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DiVito D, Wellik A, Burfield J, Peterson J, Flickinger J, Tindall A, Albanowski K, Vishnubhatt S, MacMullen L, Martin I, Muraresku C, McCormick E, George-Sankoh I, McCormack S, Goldstein A, Ganetzky R, Yudkoff M, Xiao R, Falk MJ, R Mascarenhas M, Zolkipli-Cunningham Z. Optimized Nutrition in Mitochondrial Disease Correlates to Improved Muscle Fatigue, Strength, and Quality of Life. Neurotherapeutics 2023; 20:1723-1745. [PMID: 37723406 PMCID: PMC10684455 DOI: 10.1007/s13311-023-01418-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 09/20/2023] Open
Abstract
We sought to prospectively characterize the nutritional status of adults ≥ 19 years (n = 22, 27% males) and children (n = 38, 61% male) with genetically-confirmed primary mitochondrial disease (PMD) to guide development of precision nutritional support strategies to be tested in future clinical trials. We excluded subjects who were exclusively tube-fed. Daily caloric requirements were estimated using World Health Organization (WHO) equations to predict resting energy expenditure (REE) multiplied by an activity factor (AF) based on individual activity levels. We developed a Mitochondrial Disease Activity Factors (MOTIVATOR) score to encompass the impact of muscle fatigue typical of PMD on physical activity levels. PMD cohort daily diet intake was estimated to be 1,143 ± 104.1 kcal in adults (mean ± SEM, 76.2% of WHO-MOTIVATOR predicted requirement), and 1,114 ± 62.3 kcal in children (86.4% predicted). A total of 11/22 (50%) adults and 18/38 (47.4%) children with PMD consumed ≤ 75% predicted daily Kcal needs. Malnutrition was identified in 16/60 (26.7%) PMD subjects. Increased protein and fat intake correlated with improved muscle strength in those with insufficient daily Kcal intake (≤ 75% predicted); higher protein and fat intake correlated with decreased muscle fatigue; and higher protein, fat, and carbohydrate intake correlated with improved quality of life (QoL). These data demonstrate the frequent occurrence of malnutrition in PMD and emphasize the critical need to devise nutritional interventions to optimize clinical outcomes.
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Affiliation(s)
- Donna DiVito
- Clinical Nutrition Department, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Amanda Wellik
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jessica Burfield
- Clinical Nutrition Department, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - James Peterson
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jean Flickinger
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Alyssa Tindall
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kimberly Albanowski
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shailee Vishnubhatt
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Laura MacMullen
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Isaac Martin
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Colleen Muraresku
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Elizabeth McCormick
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ibrahim George-Sankoh
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shana McCormack
- Division of Endocrinology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Amy Goldstein
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rebecca Ganetzky
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Marc Yudkoff
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Rui Xiao
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Marni J Falk
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Maria R Mascarenhas
- Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Zarazuela Zolkipli-Cunningham
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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Fainardi V, Capoferri G, Tornesello M, Pisi G, Esposito S. Telemedicine and Its Application in Cystic Fibrosis. J Pers Med 2023; 13:1041. [PMID: 37511654 PMCID: PMC10381340 DOI: 10.3390/jpm13071041] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/18/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
The care of cystic fibrosis (CF) traditionally consists of regular visits to the clinic where a multidisciplinary team can visit the patient, adjust treatments and monitor the disease. During the COVID-19 pandemic when access to hospitals and medical environments was very limited, the role of telemedicine was crucial to keep in touch with patients with chronic diseases such as CF. Increasing evidence demonstrates that electronic health can successfully support healthcare professionals in the management of people with CF. The use of devices connected to digital platforms or smartphones results in a continuous flow of data that can be shared with the clinician and the team in order to improve the knowledge of patients' diseases and the level of care needed. This narrative review aims to describe the application of telemedicine in CF disease with pros and cons. A literature analysis showed that telemedicine has several advantages in the management of patients with CF. With the evolving support of digital technology, telemedicine can promote clinical visits, adherence to daily treatment, including respiratory physiotherapy and physical exercise, early identification of pulmonary exacerbations and management of psychological issues. The main disadvantages are missed physical exam findings, lack of physical contact that can prevent conversation on sensitive topics, lack of access to technology and lack of technological skills. Furthermore, healthcare operators need appropriate training for telemedicine systems and need time to organise and analyse data generated remotely, which may increase the burden of daily work. Hybrid personalised care models that marge telemedicine and traditional care can be an ideal solution.
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Affiliation(s)
- Valentina Fainardi
- Cystic Fibrosis Unit, Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Gaia Capoferri
- Cystic Fibrosis Unit, Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Marco Tornesello
- Cystic Fibrosis Unit, Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Giovanna Pisi
- Cystic Fibrosis Unit, Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Susanna Esposito
- Cystic Fibrosis Unit, Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
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Corda J, E Holland A, Berry CD, Westrupp N, Cox NS. Validation of the 25 level modified shuttle test in children with cystic fibrosis. Pediatr Pulmonol 2023. [PMID: 37144876 DOI: 10.1002/ppul.26452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/19/2023] [Accepted: 04/23/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVE To evaluate the validity and reliability of the modified shuttle 25-level test (MST-25) in children with cystic fibrosis (CF). METHODS A prospective single center study in clinically stable children with CF. Participants undertook two testing conditions on different days: (1) 2xMST-25 tests; (2) cardiopulmonary exercise test (CPET). Test order was randomized. Nadir oxygen saturation (SpO2 ), peak heart rate (HR), breathlessness (modified Borg), rate of perceived exertion (RPE), energy expenditure (EE) and metabolic equivalents (MET) from the MST-25 and CPET were compared to assess validity, while outcomes from 2xMST-25 tests were compared for reliability. CPET was performed using breath-by-breath analysis and EE from the MST-25 obtained using the SenseWear Armband. RESULTS Strong correlations were found between MST-25 distance and peak oxygen uptake, peak work and minute ventilation on CPET (all r > 0.7, p < 0.01). Moderate correlations were found between MST-25 distance and CPET for METs (r = 0.5) and HR (r = 0.6). Weak associations between tests were evident for nadir SpO2 (r = 0.1), modified Borg (rs = 0.2) and RPE (rs = 0.2). Test-retest reliability was excellent for MST-25 distance (ICC 0.91), peak EE (ICC 0.99) and peak METs (ICC 0.90). Good reliability was achieved for HR (ICC 0.84) and modified Borg score (ICC 0.77), while moderate reliability for nadir SpO2 (ICC 0.64) and RPE (ICC 0.68) was observed. CONCLUSION The MST-25 is a valid and reliable field test for the assessment of exercise capacity in children with CF. The MST-25 can be used to accurately monitor exercise capacity and prescribe exercise training, particularly when CPET is not available.
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Affiliation(s)
- Jennifer Corda
- Department of Physiotherapy, Royal Children's Hospital, Melbourne, Australia
- Department of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Anne E Holland
- Respiratory Research@Alfred, Monash University, Melbourne, Australia
- Institute for Breathing and Sleep, Melbourne, Australia
- Department of Physiotherapy, Alfred Health, Melbourne, Australia
| | - Cassidy Du Berry
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia
- Infection and Immunity group, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Nicole Westrupp
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia
- Infection and Immunity group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Narelle S Cox
- Respiratory Research@Alfred, Monash University, Melbourne, Australia
- Institute for Breathing and Sleep, Melbourne, Australia
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Zhu A, Berends JE, Daignault-Newton S, Kaye DR, Parker C, IglayReger H, Morgan TM, Weizer AZ, Kaffenberger SD, Herrel LA, Hafez K, Skolarus TA, Montgomery JS. Use of a physical activity monitor to track perioperative activity of radical cystectomy patients our first glimpse at what our patients are doing before and after surgery. Urol Oncol 2023; 41:206.e11-206.e19. [PMID: 36842878 DOI: 10.1016/j.urolonc.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/26/2023]
Abstract
PURPOSE To optimize recovery after radical cystectomy (RC), providers stress the importance of ambulation and adequate rest. However, little is known about the activity and sleep habits of patients undergoing RC. Therefore, we utilized a wearable physical activity monitor (PAM) in the perioperative period to provide the first objective data on physical activity and sleep habits for RC patients. MATERIALS AND METHODS We prospectively identified patients ≥60 years old with planned RC. Participants completed a 4-week prehabilitation exercise program prior to surgery. They wore a PAM for 7-day intervals: at baseline, after prehabilitation, at postoperative day (POD) 30 and POD90. We tracked physical activity via metabolic equivalents (METs). METs were categorized by intensity: light (MET 1.5-<3), moderate (MET 3-<6), and vigorous (MET ≥6). We calculated daily step totals. We tracked hours slept and number of sleep awakenings. We correlated activity and sleep with self-reported quality of life (QOL). RESULTS Forty-two patients completed prehabilitation and RC. Moderate intensity exercise decreased at POD30 (61 minutes/d at baseline, 30 minutes/d at POD30, P = 0.005). Physical activity did not significantly differ for light or vigorous activity at any timepoint. RC did not significantly affect sleep. Sleep and physical activity were associated with mental and physical QOL, respectively. CONCLUSIONS This is the first study utilizing patient-worn monitors in RC to track physical activity and sleep. This study gives patients and providers a better understanding of postcystectomy recovery expectations. With these results in mind, interventions may be implemented to optimize activity and sleep in the perioperative period.
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Affiliation(s)
- Alex Zhu
- Department of Urology, Michigan Medicine, Ann Arbor, MI
| | | | | | - Deborah R Kaye
- Division of Urology, Department of Surgery, Duke University, Durham, NC
| | - Chrissy Parker
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI
| | - Heidi IglayReger
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI
| | - Todd M Morgan
- Department of Urology, Michigan Medicine, Ann Arbor, MI
| | - Alon Z Weizer
- Department of Urology, Michigan Medicine, Ann Arbor, MI
| | | | | | - Khaled Hafez
- Department of Urology, Michigan Medicine, Ann Arbor, MI
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Leone A, Rescio G, Diraco G, Manni A, Siciliano P, Caroppo A. Ambient and Wearable Sensor Technologies for Energy Expenditure Quantification of Ageing Adults. SENSORS 2022; 22:s22134893. [PMID: 35808387 PMCID: PMC9269397 DOI: 10.3390/s22134893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/23/2022] [Accepted: 06/26/2022] [Indexed: 12/10/2022]
Abstract
COVID-19 has affected daily life in unprecedented ways, with dramatic changes in mental health, sleep time and level of physical activity. These changes have been especially relevant in the elderly population, with important health-related consequences. In this work, two different sensor technologies were used to quantify the energy expenditure of ageing adults. To this end, a technological platform based on Raspberry Pi 4, as an elaboration unit, was designed and implemented. It integrates an ambient sensor node, a wearable sensor node and a coordinator node that uses the information provided by the two sensor technologies in a combined manner. Ambient and wearable sensors are used for the real-time recognition of four human postures (standing, sitting, bending and lying down), walking activity and for energy expenditure quantification. An important first aim of this work was to realize a platform with a high level of user acceptability. In fact, through the use of two unobtrusive sensors and a low-cost processing unit, the solution is easily accessible and usable in the domestic environment; moreover, it is versatile since it can be used by end-users who accept being monitored by a specific sensor. Another added value of the platform is the ability to abstract from sensing technologies, as the use of human posture and walking activity for energy expenditure quantification enables the integration of a wide set of devices, provided that they can reproduce the same set of features. The obtained results showed the ability of the proposed platform to automatically quantify energy expenditure, both with each sensing technology and with the combined version. Specifically, for posture and walking activity classification, an average accuracy of 93.8% and 93.3% was obtained, respectively, with the wearable and ambient sensor, whereas an improvement of approximately 4% was reached using data fusion. Consequently, the estimated energy expenditure quantification always had a relative error of less than 3.2% for each end-user involved in the experimentation stage, classifying the high level information (postures and walking activities) with the combined version of the platform, justifying the proposed overall architecture from a hardware and software point of view.
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Anifanti M, Giannakoulakos S, Hatziagorou E, Kampouras A, Tsanakas J, Deligiannis A, Kouidi E. Effects of a Long-Term Wearable Activity Tracker-Based Exercise Intervention on Cardiac Morphology and Function of Patients with Cystic Fibrosis. SENSORS (BASEL, SWITZERLAND) 2022; 22:4884. [PMID: 35808375 PMCID: PMC9269327 DOI: 10.3390/s22134884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/21/2022] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
Several studies have shown that patients with cystic fibrosis (CF), even at a young age, have pulmonary and cardiac abnormalities. The main complications are cardiac right ventricular (RV) systolic and/or diastolic dysfunction and pulmonary hypertension, which affects their prognosis. Exercise training (ET) is recommended in patients with CF as a therapeutic modality to improve physical fitness and health-related quality of life. However, questions remain regarding its optimal effective and safe dose and its effects on the patients’ cardiac function. The study aimed to provide a wearable activity tracker (WAT)-based ET to promote physical activity in CF patients and assess its effects on cardiac morphology and function. Forty-two stable CF individuals (aged 16.8 ± 3.6 years) were randomly assigned to either the intervention (Group A) or the control group (Group B). Group A participated in a 1-year WAT-based ET program three times per week. All patients underwent a 6-min walking test (6-MWT) and an echocardiographic assessment focused mainly on RV anatomy and function at the baseline and the end of the study. RV systolic function was evaluated by measuring the tricuspid annular plane systolic excursion (TAPSE), the systolic tricuspid annular velocity (TVS’), the RV free-wall longitudinal strain (RVFWSL), and the right ventricular four-chamber longitudinal strain (RV4CSL). RV diastolic function was assessed using early (TVE) and late (TVA) diastolic transtricuspid flow velocity and their ratio TVE/A. Pulmonary artery systolic pressure (PASP) was also estimated. In Group A after ET, the 6MWT distance improved by 20.6% (p < 0.05), TVA decreased by 17% (p < 0.05), and TVE/A increased by 13.2% (p < 0.05). Moreover, TAPSE, TVS’, RVFWSL, and RV4CSL increased by 8.3% (p < 0.05), 9.0% (p < 0.05), 13.7% (p < 0.05), and 26.7% (p < 0.05), respectively, while PASP decreased by 7.6% (p < 0.05). At the end of the study, there was a significant linear correlation between the number of steps and the PASP (r = −0.727, p < 0.01) as well as the indices of RV systolic function in Group A. In conclusion, WAT is a valuable tool for implementing an effective ET program in CF. Furthermore, ET has a positive effect on RV systolic and diastolic function.
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Affiliation(s)
- Maria Anifanti
- Laboratory of Sports Medicine, Aristotle University of Thessaloniki, 57001 Thermi, Greece; (M.A.); (S.G.); (A.D.)
| | - Stavros Giannakoulakos
- Laboratory of Sports Medicine, Aristotle University of Thessaloniki, 57001 Thermi, Greece; (M.A.); (S.G.); (A.D.)
| | - Elpis Hatziagorou
- Pediatric Pulmonology and Cystic Fibrosis Unit, Hippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (E.H.); (A.K.); (J.T.)
| | - Asterios Kampouras
- Pediatric Pulmonology and Cystic Fibrosis Unit, Hippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (E.H.); (A.K.); (J.T.)
| | - John Tsanakas
- Pediatric Pulmonology and Cystic Fibrosis Unit, Hippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (E.H.); (A.K.); (J.T.)
| | - Asterios Deligiannis
- Laboratory of Sports Medicine, Aristotle University of Thessaloniki, 57001 Thermi, Greece; (M.A.); (S.G.); (A.D.)
| | - Evangelia Kouidi
- Laboratory of Sports Medicine, Aristotle University of Thessaloniki, 57001 Thermi, Greece; (M.A.); (S.G.); (A.D.)
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Curran M, Tierney A, Collins L, Kennedy L, McDonnell C, Sheikhi A, Walsh C, Casserly B, Cahalan R. Accuracy of the ActivPAL and Fitbit Charge 2 in measuring step count in Cystic Fibrosis. Physiother Theory Pract 2021; 38:2962-2972. [PMID: 34369283 DOI: 10.1080/09593985.2021.1962463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Physical activity (PA) is important in Cystic Fibrosis (CF) management. Fitness wearables are becoming increasingly popular as measurement tools of PA; however, the accuracy of these devices should first be evaluated. OBJECTIVE The purpose of this study was to assess the accuracy of the ActivPAL and Fitbit Charge 2 as a measure of step count in Cystic Fibrosis. METHODS Twenty-one participants were recruited from an adult CF Center in Ireland for a single session of testing. Participants walked for 5 min at five pre-determined speeds in a controlled testing environment (2, 2.5, 3, 3.5 and 4 miles per hour on a treadmill) and at three self-selected speeds in a corridor (slow, medium, and fast). They concurrently wore an accelerometer (ActivPAL) and fitness wearable (Fitbit Charge 2), and both were compared to visual observations. Step count is the outcome being assessed. RESULTS The ActivPAL under-estimated step count by 0.63% across treadmill speeds and 1.1% across self-selected walking speeds. The Fitbit Charge 2 underestimated the step count by 2.97% across treadmill speeds and by 6.3% across self-selected walking speeds. Very strong correlations were found between the ActivPAL and visual observations (r: 0.93 to 0.99), while the Fitbit Charge 2 ranged from weak to very strong correlations when compared to visual observations (r: 0.34 to 0.84). CONCLUSION The ActivPAL and Fitbit Charge 2 demonstrated acceptable validity for step count measurement in CF. These devices can be used for tracking PA during interventions in people with CF.
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Affiliation(s)
- Maire Curran
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.,University Hospital Limerick. Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Audrey Tierney
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland.,Health Implementation Science and Technology Research Group, Health Research Institute, University of Limerick, Limerick, Ireland.,Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
| | | | | | | | - Ali Sheikhi
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Cathal Walsh
- Health Research Institute, University of Limerick, Limerick, Ireland
| | | | - Roisin Cahalan
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland.,Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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Curran M, Tierney AC, Collins L, Kennedy L, McDonnell C, Jurascheck AJ, Sheikhi A, Walsh C, Button B, Galvin R, Casserly B, Cahalan R. Steps Ahead: optimising physical activity in adults with cystic fibrosis: Study Protocol for a pilot randomised trial using wearable technology, goal setting and text message feedback. HRB Open Res 2020; 3:21. [PMID: 33283151 PMCID: PMC7689601 DOI: 10.12688/hrbopenres.13025.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Physical activity (PA) and exercise are widely documented as key components in the management of cystic fibrosis (CF). In recent years there have been significant improvements in telehealth, in particular; wearable technology, smartphone use and remote monitoring, all of which may have potential to impact on PA in adults with CF. The objective of this pilot randomised trial is to explore the effect of wearable technology, which is remotely monitored, combined with personalised text message feedback and goal setting, on PA in adults with CF. Secondary endpoints include lung function, aerobic capacity, quality of life, body composition, wellbeing and sleep. Methods: This is a pilot randomised trial which will be conducted at the University Hospital Limerick, Ireland. Participants will be randomised to the intervention or active comparator after their baseline assessment. The 12-week intervention will consist of wearable technology (Fitbit Charge 2) which is linked to an online monitoring system (Fitabase) that enables the physiotherapist to remotely monitor participant data. The CF physiotherapist will set individualised PA goals with each participant at baseline and will send text message feedback each week. The text messages will be personalised, one-way texts with positive reinforcement on step count attained by the participant. The active comparator group will receive this wearable technology which is also linked to Fitabase; however, no feedback will be provided to participants in this group. Both groups will be re-assessed at 12 weeks. After this point, both groups will continue with the Fitbit alone for a further 12 weeks. Both groups will be re-assessed at 24 weeks. A semi structured interview will assess satisfaction and acceptability of the intervention. Discussion: This is a novel concept which utilises modern technology, remote monitoring and personalised feedback to investigate the effect on PA in adults with CF. Trial registration: ClinicalTrials.gov NCT03672058 (14/09/2018).
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Affiliation(s)
- Maire Curran
- School of Allied Health, University of Limerick, Limerick, Ireland
- University Hospital Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Audrey C. Tierney
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology Research Group, Health Research Institute, University of Limerick, Ireland
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, Australia
| | | | | | | | | | - Ali Sheikhi
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Cathal Walsh
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Brenda Button
- Departments of Respiratory Medicine and Physiotherapy, The Alfred, Melbourne, Australia
- Department of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Rose Galvin
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Ireland
| | | | - Roisin Cahalan
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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Savi D, Graziano L, Giordani B, Schiavetto S, Vito CD, Migliara G, Simmonds NJ, Palange P, Elborn JS. New strategies of physical activity assessment in cystic fibrosis: a pilot study. BMC Pulm Med 2020; 20:285. [PMID: 33126875 PMCID: PMC7599110 DOI: 10.1186/s12890-020-01313-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/13/2020] [Indexed: 11/15/2022] Open
Abstract
Background Regular physical activity (PA) is a valued part of cystic fibrosis (CF) care. Although the accelerometer, SenseWear Armband (SWA), accurately measures habitual PA in CF, it is mostly used for research purposes. For the first time, we analyzed different methods of measuring PA in daily life by the use of smartphones and other electronic devices such as smartwatch and Fitbit. Methods Twenty-four stable adults with CF (mean age 37.5 ± 11.5SD yrs.; FEV1 58 ± 19% predicted, BMI 22.9 ± 3.2) were studied. Daily PA was monitored for seven consecutive days. All patients wore the accelerometer SWA and at the same time they monitored PA with the electronic device they used routinely. They were allocated into one of four arms according to their device: Smartwatch, Fitbit, Android smartphones and iOS smartphones. PA related measurements included: duration of PA, energy expenditure, number of steps. Results There was a good agreement between SWA and Fitbit for number of steps (p = 0.605) and energy expenditure (p = 0.143). iOS smartphones were similar to SWA in monitoring the number of steps (p = 0.911). Significant differences were found between SWA and both Smartwatch and Android smartphones. Conclusions Fitbit and iOS smartphones seem to be a valuable approach to monitor daily PA. They provide a good performance to measure step number compared to SWA. Supplementary information Supplementary information accompanies this paper at 10.1186/s12890-020-01313-5.
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Affiliation(s)
- Daniela Savi
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, 00185, Rome, Italy. .,Adult Cystic Fibrosis Centre, Royal Brompton Hospital and Imperial College, London, SW3 6NP, UK.
| | - Luigi Graziano
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, 00185, Rome, Italy
| | | | - Stefano Schiavetto
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, 00185, Rome, Italy
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, 00185, Rome, Italy
| | - Giuseppe Migliara
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, 00185, Rome, Italy
| | - Nicholas J Simmonds
- Adult Cystic Fibrosis Centre, Royal Brompton Hospital and Imperial College, London, SW3 6NP, UK
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, 00185, Rome, Italy
| | - J Stuart Elborn
- Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, UK
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10
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Curran M, Tierney AC, Collins L, Kennedy L, McDonnell C, Jurascheck AJ, Sheikhi A, Walsh C, Button B, Galvin R, Casserly B, Cahalan R. Steps Ahead: optimising physical activity in adults with cystic fibrosis: Study Protocol for a pilot randomised trial using wearable technology. HRB Open Res 2020; 3:21. [PMID: 33283151 PMCID: PMC7689601 DOI: 10.12688/hrbopenres.13025.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 08/05/2024] Open
Abstract
Background: Physical activity (PA) and exercise are widely documented as key components in the management of cystic fibrosis (CF). In recent years there have been significant improvements in telehealth, in particular; wearable technology, smartphone use and remote monitoring, all of which may have potential to impact on PA in adults with CF. The objective of this pilot randomised trial is to explore the effect of wearable technology, which is remotely monitored, combined with personalised text message feedback and goal setting, on PA in adults with CF. Secondary endpoints include lung function, aerobic capacity, quality of life, body composition, wellbeing and sleep. Methods: This is a pilot randomised trial which will be conducted at the University Hospital Limerick, Ireland. Participants will be randomised to the intervention or active comparator after their baseline assessment. The 12-week intervention will consist of wearable technology (Fitbit Charge 2) which is linked to an online monitoring system (Fitabase) that enables the physiotherapist to remotely monitor participant data. The CF physiotherapist will set individualised PA goals with each participant at baseline and will send text message feedback each week. The text messages will be personalised, one-way texts with positive reinforcement on step count attained by the participant. The active comparator group will receive this wearable technology which is also linked to Fitabase; however, no feedback will be provided to participants in this group. Both groups will be re-assessed at 12 weeks. After this point, both groups will continue with the Fitbit alone for a further 12 weeks. Both groups will be re-assessed at 24 weeks. A semi structured interview will assess satisfaction and acceptability of the intervention. Discussion: This is a novel concept which utilises modern technology, remote monitoring and personalised feedback to investigate the effect on PA in adults with CF. Trial registration: ClinicalTrials.gov NCT03672058 (14/09/2018).
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Affiliation(s)
- Maire Curran
- School of Allied Health, University of Limerick, Limerick, Ireland
- University Hospital Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Audrey C. Tierney
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology Research Group, Health Research Institute, University of Limerick, Ireland
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, Australia
| | | | | | | | | | - Ali Sheikhi
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Cathal Walsh
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Brenda Button
- Departments of Respiratory Medicine and Physiotherapy, The Alfred, Melbourne, Australia
- Department of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Rose Galvin
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Ireland
| | | | - Roisin Cahalan
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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11
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Moore CC, McCullough AK, Aguiar EJ, Ducharme SW, Tudor-Locke C. Toward Harmonized Treadmill-Based Validation of Step-Counting Wearable Technologies: A Scoping Review. J Phys Act Health 2020; 17:840-852. [PMID: 32652514 PMCID: PMC7855895 DOI: 10.1123/jpah.2019-0205] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 02/17/2020] [Accepted: 05/08/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The authors conducted a scoping review as a first step toward establishing harmonized (ie, consistent and compatible), empirically based best practices for validating step-counting wearable technologies. PURPOSE To catalog studies validating step-counting wearable technologies during treadmill ambulation. METHODS The authors searched PubMed and SPORTDiscus in August 2019 to identify treadmill-based validation studies that employed the criterion of directly observed (including video recorded) steps and cataloged study sample characteristics, protocol details, and analytical procedures. Where reported, speed- and wear location-specific mean absolute percentage error (MAPE) values were tabulated. Weighted median MAPE values were calculated by wear location and a 0.2-m/s speed increment. RESULTS Seventy-seven eligible studies were identified: most had samples averaging 54% (SD = 5%) female and 27 (5) years of age, treadmill protocols consisting of 3 to 5 bouts at speeds of 0.8 (0.1) to 1.6 (0.2) m/s, and reported measures of bias. Eleven studies provided MAPE values at treadmill speeds of 1.1 to 1.8 m/s; their weighted median MAPE values were 7% to 11% for wrist-worn, 1% to 4% for waist-worn, and ≤1% for thigh-worn devices. CONCLUSIONS Despite divergent study methodologies, the authors identified common practices and summarized MAPE values representing device step-count accuracy during treadmill walking. These initial empirical findings should be further refined to ultimately establish harmonized best practices for validating wearable technologies.
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12
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Curran M, Tierney AC, Collins L, Kennedy L, McDonnell C, Jurascheck AJ, Sheikhi A, Walsh C, Button B, Galvin R, Casserly B, Cahalan R. Steps Ahead: optimising physical activity and health in people with cystic fibrosis: Study Protocol for a pilot randomised trial. HRB Open Res 2020; 3:21. [PMID: 33283151 PMCID: PMC7689601 DOI: 10.12688/hrbopenres.13025.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2020] [Indexed: 08/05/2024] Open
Abstract
Background: Physical activity (PA) and exercise are widely documented as key components in the management of cystic fibrosis (CF). In recent years there have been significant improvements in telehealth, in particular; fitness tracking, smartphone use and remote monitoring, all of which may have potential to impact on positive health outcomes in people with CF. The objective of this pilot randomised trial is to explore the potential efficacy of a fitness tracker, which is remotely monitored, combined with personalised text message feedback and goal setting, on lung function, aerobic capacity and PA in adults with CF. Secondary endpoints include quality of life, body composition and wellbeing. Methods: This is a pilot randomised trial which will be conducted at the University Hospital Limerick, Ireland. Participants will be randomised to the intervention or active comparator after their baseline assessment. The 12-week intervention will consist of a fitness tracker (Fitbit Charge 2) which is linked to an online monitoring system (Fitabase) for data collection purposes that enables the physiotherapist to remotely monitor participant data. The CF physiotherapist will set short- and long-term goals with participants and will send one-way text message feedback on Fitbit data and weekly progress. This message will consist of positive reinforcement and re-assess participant goals. The active comparator group will receive a fitness tracker which is also linked to Fitabase; however, no feedback will be provided to participants in this group. Both groups will be re-assessed at 12 weeks. After this point, both groups will continue with the Fitbit alone for a further 12 weeks. Both groups will be re-assessed at 24 weeks. Discussion: This is a novel concept which utilises modern technology, remote monitoring and personalised feedback to investigate the effect on health outcomes in people with CF. Trial registration: ClinicalTrials.gov NCT03672058 (14/09/2018).
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Affiliation(s)
- Maire Curran
- School of Allied Health, University of Limerick, Limerick, Ireland
- University Hospital Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Audrey C. Tierney
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology Research Group, Health Research Institute, University of Limerick, Ireland
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, Australia
| | | | | | | | | | - Ali Sheikhi
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Cathal Walsh
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Brenda Button
- Departments of Respiratory Medicine and Physiotherapy, The Alfred, Melbourne, Australia
- Department of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Rose Galvin
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Ireland
| | | | - Roisin Cahalan
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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13
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Burton K, Morris NR, Reid D, Smith D, Kuys S. Increased physical activity post-exacerbation is associated with decreased systemic inflammation in cystic fibrosis - An observational study. Physiother Theory Pract 2019; 36:1457-1465. [PMID: 30686137 DOI: 10.1080/09593985.2019.1566942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background and Objective: We assessed whether measured physical activity in adults with cystic fibrosis (CF) following in-hospital treatment for an acute exacerbation was impacted by levels of systemic and airway inflammation, and whether physical activity post-discharge predicted for time to next pulmonary exacerbation. Methods: Adults with CF were included following hospitalization for a pulmonary exacerbation, and were followed for 12 months. Inflammatory markers and physical activity were measured immediately post-discharge via sputum and plasma concentrations of interleukin-6, interleukin-8, and tumor necrosis factor-α. Physical activity was monitored for 7 days via a Sensewear Armband. Statistical analyses included Shapiro-Wilk's test and Q-Q plots to determine normal distribution, t-tests, Pearson's correlational analyses, and one-way MANOVAs. Results: Thirty-one adults with CF (13 females, 28.8 ± 8.8 years, forced expiratory volume in 1 s (FEV1) 59.4 ± 23.0% predicted) were prospectively recruited. Physical activity negatively correlated with plasma inflammation (r = -0.48, p < 0.01), and positively with FEV1 (r = 0.45, p < 0.05) and body mass index (r = 0.39, p < 0.05). There was no significant relationship between time to re-exacerbation and any inflammatory markers or measurement of physical activity (all p > 0.05). Conclusion: Increased physical activity following exacerbation in CF is associated with lower levels of systemic inflammation. Time to re-exacerbation is not related to post-discharge inflammation or physical activity levels.
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Affiliation(s)
- Kate Burton
- Menzies Health Institute School of Allied Health Sciences, Griffith University , Southport, QLD, Australia.,Adult Cystic Fibrosis Centre, The Prince Charles Hospital , Brisbane, QLD, Australia.,Physiotherapy Department, Logan Hospital, Metro South Hospital & Health Service , Meadowbrook, QLD, Australia
| | - Norman R Morris
- Menzies Health Institute School of Allied Health Sciences, Griffith University , Southport, QLD, Australia.,Allied Health Research Collaborative, The Prince Charles Hospital , Brisbane, QLD, Australia
| | - David Reid
- Adult Cystic Fibrosis Centre, The Prince Charles Hospital , Brisbane, QLD, Australia.,Lung Inflammation & Infection Team, QIMR-Berghofer Institute of Medical Research , Brisbane, QLD, Australia
| | - Daniel Smith
- Adult Cystic Fibrosis Centre, The Prince Charles Hospital , Brisbane, QLD, Australia
| | - Suzanne Kuys
- Menzies Health Institute School of Allied Health Sciences, Griffith University , Southport, QLD, Australia.,School of Physiotherapy, Australian Catholic University , Banyo, QLD, Australia
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14
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Savi D, Di Paolo M, Simmonds NJ, Pascucci C, Quattrucci S, Palange P. Is daily physical activity affected by dynamic hyperinflation in adults with cystic fibrosis? BMC Pulm Med 2018; 18:60. [PMID: 29673350 PMCID: PMC5907710 DOI: 10.1186/s12890-018-0623-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 04/09/2018] [Indexed: 01/02/2023] Open
Abstract
Background The aim of this study was to investigate the relationship between dynamic hyperinflation and daily physical activity (DPA) in adults with cystic fibrosis (CF). Methods Thirty-four clinically stable CF were studied. All patients undertook incremental cardiopulmonary exercise testing (CPET). CPET-related measurements included: oxygen uptake (V’O2), carbon dioxide production (V’CO2), ventilatory profile, work rate (W), inspiratory capacity (IC), end-expiratory lung volume (EELV). PA was assessed using the accelerometer SenseWear Pro3 Armband. Results Exercise tolerance was reduced in most of patients and the mean V’O2,peak value was 75.2% of predicted (28.5 ± 4.8 ml/min/kg). Seventy % of patients responded to CPET with dynamic hyperinflation. Higher incidence of dynamic hyperinflation was found in CF males compared to CF females (p = 0.026). Patients who developed dynamic hyperinflation during CPET had higher vigorous PA (p = 0.01) and more total energy expenditure (p = 0.006) than patients who did not. EELVΔ was related to activities requiring vigorous intensity and total energy expenditure (R = 0.46, p = 0.001; R = 0.57, p < 0.001). Conclusions In adults with CF and mild to moderate lung impairment, DPA might not be limited by dynamic hyperinflation. Electronic supplementary material The online version of this article (10.1186/s12890-018-0623-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniela Savi
- Department of Public Health and Infectious Diseases, Adult Cystic Fibrosis Center, Sapienza University of Rome, 00185, Rome, Italy. .,Cystic Fibrosis Unit, Bambino Gesù Children's Hospital, Rome, Italy.
| | - Marcello Di Paolo
- Department of Public Health and Infectious Diseases, Adult Cystic Fibrosis Center, Sapienza University of Rome, 00185, Rome, Italy
| | - Nicholas J Simmonds
- Department of Cystic Fibrosis, Royal Brompton Hospital and Imperial College, London, SW3 6NP, UK
| | - Chiara Pascucci
- Department of Experimental Medicine, Sapienza University of Rome, 00185, Rome, Italy
| | - Serena Quattrucci
- Department of Pediatrics, Cystic Fibrosis Center, Sapienza University of Rome, 00185, Rome, Italy
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Adult Cystic Fibrosis Center, Sapienza University of Rome, 00185, Rome, Italy.,Eleonora Lorrillard-Spencer Cenci Foundation, 00185, Rome, Italy
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15
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Koehler K, Drenowatz C. Monitoring Energy Expenditure Using a Multi-Sensor Device-Applications and Limitations of the SenseWear Armband in Athletic Populations. Front Physiol 2017; 8:983. [PMID: 29249986 PMCID: PMC5714893 DOI: 10.3389/fphys.2017.00983] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 11/17/2017] [Indexed: 11/17/2022] Open
Abstract
In order to monitor their energy requirements, athletes may desire to assess energy expenditure (EE) during training and competition. Recent technological advances and increased customer interest have created a market for wearable devices that measure physiological variables and bodily movement over prolonged time periods and convert this information into EE data. This mini-review provides an overview of the applicability of the SenseWear armband (SWA), which combines accelerometry with measurements of heat production and skin conductivity, to measure total daily energy expenditure (TDEE) and its components such as exercise energy expenditure (ExEE) in athletic populations. While the SWA has been shown to provide valid estimates of EE in the general population, validation studies in athletic populations indicate a tendency toward underestimation of ExEE particularly during high-intensity exercise (>10 METs) with an increasing underestimation as exercise intensity increases. Although limited information is available on the accuracy of the SWA during resistance exercise, high-intensity interval exercise, or mixed exercise forms, there seems to be a similar trend of underestimating high levels of ExEE. The SWA, however, is capable of detecting movement patterns and metabolic measurements even at high exercise intensities, suggesting that underestimation may result from limitations in the proprietary algorithms. In addition, the SWA has been used in the assessment of sleep quantity and quality as well as non-exercise activity thermogenesis. Overall, the SWA provides viable information and remains to be used in various clinical and athletic settings, despite the termination of its commercial sale.
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Affiliation(s)
- Karsten Koehler
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Clemens Drenowatz
- Division of Physical Education, University of Education Upper Austria, Linz, Austria
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16
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Sperlich B, Becker M, Hotho A, Wallmann-Sperlich B, Sareban M, Winkert K, Steinacker JM, Treff G. Sedentary Behavior among National Elite Rowers during Off-Training-A Pilot Study. Front Physiol 2017; 8:655. [PMID: 28979208 PMCID: PMC5611419 DOI: 10.3389/fphys.2017.00655] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 08/17/2017] [Indexed: 01/15/2023] Open
Abstract
The aim of this pilot study was to analyze the off-training physical activity (PA) profile in national elite German U23 rowers during 31 days of their preparation period. The hours spent in each PA category (i.e., sedentary: <1.5 metabolic equivalents (MET); light physical activity: 1.5–3 MET; moderate physical activity: 3–6 MET and vigorous intense physical activity: >6 MET) were calculated for every valid day (i.e., >480 min of wear time). The off-training PA during 21 weekdays and 10 weekend days of the final 11-week preparation period was assessed by the wrist-worn multisensory device Microsoft Band II (MSBII). A total of 11 rowers provided valid data (i.e., >480 min/day) for 11.6 week days and 4.8 weekend days during the 31 days observation period. The average sedentary time was 11.63 ± 1.25 h per day during the week and 12.49 ± 1.10 h per day on the weekend, with a tendency to be higher on the weekend compared to weekdays (p = 0.06; d = 0.73). The average time in light, moderate and vigorous PA during the weekdays was 1.27 ± 1.15, 0.76 ± 0.37, 0.51 ± 0.44 h per day, and 0.67 ± 0.43, 0.59 ± 0.37, 0.53 ± 0.32 h per weekend day. Light physical activity was higher during weekdays compared to the weekend (p = 0.04; d = 0.69). Based on our pilot study of 11 national elite rowers we conclude that rowers display a considerable sedentary off-training behavior of more than 11.5 h/day.
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Affiliation(s)
- Billy Sperlich
- Integrative and Experimental Exercise Science, Institute for Sport Sciences, University of WuerzburgWuerzburg, Germany
| | - Martin Becker
- DMIR Research Group, University of WuerzburgWuerzburg, Germany
| | - Andreas Hotho
- DMIR Research Group, University of WuerzburgWuerzburg, Germany.,L3S Research CenterHanover, Germany
| | - Birgit Wallmann-Sperlich
- Institute for Sport Sciences, University of WuerzburgWuerzburg, Germany.,Institute of Health Promotion and Clinical Movement Science, German Sport University CologneCologne, Germany
| | - Mahdi Sareban
- Division of Sports and Rehabilitation Medicine, Ulm University HospitalUlm, Germany.,Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical UniversitySalzburg, Austria
| | - Kay Winkert
- Division of Sports and Rehabilitation Medicine, Ulm University HospitalUlm, Germany
| | - Jürgen M Steinacker
- Division of Sports and Rehabilitation Medicine, Ulm University HospitalUlm, Germany
| | - Gunnar Treff
- Division of Sports and Rehabilitation Medicine, Ulm University HospitalUlm, Germany
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17
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Ramdharry GM, Pollard AJ, Grant R, Dewar EL, Laurá M, Moore SA, Hallsworth K, Ploetz T, Trenell MI, Reilly MM. A study of physical activity comparing people with Charcot-Marie-Tooth disease to normal control subjects. Disabil Rehabil 2017; 39:1753-1758. [PMID: 27684376 PMCID: PMC5592965 DOI: 10.1080/09638288.2016.1211180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Charcot Marie Tooth disease (CMT) describes a group of hereditary neuropathies that present with distal weakness, wasting and sensory loss. Small studies indicate that people with CMT have reduced daily activity levels. This raises concerns as physical inactivity increases the risk of a range of co- morbidities, an important consideration in the long-term management of this disease. This study aimed to compare physical activity, patterns of sedentary behavior and overall energy expenditure of people with CMT and healthy matched controls. METHODS We compared 20 people with CMT and 20 matched controls in a comparison of physical activity measurement over seven days, using an activity monitor. Patterns of sedentary behavior were explored through a power law analysis. RESULTS Results showed a decrease in daily steps taken in the CMT group, but somewhat paradoxically, they demonstrate shorter bouts of sedentary activity and more frequent transitions from sedentary to active behaviors. No differences were seen in energy expenditure or time spent in sedentary, moderate or vigorous activity. CONCLUSION The discrepancy between energy expenditure and number of steps could be due to higher energy requirements for walking, but also may be due to an over-estimation of energy expenditure by the activity monitor in the presence of muscle wasting. Alternatively, this finding may indicate that people with CMT engage more in activities or movement not related to walking. Implications for Rehabilitation Charcot-Marie-Tooth disease: • People with Charcot-Marie-Tooth disease did not show a difference in energy expenditure over seven days compared to healthy controls, but this may be due to higher energy costs of walking, and/or an over estimation of energy expenditure by the activity monitor in a population where there is muscle wasting. This needs to be considered when interpreting activity monitor data in people with neuromuscular diseases. • Compared to healthy controls, people with Charcot-Marie-Tooth disease had a lower step count over seven days, but exhibited more frequent transitions from sedentary to active behaviors • High Body Mass Index and increased time spent sedentary were related factors that have implications for general health status. • Understanding the profile of physical activity and behavior can allow targeting of rehabilitation interventions to address mobility and fitness.
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Affiliation(s)
- Gita M Ramdharry
- a Faculty of Health, Social Care and Education , Kingston University and St George's University of London , London , UK
- b MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery , London , UK
| | - Alexander J Pollard
- b MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery , London , UK
- c Department of Molecular Neuroscience , UCL Institute of Neurology , London, London , UK
| | - Robert Grant
- a Faculty of Health, Social Care and Education , Kingston University and St George's University of London , London , UK
| | - Elizabeth L Dewar
- b MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery , London , UK
| | - Matilde Laurá
- b MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery , London , UK
- c Department of Molecular Neuroscience , UCL Institute of Neurology , London, London , UK
| | - Sarah A Moore
- d Movelab , Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK
| | - Kate Hallsworth
- d Movelab , Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK
| | - Thomas Ploetz
- e School of Computing Science, Newcastle University , Newcastle upon Tyne , UK
| | - Michael I Trenell
- d Movelab , Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK
| | - Mary M Reilly
- b MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery , London , UK
- c Department of Molecular Neuroscience , UCL Institute of Neurology , London, London , UK
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18
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Sheahan H, Canning K, Refausse N, Kinnear EM, Jorgensen G, Walsh JR, Lazzarini PA. Differences in the daily activity of patients with diabetic foot ulcers compared to controls in their free-living environments. Int Wound J 2017; 14:1175-1182. [PMID: 28707412 DOI: 10.1111/iwj.12782] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/29/2017] [Accepted: 05/31/2017] [Indexed: 12/30/2022] Open
Abstract
The aims of our study were to investigate multiple daily activity outcomes in patients with diabetic foot ulcers (DFU) compared to diabetic peripheral neuropathy (DPN) and diabetes (DM) controls in their free-living environments. We examined daily activity outcomes of 30 patients with DFU, 23 DPN and 20 DM. All patients wore a validated multi-sensor device for > 5 days (>22 hours per day) to measure their daily activity outcomes: steps, energy expenditure (kJ), average metabolic equivalent tasks (METs), physical activity (>3·0 METs) duration and energy expenditure, lying duration, sleep duration and sleep quality. We found that DFU patients recorded fewer median (interquartile ranges, IQR) daily steps [2154 (1621-4324)] than DPN [3660 (2742-7705)] and DM [5102 (4011-7408)] controls (P < 0·05). In contrast, DFU patients recorded more mean ± SD daily energy expenditure (kJ) (13 006 ± 3559) than DPN (11 085 ± 1876) and DM (11 491 ± 1559) controls (P < 0·05). We found no other differences in daily activity outcomes (P > 0·1). We conclude that DFU patients typically take fewer steps but expend more energy during their normal daily activity than DPN and DM controls. We hypothesise that the increased energy expenditure for DFU patients may be due to wound healing or an inefficient gait strategy. Further investigations into this energy imbalance in DFU patients may improve healing in future.
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Affiliation(s)
- Helen Sheahan
- Community Diabetes Service, Metro North Hospital & Health Service, Brisbane, Australia.,Department of Podiatry, Metro North Hospital & Health Service, Brisbane, Australia
| | - Kimberley Canning
- Community Diabetes Service, Metro North Hospital & Health Service, Brisbane, Australia.,Department of Podiatry, Metro North Hospital & Health Service, Brisbane, Australia
| | - Nishka Refausse
- Community Diabetes Service, Metro North Hospital & Health Service, Brisbane, Australia.,Department of Podiatry, Metro North Hospital & Health Service, Brisbane, Australia
| | - Ewan M Kinnear
- Department of Podiatry, Metro North Hospital & Health Service, Brisbane, Australia.,Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia
| | - Greg Jorgensen
- Department of Sleep Science, The Prince Charles Hospital, Brisbane, Australia
| | - James R Walsh
- Heart Lung Institute, The Prince Charles Hospital, Brisbane, Australia
| | - Peter A Lazzarini
- Department of Podiatry, Metro North Hospital & Health Service, Brisbane, Australia.,Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia.,School of Clinical Science, Queensland University of Technology, Brisbane, Australia
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BEAUDOIN NADIA, BOUVET GUILLAUMEF, CORIATI ADÈLE, RABASA-LHORET RÉMI, BERTHIAUME YVES. Combined Exercise Training Improves Glycemic Control in Adult with Cystic Fibrosis. Med Sci Sports Exerc 2017; 49:231-237. [DOI: 10.1249/mss.0000000000001104] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Plasma kisspeptin and ghrelin levels are independently correlated with physical activity in patients with anorexia nervosa. Appetite 2017; 108:141-150. [DOI: 10.1016/j.appet.2016.09.032] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/01/2016] [Accepted: 09/27/2016] [Indexed: 12/22/2022]
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21
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Jimenez-Moreno AC, Newman J, Charman SJ, Catt M, Trenell MI, Gorman GS, Hogrel JY, Lochmüller H. Measuring Habitual Physical Activity in Neuromuscular Disorders: A Systematic Review. J Neuromuscul Dis 2017; 4:25-52. [PMID: 28269791 PMCID: PMC5345641 DOI: 10.3233/jnd-160195] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Free-living or habitual physical activity (HPA) refers to someone's performance in his or her free-living environment. Neuromuscular disorders (NMD) manifest through HPA, and the observation of HPA can be used to identify clinical risks and to quantify outcomes in research. This review summarizes and analyses previous studies reporting the assessment of HPA in NMD, and may serve as the basis for evidence-based decision-making when considering assessing HPA in this population. METHODS A systematic review was performed to identify all studies related to HPA in NMD, followed by a critical appraisal of the assessment methodology and a final review of the identified HPA tools. RESULTS A total of 22 studies were selected, reporting on eight different direct tools (or activity monitors) and ten structured patient-reported outcomes. Overall, HPA patterns in NMD differ from healthy control populations. There was a noticeable lack of validation studies for these tools and outcome measures in NMD. Very little information regarding feasibility and barriers for the application of these tools in this population have been published. CONCLUSIONS The variety and heterogeneity of tools and methods in the published literature makes the comparison across different studies difficult, and methodological guidelines are warranted. We propose a checklist of considerations for the assessment and reporting of HPA in NMD.
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Affiliation(s)
- Aura Cecilia Jimenez-Moreno
- John Walton Muscular Dystrophy Research Centre, MRC centre for Neuromuscular Disease, Institute of Genetic Medicine, Newcastle University, UK
| | - Jane Newman
- Movelab, Institute of Cellular Medicine, Newcastle University, UK
| | - Sarah J. Charman
- Movelab, Institute of Cellular Medicine, Newcastle University, UK
| | - Michael Catt
- Institute of Neuroscience, Newcastle University, UK
| | | | | | - Jean-Yves Hogrel
- Neuromuscular Physiology and Evaluation Lab, Institute of Myology, Paris, France
| | - Hanns Lochmüller
- John Walton Muscular Dystrophy Research Centre, MRC centre for Neuromuscular Disease, Institute of Genetic Medicine, Newcastle University, UK
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Glucose Fluctuations are Not Modulated by the Proportion of Calories from Macronutrients or Spontaneous Total Energy Expenditure in Adults with Cystic Fibrosis. Can J Diabetes 2016; 40:389-392. [DOI: 10.1016/j.jcjd.2016.05.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 01/20/2016] [Accepted: 05/10/2016] [Indexed: 11/20/2022]
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23
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Evaluation of a non-invasive multisensor accelerometer for calculating energy expenditure in ventilated intensive care patients compared to indirect calorimetry and predictive equations. J Clin Monit Comput 2016; 31:1009-1017. [PMID: 27628058 DOI: 10.1007/s10877-016-9934-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 09/08/2016] [Indexed: 01/15/2023]
Abstract
Continuous measurement of resting energy expenditure (REE) in critically ill patients remains challenging but is required to prevent malnutrition. SenseWear Pro 3 Armband (SWA) is a research grade accelerometer for assessment of REE with the advantage of easy handling. In a prospective study we compared SWA with indirect calorimetry (IC) and predictive equations in critically ill, ventilated patients. REE was measured by SWA, IC and calculated by predictive formulas. Potential confounding factors that influence REE were also recorded. Results of SenseWear Armband and indirect calorimetry were compared using the Bland-Altman method. 34 ICU patients were investigated. SWA underestimated resting energy expenditure compared to IC with a mean bias of ΔREE = -253.6 ± 333.2 kcal, equivalent to -11.7 % (p = 0.025). This underestimation was seen in both, medical (-14.9 %) and surgical (-12.9 %) patients and the bias was greater in patients with fever (-19.0 %), tachycardia (-18.7 %) or tachypnea (-26.2 %). Differences were also noted when SWA was compared to predictive formulas. At present, SWA cannot be regarded as an alternative to indirect calorimetry. Individual measurements are often inaccurate and should be used with caution until improved algorithms, based on the results of this study, have been implemented.
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24
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Low levels of physical activity predict worse survival to lung transplantation and poor early post-operative outcomes. J Heart Lung Transplant 2016; 35:1041-3. [DOI: 10.1016/j.healun.2016.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 03/11/2016] [Accepted: 05/12/2016] [Indexed: 11/24/2022] Open
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25
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On Curating Multimodal Sensory Data for Health and Wellness Platforms. SENSORS 2016; 16:s16070980. [PMID: 27355955 PMCID: PMC4970031 DOI: 10.3390/s16070980] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 06/14/2016] [Accepted: 06/21/2016] [Indexed: 11/26/2022]
Abstract
In recent years, the focus of healthcare and wellness technologies has shown a significant shift towards personal vital signs devices. The technology has evolved from smartphone-based wellness applications to fitness bands and smartwatches. The novelty of these devices is the accumulation of activity data as their users go about their daily life routine. However, these implementations are device specific and lack the ability to incorporate multimodal data sources. Data accumulated in their usage does not offer rich contextual information that is adequate for providing a holistic view of a user’s lifelog. As a result, making decisions and generating recommendations based on this data are single dimensional. In this paper, we present our Data Curation Framework (DCF) which is device independent and accumulates a user’s sensory data from multimodal data sources in real time. DCF curates the context of this accumulated data over the user’s lifelog. DCF provides rule-based anomaly detection over this context-rich lifelog in real time. To provide computation and persistence over the large volume of sensory data, DCF utilizes the distributed and ubiquitous environment of the cloud platform. DCF has been evaluated for its performance, correctness, ability to detect complex anomalies, and management support for a large volume of sensory data.
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26
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Totosy de Zepetnek J, Pelletier C, Hicks A, MacDonald M. The Authors Respond. Arch Phys Med Rehabil 2016; 97:1039-40. [DOI: 10.1016/j.apmr.2016.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 02/29/2016] [Indexed: 10/21/2022]
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27
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Hoo Z, Daniels T, Wildman M, Teare M, Bradley J. Airway clearance techniques used by people with cystic fibrosis in the UK. Physiotherapy 2015; 101:340-8. [DOI: 10.1016/j.physio.2015.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 01/11/2015] [Indexed: 11/26/2022]
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28
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Savi D, Simmonds N, Di Paolo M, Quattrucci S, Palange P, Banya W, Hopkinson NS, Bilton D. Relationship between pulmonary exacerbations and daily physical activity in adults with cystic fibrosis. BMC Pulm Med 2015; 15:151. [PMID: 26627849 PMCID: PMC4667472 DOI: 10.1186/s12890-015-0151-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 11/24/2015] [Indexed: 11/22/2022] Open
Abstract
Background The aim of this study was to examine the relationship between pulmonary exacerbations and physical activity (PA) in adults with cystic fibrosis (CF). Methods We grouped adults with CF according to their exacerbation status in the year before study enrolment: (1) <1 exacerbation/year; (2) 1–2 exacerbations/year; and (3) >2 exacerbations/year. PA was assessed objectively by means of an accelerometer at the time of study enrolment. Results Patients with >2 exacerbations/year spent less time in PA; specifically, fewer activities of mild intensity [>3 metabolic equivalents (METs)], and lower active energy expenditure (P = 0.01 and P = 0.03, respectively). After correcting for relevant confounders, PA levels were not related to the exacerbation frequency in the preceding year. PA at moderate intensity (4.8–7.2 METs) or greater (>7.2 METs) was independently associated with gender and FEV1 % predicted (P = 0.007 and P = 0.04, respectively). Compared with men, women had reduced vigorous activities (P = 0.01) and active energy expenditure (P = 0.01). Conclusions Adult CF patients with more pulmonary exacerbations in the preceding year have more advanced disease and are less active than their peers. PA was independently associated with gender and airflow obstruction. Gender differences in PA are evident in CF adults.
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Affiliation(s)
- Daniela Savi
- Department of Pediatrics and Pediatric Neurology, Cystic Fibrosis Center, Sapienza University of Rome, Viale Regina Elena, 324-00185, Rome, Italy. .,Department of Cystic Fibrosis, Royal Brompton Hospital and Imperial College, London, SW3 6NP, UK.
| | - Nicholas Simmonds
- Department of Cystic Fibrosis, Royal Brompton Hospital and Imperial College, London, SW3 6NP, UK. .,NIHR Respiratory BRU, Royal Brompton Hospital NHS Foundation Trust, London, SW3 6NP, UK.
| | - Marcello Di Paolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy.
| | - Serena Quattrucci
- Department of Pediatrics and Pediatric Neurology, Cystic Fibrosis Center, Sapienza University of Rome, Viale Regina Elena, 324-00185, Rome, Italy.
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy. .,Eleonora Lorrillard-Spencer Cenci Foundation, 00185, Rome, Italy.
| | - Winston Banya
- NIHR Respiratory BRU, Royal Brompton Hospital NHS Foundation Trust, London, SW3 6NP, UK.
| | - Nicholas S Hopkinson
- NIHR Respiratory BRU, Royal Brompton Hospital NHS Foundation Trust, London, SW3 6NP, UK.
| | - Diana Bilton
- Department of Cystic Fibrosis, Royal Brompton Hospital and Imperial College, London, SW3 6NP, UK.
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29
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Dhillon SS, Sima CA, Kirkham AR, Syed N, Camp PG. Physical Activity Measurement Accuracy in Individuals With Chronic Lung Disease: A Systematic Review With Meta-Analysis of Method Comparison Studies. Arch Phys Med Rehabil 2015; 96:2079-88.e10. [DOI: 10.1016/j.apmr.2015.05.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 05/01/2015] [Accepted: 05/19/2015] [Indexed: 12/20/2022]
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30
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Bradley J, O'Neill B, Kent L, Hulzebos EH, Arets B, Hebestreit H, Alison J, Arets B, Boas S, Bradley J, Button B, Bye P, Cerny F, Cooper D, Downs A, Dwyer T, Forster E, Gallagher C, Gruber W, Hebestreit A, Hebestreit H, Huber M, Hulzebos E, Johnstone Z, Lands L, Lannefors L, Lessine F, Lindblad A, Lowman J, Mandrusiak A, Martensson M, McIlwaine M, Möller A, Molloy M, Montgomery G, Morrison L, Murray J, Nippins M, Orenstein D, Prasaad A, Renner S, Salhberg M, Schneiderman J, Swisher A, Urquhart D, Zeitoun M. Physical activity assessment in cystic fibrosis: A position statement. J Cyst Fibros 2015. [DOI: 10.1016/j.jcf.2015.05.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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31
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The Impact of Different Degrees of Feedback on Physical Activity Levels: A 4-Week Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:6561-81. [PMID: 26067990 PMCID: PMC4483716 DOI: 10.3390/ijerph120606561] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 05/26/2015] [Accepted: 06/03/2015] [Indexed: 11/17/2022]
Abstract
Assessing levels of physical activity (PA) and providing feedback about these levels might have an effect on participant's PA behavior. This study discusses the effect of different levels of feedback--from minimal to use of a feedback display and coach--on PA over a 4-week intervention period. PA was measured at baseline, during and immediately after the intervention. Participants (n=227) were randomly assigned to a Minimal Intervention Group (MIG-no feedback), Pedometer Group (PG-feedback on steps taken), Display Group (DG-feedback on steps, minutes of moderate to vigorous physical activity and energy expenditure) or Coaching Group (CoachG-same as DG with need-supportive coaching). Two-way ANCOVA showed no significant Group×Time interaction effect for the different PA variables between the MIG and PG. Also no differences emerged between PG and DG. As hypothesized, CoachG had higher PA values throughout the intervention compared with DG. Self-monitoring using a pedometer resulted in more steps compared with a no-feedback condition at the start of the intervention. However, adding individualized coaching seems necessary to increase the PA level until the end of the intervention.
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32
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Lee JA, Laurson KR. Validity of the SenseWear armband step count measure during controlled and free-living conditions. J Exerc Sci Fit 2015; 13:16-23. [PMID: 29541094 PMCID: PMC5812852 DOI: 10.1016/j.jesf.2014.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 10/27/2014] [Accepted: 11/07/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/OBJECTIVE Advances in technology continue to provide numerous options for physical activity assessment. These advances necessitate evaluation of the validity of newly developed activity monitors being used in clinical and research settings. The purpose of this study was to validate the SenseWear Pro3 Armband (SWA) step counts during treadmill walking and free-living conditions. METHODS Study 1 observed 39 individuals (17 males, 22 females) wearing an SWA and a Yamax Digiwalker SW-701 pedometer (DIGI) during treadmill walking, utilizing manually counted steps as the criterion. Study 2 compared free-living step count data from 35 participants (17 males, 18 females) wearing the SWA and DIGI (comparison) for 3 consecutive days. RESULTS During Study 1, the SWA underestimated steps by 16.0%, 10.7%, 5.6%, 6.1%, and 6.5% at speeds of 54 m/min, 67 m/min, 80 m/min, 94 m/min, and 107 m/min, respectively, compared to manually counted steps. During Study 2, the intraclass correlation (ICC) coefficient of mean steps/d between the SWA and DIGI was strong (r = 0.98, p < 0.001). Unlike Study 1, the SWA overestimated step counts during the 3-day wear period by an average of 1028 steps/d (or +11.3%) compared to the DIGI. When analyzed individually, the SWA consistently overestimated step counts for each day (p < 0.05). CONCLUSION The SWA underestimates steps during treadmill walking and appears to overestimate steps during free-living compared to the DIGI pedometer. Caution is warranted when using the SWA to count steps. Modifications are needed to enhance step counting accuracy.
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Affiliation(s)
- Joey Allen Lee
- Illinois State University, School of Kinesiology and Recreation, Normal, IL, USA
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33
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Savi D, Di Paolo M, Simmonds N, Onorati P, Internullo M, Quattrucci S, Winston B, Laveneziana P, Palange P. Relationship between daily physical activity and aerobic fitness in adults with cystic fibrosis. BMC Pulm Med 2015; 15:59. [PMID: 25952747 PMCID: PMC4430900 DOI: 10.1186/s12890-015-0036-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 04/15/2015] [Indexed: 12/02/2022] Open
Abstract
Background The best clinical practice to investigate aerobic fitness includes measurements obtained during cardiopulmonary exercise testing (CPET), however it remains an underutilised clinical measure in cystic fibrosis (CF). To investigate this further, different methods of quantifying exercise capacity in CF are required. The possibility that measuring physical activity (PA) by a portable accelerometer could be used to assess the CF aerobic state and could be added among the CPET surrogates has not been investigated. The aim of this study was to examine the relationship between PA and exercise fitness both at submaximal and maximal levels in clinically stable adults with CF. Methods Thirty CF patients (FEV1 71 ± 19% predicted) and fifteen healthy controls undertook an incremental CPET on a cycle ergometer. CPET-related measurements included: oxygen uptake (V’O2), carbon dioxide production (V’CO2), ventilatory profile, heart rate (HR) and oxygen pulse (V’O2/HR) throughout exercise and at lactic threshold (LT) and peak. LT measures represent submaximal exercise related data. PA was assessed using the accelerometer SenseWear Pro3 Armband. Results Moderate (>4.8 metabolic equivalents (METS)) and moderate + vigorous (>7.2 METS) PA was related to V’O2 (p = 0.005 and p = 0.009, respectively) and work rate (p = 0.004 and p = 0.002, respectively) at LT. Moderate PA or greater was positively related to peak V’O2 (p = 0.005 and p = 0.003, respectively). Daily PA levels were similar in CF and healthy controls. Except for peak values, V’O2 profile and the V’O2 at LT were comparable between CF and healthy controls. Conclusions In adult CF patients daily PA positively correlated with aerobic capacity. PA measurements are a valuable tool in the assessment of exercise performance in an adult CF population and could be used for interventional exercise trials to optimize exercise performance and health status. PA levels and parameters obtained at submaximal exercise are similar in CF and in healthy controls. Electronic supplementary material The online version of this article (doi:10.1186/s12890-015-0036-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniela Savi
- Department of Pediatrics and Pediatric Neurology, Cystic Fibrosis Center, Sapienza University of Rome, 00185, Rome, Italy.
| | - Marcello Di Paolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy.
| | - Nicholas Simmonds
- Department of Cystic Fibrosis, Royal Brompton Hospital and Imperial College, SW3 6NP, London, UK.
| | - Paolo Onorati
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy.
| | - Mattia Internullo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy.
| | - Serena Quattrucci
- Department of Pediatrics and Pediatric Neurology, Cystic Fibrosis Center, Sapienza University of Rome, 00185, Rome, Italy.
| | - Banya Winston
- NIHR Respiratory BRU, Royal Brompton Hospital NHS Foundation Trust, SW3 6NP, London, UK.
| | - Pierantonio Laveneziana
- Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Universités, UPMC University Paris 06, UMR_S, 1158 75005, Paris, France. .,Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM, UMR_S, 1158 75005, Paris, France. .,AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée, 75013, Paris, France.
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy. .,Eleonora Lorrillard-Spencer Cenci Foundation, Rome, Italy.
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34
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Van Hoye K, Boen F, Lefevre J. Validation of the SenseWear Armband in different ambient temperatures. J Sports Sci 2014; 33:1007-18. [PMID: 25537112 DOI: 10.1080/02640414.2014.981846] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examines the validity of the SenseWear Armband in different temperatures using the old (SenseWear v2.2) and newest version of the algorithm (SenseWear v5.2) against indirect calorimetry (IC). Thirty-nine male and female students (21.1 ± 1.41 years) completed an exercise trial in 19°C, 26°C and 33°C consisting of 5 min standing followed by alternating walking/running at 35% and 65% of their maximal oxygen uptake. The accuracy of the algorithms was evaluated by comparing estimated energy expenditure (EE) to IC using a mixed-model design. No difference was reported in EE between the different temperatures for IC. Both algorithms estimated EE significantly higher when exercising at high intensity in 33°C compared to 19°C. Compared to IC, SenseWear v2.2 accurately estimated EE during standing and light intensity exercise but underestimated EE when exercising in a hot environment and at high intensity. SenseWear v5.2 showed a difference when exercising at high intensity in thermoneutral and warm conditions. The new algorithm improved EE estimation in hot environments and at high intensity compared to the old version. However, given the inherent inaccuracy of the EE estimates of SenseWear, greater weight should be given to direct monitor outputs rather than the ability of a monitor to estimate EE precisely.
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Affiliation(s)
- Karen Van Hoye
- a Physical Activity, Sports and Health, Kinesiology , Leuven , Belgium
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35
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Almeida GJ, Wert DM, Brower KS, Piva SR. Validity of physical activity measures in individuals after total knee arthroplasty. Arch Phys Med Rehabil 2014; 96:524-31. [PMID: 25450127 DOI: 10.1016/j.apmr.2014.10.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 10/02/2014] [Accepted: 10/03/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the concurrent criterion-related validity of 2 activity monitors in comparison with the criterion method of indirect calorimetry in older adults after total knee arthroplasty (TKA). DESIGN Validation study. SETTING Subjects completed 9 increasingly demanding daily activities in a research laboratory; each activity was performed for 7 minutes, for a total of 80 minutes, while the activity monitors and criterion method were used concurrently. PARTICIPANTS Subjects (N=21, 67% women) had a mean age ± SD of 68±7 years and a body mass index of 29±4. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Energy expenditure (in kcal/min) measured by accelerometer-based and multisensor-based monitors and by a criterion method. Validity was assessed by the paired t test, intraclass correlation coefficient (ICC), and Bland-Altman plots comparing the measurements from the activity monitors with those of the criterion method. RESULTS Measurements from the accelerometer-based monitor were significantly lower than those of the criterion method across all walking and nonwalking activities. The underestimations ranged from 40% to 100%. The accelerometer-based monitor demonstrated small to moderate agreement compared with the criterion method (ICCs from 0 to .38). Measurements from the multisensor-based monitor were significantly lower than those of the criterion method during several nonwalking activities; yet, the differences were minor (2%-19%). Measurements from the multisensor-based monitor during walking activities were not different compared with the criterion method. The multisensor-based monitor demonstrated moderate to excellent agreement with the criterion method (ICCs from .48 to .81). CONCLUSIONS The multisensor-based monitor showed better criterion-related validity than the accelerometer-based monitor and should be considered as a tool to measure physical activity in individuals after TKA.
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Affiliation(s)
- Gustavo J Almeida
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA.
| | - David M Wert
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA
| | - Kelly S Brower
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Sara R Piva
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA
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Martien S, Seghers J, Boen F, Delecluse C. Energy Expenditure in Institutionalized Older Adults: Validation of SenseWear Mini. Med Sci Sports Exerc 2014; 47:1265-71. [PMID: 25251046 DOI: 10.1249/mss.0000000000000529] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Objective methods to quantify physical activity (PA) and predict energy expenditure (EE) are needed in the old and old-old. The aim of the present study was to evaluate the validity of EE estimates by the SenseWear Mini (SWMini) compared with indirect calorimetry during daily life activities in institutionalized older adults. METHODS Sixty nursing home residents (mean age = 85.5 ± 5.5 yr) wore the SWMini during rest (sitting quietly) and three activity tasks (walking, sitting/rising/walking, and moving objects). SWMini data were processed using software version 7.0. The criterion EE (kcal·min⁻¹) was estimated by a portable gas analyzer, Oxycon Mobile (OM). RESULTS The analyses revealed high correlations (rsitting = 0.68, ractivity tasks = 0.88) between EE estimated by OM and SWMini. EE increased between sitting periods and activity tasks for EE estimated by OM (mean difference = 61.5% ± 8.9%), as well as for EE estimated by SWMini (mean difference = 58.2% ± 7.4%) (P < 0.001). However, SWMini significantly underestimated EE, with an overall absolute percent error of 14.1% ± 7.9%. The largest absolute percent differences were observed during sitting periods compared with activity tasks (P < 0.05). Older age significantly reduced accuracy, explaining 12% of the variance in total percent error (β = 0.42, t = 2.84, P < 0.05). CONCLUSIONS The high percent error scores indicate that the SWMini is of limited value for quantifying EE in the old and old-old. The accuracy could be improved by developing accurate age- and activity-specific algorithms. On the other hand, the SWMini can be used as a suitable device for researchers interested in specific levels and patterns of PA and sedentary behavior.
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Affiliation(s)
- Sofie Martien
- KU Leuven, Department of Kinesiology, Heverlee, BELGIUM
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Devi R, Powell J, Singh S. A web-based program improves physical activity outcomes in a primary care angina population: randomized controlled trial. J Med Internet Res 2014; 16:e186. [PMID: 25217464 PMCID: PMC4180351 DOI: 10.2196/jmir.3340] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 06/17/2014] [Accepted: 07/10/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Angina affects more than 50 million people worldwide. Secondary prevention interventions such as cardiac rehabilitation are not widely available for this population. An Internet-based version could offer a feasible alternative. OBJECTIVE Our aim was to examine the effectiveness of a Web-based cardiac rehabilitation program for those with angina. METHODS We conducted a randomized controlled trial, recruiting those diagnosed with angina from general practitioners (GPs) in primary care to an intervention or control group. Intervention group participants were offered a 6-week Web-based rehabilitation program ("ActivateYourHeart"). The program was introduced during a face-to-face appointment and then delivered via the Internet (no further face-to-face contact). The program contained information about the secondary prevention of coronary heart disease (CHD) and set each user goals around physical activity, diet, managing emotions, and smoking. Performance against goals was reviewed throughout the program and goals were then reset/modified. Participants completed an online exercise diary and communicated with rehabilitation specialists through an email link/synchronized chat room. Participants in the control group continued with GP treatment as usual, which consisted of being placed on a CHD register and attending an annual review. Outcomes were measured at 6-week and 6-month follow-ups during face-to-face assessments. The primary outcome measure was change in daily steps at 6 weeks, measured using an accelerometer. Secondary outcome measures were energy expenditure (EE), duration of sedentary activity (DSA), duration of moderate activity (DMA), weight, diastolic/systolic blood pressure, and body fat percentage. Self-assessed questionnaire outcomes included fat/fiber intake, anxiety/depression, self-efficacy, and quality of life (QOL). RESULTS A total of 94 participants were recruited and randomized to the intervention (n=48) or the usual care (n=46) group; 84 and 73 participants completed the 6-week and 6-month follow-ups, respectively. The mean number of log-ins to the program was 18.68 (SD 13.13, range 1-51), an average of 3 log-ins per week per participant. Change in daily steps walked at the 6-week follow-up was +497 (SD 2171) in the intervention group and -861 (SD 2534) in the control group (95% CI 263-2451, P=.02). Significant intervention effects were observed at the 6-week follow-up in EE (+43.94 kcal, 95% CI 43.93-309.98, P=.01), DSA (-7.79 minutes, 95% CI -55.01 to -7.01, P=.01), DMA (+6.31 minutes, 95% CI 6.01-51.20, P=.01), weight (-0.56 kg, 95% CI -1.78 to -0.15, P=.02), self-efficacy (95% CI 0.30-4.79, P=.03), emotional QOL score (95% CI 0.01-0.54, P=.04), and angina frequency (95% CI 8.57-35.05, P=.002). Significant benefits in angina frequency (95% CI 1.89-29.41, P=.02) and social QOL score (95% CI 0.05-0.54, P=.02) were also observed at the 6-month follow-up. CONCLUSIONS An Internet-based secondary prevention intervention could be offered to those with angina. A larger pragmatic trial is required to provide definitive evidence of effectiveness and cost-effectiveness. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN): 90110503; http://www.controlled-trials.com/ISRCTN90110503/ISRCTN90110503 (Archived by WebCite at http://www.webcitation.org/6RYVOQFKM).
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Affiliation(s)
- Reena Devi
- Coventry University, Applied Research Centre in Health and Lifestyle Interventions, Coventry, United Kingdom.
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Waliany S, Dieli-Conwright CM, Frankel PH, Hurria A, Chao J, Tiep B, Mortimer JE. Validation and feasibility of a caloric expenditure measuring device in women with early-stage breast cancer. Support Care Cancer 2014; 22:2329-36. [PMID: 25082619 DOI: 10.1007/s00520-014-2212-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 03/09/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The purpose of this study is to validate the Bodybugg (BB), a caloric expenditure measuring device, in breast cancer patients undergoing adjuvant and neoadjuvant chemotherapy for early-stage breast cancer. METHODS Twenty-five women with stages I-III breast cancer who were to receive adjuvant dose-dense doxorubicin/cyclophosphamide were recruited. Participants were asked to wear the BB and record activity logs for seven pretreatment days (prior to commencing chemotherapy) and seven posttreatment days (upon completing cycle 4 of chemotherapy). The BB's caloric expenditure measurements were used to calculate metabolic equivalent (MET) values of patients' recorded activities. BB-calculated METs were compared with matching METs from the 2011 Compendium of Physical Activities Tracking Guide to assess accuracy of the device. RESULTS The overall patient sample wore the device for an average of 5.32 (SD 1.75) pre- and 4.88 (SD 2.01) posttreatment days. The mean pairwise difference between BB and Compendium METs was 0.043 (SD 0.77) for 308 pretreatment activities recorded by 12 patients and 0.065 (SD 0.61) for 108 posttreatment activities recorded by 6 patients, indicating close to zero bias between the BB's and Compendium's measurements. Hierarchical linear modeling showed that Compendium METs strongly predict for BB METs (P < 0.00001). CONCLUSIONS The BB is feasible to use in study designs involving defined time periods of measurement and provides accurate and objective measurements of caloric expenditure in breast cancer patients.
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Affiliation(s)
- Sarah Waliany
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, USA
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Hermann A, Ried-Larsen M, Jensen AK, Holst R, Andersen LB, Overgaard S, Holsgaard-Larsen A. Low validity of the Sensewear Pro3 activity monitor compared to indirect calorimetry during simulated free living in patients with osteoarthritis of the hip. BMC Musculoskelet Disord 2014; 15:43. [PMID: 24552503 PMCID: PMC3938645 DOI: 10.1186/1471-2474-15-43] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 02/11/2014] [Indexed: 12/02/2022] Open
Abstract
Background To validate physical activity estimates by the Sensewear Pro3 activity monitor compared with indirect calorimetry during simulated free living in patients diagnosed with osteoarthritis of the hip pre or post total hip arthroplasty. Methods Twenty patients diagnosed with hip osteoarthritis (10 pre- and 10 post total hip arthroplasty; 40% female; age: 63.3 ± 9.0; BMI: 23.7 ± 3.7). All patients completed a 2 hour protocol of simulated free living with 8 different typical physical activity types. Energy consumption (kcal/min) was estimated by the Sense Wear pro3 Armband activity monitor and validated against indirect calorimetry (criterion method) by means of a portable unit (Cosmed K4b2). Bias and variance was analyzed using functional ANOVA. Results Mean bias during all activities was 1.5 Kcal/min 95%CI [1.3; 1.8] corresponding to 72% (overestimation). Normal gait speed showed an overestimation of 2.8 Kcal/min, 95%CI [2.3; 3.3] (93%) while an underestimation of -1.1 Kcal/min, 95%CI [-1.8; -0.3] (-25%) was recorded during stair climb. Activities dominated by upper body movements showed large overestimation with 4.37 Kcal/min, 95%CI [3.8; 5.1] (170%) being recorded during gardening. Both bias and variance appeared to be dependent on activity type. Conclusion The activity monitor generally overestimated the energy consumption during common activities of low to medium intensity in the patient group. The size and direction of the bias was highly dependent on the activity type which indicates the activity monitor is of limited value in patients with hip osteoarthritis and that the results do not express the real energy expenditure.
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Affiliation(s)
- Andreas Hermann
- Orthopedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.
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Hulzebos E, Dadema T, Takken T. Measurement of physical activity in patients with cystic fibrosis: a systematic review. Expert Rev Respir Med 2014; 7:647-53. [DOI: 10.1586/17476348.2013.839248] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Cox NS, Alison JA, Button BM, Wilson JW, Morton JM, Dowman LM, Holland AE. Validation of a multi-sensor armband during free-living activity in adults with cystic fibrosis. J Cyst Fibros 2013; 13:347-50. [PMID: 24374296 DOI: 10.1016/j.jcf.2013.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 11/18/2013] [Accepted: 11/21/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND The SenseWear Armband (SWA) provides simple and non-invasive measures of energy expenditure (EE) during physical activity, however its accuracy in adults with cystic fibrosis (CF) during free living physical activities has not been established. METHODS 26 CF adults (mean FEV1 63% predicted; 11 males) completed a series of standardised static and active tasks with simultaneous analysis of EE via the SWA and indirect calorimetry (IC). RESULTS Mean difference and limits of agreement between EE values from the SWA and IC across all activities were -0.02METs (95% CI -1.1 to 1.1). There was moderate agreement between the two measures (ICC 0.4; 95% CI: 0 to 0.7; p=0.03). For individual activity tasks ICC ranged from 0.1 to 0.6. CONCLUSION Overall, the SWA demonstrated good agreement with IC for EE estimates in CF adults during a series of free-living activities, however accuracy was variable when assessing EE for specific activities of shorter duration.
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Affiliation(s)
- Narelle S Cox
- School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Australia.
| | - Jennifer A Alison
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Australia; Department of Physiotherapy, Royal Prince Alfred Hospital, Australia
| | - Brenda M Button
- Department of Physiotherapy, Alfred Hospital, Australia; Department of Medicine, Alfred Campus, Monash University, Australia; Department of AIRmed, Alfred Hospital, Australia
| | - John W Wilson
- Department of Medicine, Alfred Campus, Monash University, Australia; Department of AIRmed, Alfred Hospital, Australia
| | - Judith M Morton
- Department of Respiratory Medicine, Monash Health, Australia; Department of Medicine, Monash Campus, Monash University, Australia
| | - Leona M Dowman
- School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Australia
| | - Anne E Holland
- School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Australia; Department of Physiotherapy, Alfred Hospital, Australia
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Savi D, Quattrucci S, Internullo M, De Biase RV, Calverley PMA, Palange P. Measuring habitual physical activity in adults with cystic fibrosis. Respir Med 2013; 107:1888-94. [PMID: 24094944 DOI: 10.1016/j.rmed.2013.09.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 09/13/2013] [Accepted: 09/14/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND The aim of the present study was to determine whether different methods of recording physical activity (PA), i.e., accelerometers vs questionnaires, provided similar information in adults with cystic fibrosis (CF). METHODS 20 CF (age 33 ± 8SD yrs, FEV1 68 ± 16% predicted) and 11 age-matched healthy controls completed the Habitual Activity Estimation Scale (HAES) questionnaire and wore a biaxial accelerometer (SenseWear Pro3 Armband). Exercise tolerance was measured in CF. RESULTS Patients had similar values in PA compared with controls. None of PA categories estimated by HAES questionnaire correlated with PA categories measured by the accelerometer; in CF the HAES questionnaire overestimated the effective levels of PA measured by the accelerometer. There were no differences between weekdays and weekend days PA levels provided by the accelerometer. In CF the questionnaire detected different time reported during the "somewhat inactive" and "somewhat active" categories (z = 2.651; p = 0.008; z = -2.651; p = 0.008), weekdays vs weekend; patients reported more time spent in activity (somewhat active & very active) during the weekend (z = -2.203; p = 0.02). Peak oxygen uptake correlated with accelerometer activities of "moderate" (>4.8 metabolic equivalents (METS)) and "vigorous" (>7.2 METS) intensity (r = 0.503, p = 0.02; r = 0.545, p = 0.01). CONCLUSIONS In adults with cystic fibrosis PA levels are better evaluated by the accelerometer and are similar to the controls. PA measured by the accelerometer is similar during the week and correlates with exercise tolerance.
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Affiliation(s)
- Daniela Savi
- Department of Pediatrics and Pediatric Neurology, Cystic Fibrosis Center, Sapienza University of Rome, Viale Regina Elena, 324, Rome 00185, Italy.
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Casiraghi F, Lertwattanarak R, Luzi L, Chavez AO, Davalli AM, Naegelin T, Comuzzie AG, Frost P, Musi N, Folli F. Energy expenditure evaluation in humans and non-human primates by SenseWear Armband. Validation of energy expenditure evaluation by SenseWear Armband by direct comparison with indirect calorimetry. PLoS One 2013; 8:e73651. [PMID: 24069218 PMCID: PMC3777938 DOI: 10.1371/journal.pone.0073651] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 07/22/2013] [Indexed: 11/25/2022] Open
Abstract
Introduction The purpose of this study was to compare and validate the use of SenseWear Armband (SWA) placed on the arm (SWA ARM) and on the back (SWA BACK) in healthy humans during resting and a cycle-ergometer exercise and to evaluate the SWA to estimate Resting Energy Expenditure (REE) and Total Energy Expenditure (TEE) in healthy baboons. Methods We studied 26 (15F/11M) human subjects wearing SWA in two different anatomical sites (arm and back) during resting and a cycle-ergometer test and directly compared these results with indirect calorimetry evaluation (IC), performed at the same time. We then inserted the SWA in a metabolic jacket for baboons and evaluated the TEE and REE in free living condition for 6 days in 21 (8F/13M) non-human primates. Results In humans we found a good correlation between SWA place on the ARM and on the BACK with IC during the resting experiment (1.1±0.3 SWAs, 1±0.2 IC kcal/min) and a slight underestimation in the SWAs data compared with IC during the cycle-ergometer exercise (5±1.9 SWA ARM, 4.5±1.5 SWA BACK and 5.4±2.1 IC kcal/min). In the non-human primate (baboons) experiment SWA estimated a TEE of 0.54±0.009 kcal/min during free living and a REE of 0.82±0.06 kcal/min. Conclusion SWA, an extremely simple and inexpensive apparatus, provides quite accurate measurements of energy expenditure in humans and in baboons. Energy expenditure data obtained with SWA are highly correlated with the data obtained with “gold standard”, IC, in humans.
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Affiliation(s)
- Francesca Casiraghi
- Department of Medicine/Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
- Metabolism Research Center, I.R.C.C.S. Policlinico San Donato Hospital, Milano, Italy
| | - Raweewan Lertwattanarak
- Department of Medicine/Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
- Texas Diabetes Institute, San Antonio, Texas, United States of America
| | - Livio Luzi
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
- Metabolism Research Center, I.R.C.C.S. Policlinico San Donato Hospital, Milano, Italy
| | - Alberto O. Chavez
- Department of Medicine/Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | | | - Terry Naegelin
- Southwest National Primate Research Center, San Antonio, Texas, United States of America
| | - Anthony G. Comuzzie
- Southwest National Primate Research Center, San Antonio, Texas, United States of America
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, Texas, United States of America
| | - Patricia Frost
- Southwest National Primate Research Center, San Antonio, Texas, United States of America
| | - Nicolas Musi
- Department of Medicine/Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
- Texas Diabetes Institute, San Antonio, Texas, United States of America
| | - Franco Folli
- Department of Medicine/Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, Texas, United States of America
- * E-mail:
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Reeve MD, Pumpa KL, Ball N. Accuracy of the SenseWear Armband Mini and the BodyMedia FIT in resistance training. J Sci Med Sport 2013; 17:630-4. [PMID: 24120404 DOI: 10.1016/j.jsams.2013.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 08/02/2013] [Accepted: 08/23/2013] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To examine the validity and reliability of the SenseWear Armband Mini and BodyMedia FIT in comparison to the Cosmed K4b(2) portable for assessing energy expenditure during resistance training. DESIGN Lab based validation and reliability study. METHODS Eleven males and 7 females (age = 22.7 ± 4.5 years) completed two resistance-training sessions. Total energy expenditure was simultaneously assessed by the SenseWear Armband Mini, BodyMedia FIT and Cosmed K4b(2) portable. The resistance-training sessions involved 3 sets of 10 repetitions for 9 different exercises. The weight lifted was 70% of the participants 1 repetition max with 90-s rest intervals. Validity and re-test reliability was assessed using Pearson correlations and mean change (%) ± 90% confidence limits and log transformed typical error measurements (TEMCV%). RESULTS A very large correlation was identified for total energy expenditure (Kcal) from both the SenseWear Armband Mini and BodyMedia FIT in comparison to the Cosmed K4b(2) portable (r = 0.77 and r = 0.78, respectively) and an almost perfect correlation was observed for total energy expenditure (Kcal) between the SenseWear Armband Mini and BodyMedia FIT (r = 0.97). A small percent mean change for the SenseWear Armband Mini (23.7%) and a trivial percent mean change for the BodyMedia FIT (13.8%) was observed in comparison to the Cosmed K4b(2) portable with a tendency to underestimate total energy expenditure. The SenseWear Armband Mini and BodyMedia FIT displayed an almost perfect correlation for total energy expenditure (Kcal) between sessions (r = 0.96 and r = 0.97, respectively) whilst TEMCV% of 5.1 and 4.3, respectively were observed. CONCLUSIONS The SenseWear Armband Mini and BodyMedia FIT provide a valid and reliable measure of energy expenditure during resistance training. There was no significant difference in validity or reliability observed between the SenseWear Armband Mini and BodyMedia FIT.
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Affiliation(s)
- Michael D Reeve
- National Institute of Sports Studies, University of Canberra, Australia
| | - Kate L Pumpa
- National Institute of Sports Studies, University of Canberra, Australia.
| | - Nick Ball
- National Institute of Sports Studies, University of Canberra, Australia
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Tierney M, Fraser A, Purtill H, Kennedy N. Study to determine the criterion validity of the SenseWear Armband as a measure of physical activity in people with rheumatoid arthritis. Arthritis Care Res (Hoboken) 2013; 65:888-95. [PMID: 23213019 DOI: 10.1002/acr.21914] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 11/06/2012] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Measuring physical activity in people with rheumatoid arthritis (RA) is of great importance in light of the increased mortality in this population due to cardiovascular disease. Validation of activity monitors in specific populations is recommended to ensure the accuracy of physical activity measurement. Thus, the purpose of this study was to determine the validity of the SenseWear Pro3 Armband (SWA) as a measure of physical activity during activities of daily living (ADL) in people with RA. METHODS Fourteen subjects (8 men and 6 women) with a diagnosis of RA were recruited from rheumatology clinics at the Mid-Western Regional Hospitals, Limerick, Ireland. Participants undertook a series of ADL of varying intensities. The SWA was compared to the criterion measures of the Oxycon Mobile indirect calorimetry system (energy expenditure in kJ) and of manual video observation (step count). Bland and Altman, intraclass correlation coefficient (ICC), and correlation analyses were done using SPSS, version 19.0. RESULTS The SWA showed substantial agreement (ICC 0.717, P < 0.001) and a strong relationship (Pearson's correlation coefficient = 0.852) compared with the criterion measure when estimating energy expenditure during ADL. However, it was found that the SWA overestimated energy expenditure, particularly at higher intensity levels. The ability of the SWA to estimate step counts during ADL was poor (ICC 0.304, P = 0.038). CONCLUSION The SWA can be considered a valid tool to estimate energy expenditure during ADL in the RA population; however, attention should be paid to its tendency to overestimate energy expenditure.
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Affiliation(s)
- Marie Tierney
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland.
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Minakata Y, Sugino A, Kanda M, Ichikawa T, Akamatsu K, Koarai A, Hirano T, Nakanishi M, Sugiura H, Matsunaga K, Ichinose M. Reduced level of physical activity in Japanese patients with chronic obstructive pulmonary disease. Respir Investig 2013; 52:41-8. [PMID: 24388370 DOI: 10.1016/j.resinv.2013.06.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 06/03/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND There is increasing interest in the quantification of physical activity (PA) with an accelerometer for the management of chronic obstructive pulmonary disease (COPD). However, a detailed understanding of the PA in Japanese patients with COPD is lacking. We evaluated the levels of PA in terms of intensity in Japanese patients with COPD and evaluated the factors, which could influence the PA. METHODS Forty-three outpatients with COPD and 21 age-matched healthy subjects were monitored with a triaxial accelerometer, and their PA was compared. Furthermore, the effects of pulmonary function, ADO index (age, dyspnea, and airflow obstruction) and modified BODE index (body mass index, airflow obstruction, dyspnea, and exercise capacity) on the PA were evaluated. RESULTS The PA in COPD was significantly reduced at all intensities. The reduced levels of PA in COPD were 23.1% at ≥2.0 metabolic equivalents (METs), 33.0% at ≥2.5 METs, 50.9% at ≥3.0 METs, and 66.9% at ≥3.5 METs, compared with that of healthy subjects, and the reduction was significant at GOLD stage III. The values of FVC, FEV1.0, and DLCO/VA were correlated with that of the PA, but the lung volume parameters were not. The ADO and modified BODE indices were also well correlated with the PA. CONCLUSIONS The reduced levels of PA in Japanese patients with COPD were objectively demonstrated in terms of intensity that could provide us a new target for the management of COPD.
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Affiliation(s)
- Yoshiaki Minakata
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Akihito Sugino
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Masae Kanda
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Tomohiro Ichikawa
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Keiichiro Akamatsu
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Akira Koarai
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan.
| | - Tsunahiko Hirano
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Masanori Nakanishi
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Hisatoshi Sugiura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan.
| | - Kazuto Matsunaga
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Masakazu Ichinose
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan.
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Holmes H, Wood J, Jenkins S, Winship P, Lunt D, Bostock S, Hill K. Xbox Kinect™ represents high intensity exercise for adults with cystic fibrosis. J Cyst Fibros 2013; 12:604-8. [PMID: 23746575 DOI: 10.1016/j.jcf.2013.05.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 04/20/2013] [Accepted: 05/07/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Exercise is important for patients with cystic fibrosis (CF). Interactive gaming consoles are a new trend in exercise. This study sought to determine the exercise intensity of training using the Xbox Kinect(™). METHODS Participants with CF completed two sessions separated by ≤10 days. The first session involved a cardiopulmonary exercise test (CPET) to measure peak exercise capacity. The second session involved 20 min of exercise using the Xbox Kinect™. RESULTS Ten participants (median [interquartile range] FEV1 58 [46]%, 29 [6] years, 6 males) completed the study. The average heart rate over the final 10 min of exercise using the Xbox Kinect™, expressed as a percentage of the peak heart rate achieved on the CPET, was 86% (95% confidence interval, 81 to 92%). CONCLUSIONS Training using the Xbox Kinect™ represents high intensity exercise for adults with CF and may be a suitable alternative to conventional exercise modalities.
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Affiliation(s)
- Hayley Holmes
- School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, 6845 Western Australia, Australia
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Burtin C, Van Remoortel H, Vrijsen B, Langer D, Colpaert K, Gosselink R, Decramer M, Dupont L, Troosters T. Impact of exacerbations of cystic fibrosis on muscle strength. Respir Res 2013; 14:46. [PMID: 23601143 PMCID: PMC3637497 DOI: 10.1186/1465-9921-14-46] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 04/10/2013] [Indexed: 11/13/2022] Open
Abstract
Background Adult patients with cystic fibrosis have peripheral muscle weakness, which is related to exercise intolerance and poor prognosis. The influence of acute exacerbations on muscle strength has been poorly studied. This study aimed to investigate whether quadriceps force (QF), as assessed with an involuntary technique, changes during intravenous antibiotics therapy (IVAT) for an exacerbation. Methods QF was measured in 20 patients using twitch stimulation of the femoral nerve at the day of hospitalization (day 1) and at termination (day 14) of the IVAT. Physical activity was monitored during IVAT using a SenseWear armband. Ten stable patients served as control subjects. Results QF did not change during exacerbation (potentiated twitch force at day 1: 140 ± 42 N, at day 14: 140 ± 47 N), but a decrease was observed in individual patients. Changes in twitch force during exacerbation were correlated with time spent in activities of at least moderate intensity (r = 0.61, p = 0.007). Conclusions QF does not systematically decrease during exacerbations of cystic fibrosis. Individual changes in QF are well correlated with daily time spent in activities of at least moderate intensity.
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Affiliation(s)
- Chris Burtin
- Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
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Physical activity levels of patients with cystic fibrosis hospitalised with an acute respiratory exacerbation. Respir Med 2013; 107:1014-20. [PMID: 23601566 DOI: 10.1016/j.rmed.2013.03.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 02/27/2013] [Accepted: 03/01/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The physical activity levels of adult patients with cystic fibrosis hospitalised for an acute respiratory exacerbation is unknown. METHODS A prospective observational study was undertaken. Physical activity levels were measured for a 24-h period using an activity monitor (SenseWear(®) Pro 3) during hospitalisation for an acute respiratory exacerbation and one month post-discharge. Measures of exercise tolerance and muscle strength were also recorded. RESULTS Twenty-four patients completed the study. Most outcomes significantly increased from hospitalisation to one month post-discharge. Time spent doing physical activity (≥3 METs) increased from a mean ± SD of 95 ± 58 to 209 ± 111 min. CONCLUSIONS Hospitalisation for an acute respiratory exacerbation was associated with less time spent performing physical activity compared to one month post-discharge. Physical activity levels were higher than anticipated, even during hospitalisation, suggesting an increased metabolic rate may have contributed to the physical activity levels documented. Activity level definitions for moderate intensity exercise that are based on higher MET levels seemed more appropriate in this patient setting. CLINICAL TRIAL REGISTRY Australian New Zealand Clinical Trials Registry Number: ACTRN12610000595011.
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Dobbins C, Fergus P, Stratton G, Rosenberg M, Merabti M. Monitoring and Reducing Sedentary Behavior in the Elderly with the Aid of Human Digital Memories. Telemed J E Health 2013; 19:173-85. [DOI: 10.1089/tmj.2012.0129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Chelsea Dobbins
- School of Computing & Mathematical Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Paul Fergus
- School of Computing & Mathematical Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Gareth Stratton
- Sport and Health Portfolio, College of Engineering, Swansea University, Swansea, United Kingdom
| | - Michael Rosenberg
- Health Promotion Evaluation Unit, The University of Western Australia, Crawley, Western Australia, Australia
| | - Madjid Merabti
- School of Computing & Mathematical Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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