliability, and criterion validity. To assess the validity of the P-ESES-T, the associations between the P-SES-T and the Pregnancy Physical Activity Questionnaire (PPAQ), the Sensewear Pro3 Armband (n = 31), and the Exercise Barries/Benefits Scale (EBBS) were analyzed. ResultsTest-retest reliability for the P-ESES-T total score was found to be very strong (ICCs: 0.986, p < 0.001). Cronbach’s α coefficient was 0.899. There were strong correlations between the total scores of the P-ESES-T and PPAQ, and EBBS (r = 0.780, r = 0.874; p < 0.001). However, no significant correlations were found between the total number of steps and energy expenditure obtained from the physical activity monitor and the P-ESES-T (p > 0.05). ConclusionThe P-ESES-T is a reliable and valid tool that can be used to evaluate exercise self-efficacy, which is an important factor that affects exercise participation during pregnancy.

Quantification of Non-Motor Symptoms in Parkinsonian Cynomolgus Monkeys.

Parkinson's disease (PD) is a neurodegenerative disorder that features motor and non-motor deficits. The use of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced dopamine neuron degeneration has been widely practiced to produce reliable animal models of PD. However, most previous preclinical studies focused on motor dysfunction, and few non-motor symptoms were evaluated. Thus far, there is a lack of comprehensive investigations of the non-motor symptoms in animal models. In this study, we aim to use a battery of behavioral methods to evaluate non-motor symptoms in MPTP-induced non-human primate PD models. Cognitive function, sleep, and psychiatric behaviors were evaluated in MPTP-treated cynomolgus monkeys. The tests consisted of a delayed matching-to-sample (DMTS) task, the use of a physical activity monitor (PAM), an apathy feeding task (AFT), the human intruder test (HIT), novel fruit test (NFT), and predator confrontation test (PCT). In addition, we tested whether the dopamine receptor agonist pramipexole (PPX) can improve these non-motor symptoms. The present results show that the MPTP-treated monkeys exhibited cognitive deficits, abnormal sleep, and anxiety-like behaviors when compared to the control monkeys. These symptoms were relieved partially by PPX. These results suggest that MPTP-induced PD monkeys displayed non-motor symptoms that were similar to those found in PD patients. PPX treatment showed moderate therapeutic effects on these non-motor symptoms. This battery of behavioral tests may provide a valuable model for future preclinical research.

Effects of a Multicomponent Exercise and Therapeutic Lifestyle (CERgAS) Intervention on Gait Function in Lower-Income Urban-Dwelling Older Adults: A Cluster Randomized Controlled Trial.

This study aims to determine the effectiveness of a multicomponent exercise and therapeutic lifestyle (CERgAS) intervention at improving gait speed among older people in an urban poor setting in Malaysia. A total of 249 participants were divided into the intervention (n = 163) and control (n = 86) groups. The mean (SD) age of participants was 67.83 (6.37) and consisted of 88 (35.3%) males and 161 (64.7%) females. A generalized estimating equation with an intention-to-treat analysis was used to measure gait speed at four time points, baseline (T0), 6weeks (T1), 3months postintervention (T2), and 6months postintervention (T3). The results showed significant changes for time between T0 and T3 (mean difference = 0.0882, p = .001), whereas no significant association were found for group (p = .650) and interaction (p = .348) effects. A 6-week intervention is inadequate to improve gait speed. Future efforts should introduce physical activity monitoring and increase exercise duration, frequency, and intensity.

IoT-Integrated System for Continuous Assessment of Elementary School Martial Arts Education with Automated Classifier

The IoT system would facilitate the continuous assessment of students' martial arts development by tracking their progress over time. The integration of Internet of Things (IoT) technology in elementary school martial arts education has the potential to revolutionize the learning experience and promote holistic development. This paper proposed an IoT-integrated system for the assessment of elementary school martial arts education. The proposed architecture incorporates an Automated Ranking Parallel Classifier (ARPC) model. The proposed ARPC system incorporates physical health monitoring and assessment, providing real-time data on students' physical activity, heart rate, and other relevant health metrics. The IoT system enables continuous monitoring of students' physical activity, allowing instructors to track their progress, level of engagement, and effort. the system monitors students' physical health parameters, such as heart rate, respiration rate, and sleep patterns, enabling early detection of health issues and supporting overall well-being. The ARPC model comprises the ranking of the features in the IoT data with parallel data processing. With ARPC the activities of the students are monitored and martial arts education in elementary schools is examined. Simulation analysis stated that the ARPC model achieves a higher classification accuracy of 99.73% compared with the conventional state-of-art techniques.