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Camerlingo N, Cai X, Adamowicz L, Welbourn M, Psaltos DJ, Zhang H, Messere A, Selig J, Lin W, Sheriff P, Demanuele C, Santamaria M, Karahanoglu FI. Measuring gait parameters from a single chest-worn accelerometer in healthy individuals: a validation study. Sci Rep 2024; 14:13897. [PMID: 38886358 PMCID: PMC11183133 DOI: 10.1038/s41598-024-62330-6] [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] [Received: 12/14/2023] [Accepted: 05/15/2024] [Indexed: 06/20/2024] Open
Abstract
Digital health technologies (DHTs) are increasingly being adopted in clinical trials, as they enable objective evaluations of health parameters in free-living environments. Although lumbar accelerometers notably provide reliable gait parameters, embedding accelerometers in chest devices, already used for vital signs monitoring, could capture a more comprehensive picture of participants' wellbeing, while reducing the burden of multiple devices. Here we assess the validity of gait parameters measured from a chest accelerometer. Twenty healthy adults (13 females, mean ± sd age: 33.9 ± 9.1 years) instrumented with lumbar and chest accelerometers underwent in-lab and outside-lab walking tasks, while monitored with reference devices (an instrumented mat, and a 6-accelerometers set). Gait parameters were extracted from chest and lumbar accelerometers using our open-source Scikit Digital Health gait (SKDH-gait) algorithm, and compared against reference values via Bland-Altman plots, Pearson's correlation, and intraclass correlation coefficient. Mixed effects regression models were performed to investigate the effect of device, task, and their interaction. Gait parameters derived from chest and lumbar accelerometers showed no significant difference and excellent agreement across all tasks, as well as good-to-excellent agreement and strong correlation against reference values, thus supporting the deployment of a single multimodal chest device in clinical trials, to simultaneously measure gait and vital signs.Trial Registration: The study was reviewed and approved by the Advarra IRB (protocol number: Pro00043100).
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Affiliation(s)
| | - X Cai
- Pfizer, Inc., Cambridge, MA, USA
| | | | | | | | - H Zhang
- Pfizer, Inc., Cambridge, MA, USA
| | | | - J Selig
- Pfizer, Inc., Cambridge, MA, USA
| | - W Lin
- Pfizer, Inc., Cambridge, MA, USA
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Arrué P, Laksari K, Russo M, La Placa T, Smith M, Toosizadeh N. Associating frailty and dynamic dysregulation between motor and cardiac autonomic systems. FRONTIERS IN AGING 2024; 5:1396636. [PMID: 38803576 PMCID: PMC11128670 DOI: 10.3389/fragi.2024.1396636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024]
Abstract
Frailty is a geriatric syndrome associated with the lack of physiological reserve and consequent adverse outcomes (therapy complications and death) in older adults. Recent research has shown associations between heart rate (HR) dynamics (HR changes during physical activity) with frailty. The goal of the present study was to determine the effect of frailty on the interconnection between motor and cardiac systems during a localized upper-extremity function (UEF) test. Fifty-six individuals aged 65 or above were recruited and performed the previously developed UEF test consisting of 20-s rapid elbow flexion with the right arm. Frailty was assessed using the Fried phenotype. Wearable gyroscopes and electrocardiography were used to measure motor function and HR dynamics. In this study, the interconnection between motor (angular displacement) and cardiac (HR) performance was assessed, using convergent cross-mapping (CCM). A significantly weaker interconnection was observed among pre-frail and frail participants compared to non-frail individuals (p < 0.01, effect size = 0.81 ± 0.08). Using logistic models, pre-frailty and frailty were identified with sensitivity and specificity of 82%-89%, using motor, HR dynamics, and interconnection parameters. Findings suggested a strong association between cardiac-motor interconnection and frailty. Adding CCM parameters in a multimodal model may provide a promising measure of frailty.
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Affiliation(s)
- Patricio Arrué
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States
| | - Kaveh Laksari
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States
- Department of Aerospace and Mechanical Engineering, University of Arizona, Tucson, AZ, United States
| | - Mark Russo
- Department of Surgery, Division of Cardiac Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Tana La Placa
- Department of Surgery, Division of Cardiac Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Meghan Smith
- Department of Surgery, Division of Cardiac Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Nima Toosizadeh
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States
- Arizona Center on Aging (ACOA), Department of Medicine, University of Arizona, Tucson, AZ, United States
- Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, AZ, United States
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Álvarez-Millán L, Lerma C, Castillo-Castillo D, Quispe-Siccha RM, Pérez-Pacheco A, Rivera-Sánchez J, Fossion R. Chronotropic Response and Heart Rate Variability before and after a 160 m Walking Test in Young, Middle-Aged, Frail, and Non-Frail Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148413. [PMID: 35886265 PMCID: PMC9320251 DOI: 10.3390/ijerph19148413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 02/04/2023]
Abstract
The frailty syndrome is characterized by a decreased capacity to adequately respond to stressors. One of the most impaired physiological systems is the autonomous nervous system, which can be assessed through heart rate (HR) variability (HRV) analysis. In this article, we studied the chronotropic response (HR and HRV) to a walking test. We also analyzed HRV indices in rest as potential biomarkers of frailty. For this, a 160 m-walking test and two standing rest tests (before and after the walking) were performed by young (19−29 years old, n = 21, 57% women), middle-aged (30−59 years old, n = 16, 62% women), and frail older adults (>60 years old, n = 28, 40% women) and non-frail older adults (>60 years old, n = 15, 71% women), classified with the FRAIL scale and the Clinical Frailty Scale (CFS). Frequency domain parameters better allowed to distinguish between frail and non-frail older adults (low-frequency power LF, high-frequency power HF (nu), LF/HF ratio, and ECG-derived respiration rate EDR). Frail older adults showed an increased HF (nu) and EDR and a reduced LF (nu) and LF/HF compared to non-frail older adults. The increase in HF (nu) could be due to a higher breathing effort. Our results showed that a walk of 160 m is a sufficient cardiovascular stressor to exhibit an attenuated autonomic response in frail older adults. Several HRV indices showed to be potential biomarkers of frailty, being LF (nu) and the time required to reach the maximum HR the best candidates.
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Affiliation(s)
- Lesli Álvarez-Millán
- Programa de Doctorado en Ciencias Biomédicas, Universidad Nacional Autónoma de México (UNAM), Mexico City 04510, Mexico;
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City 04510, Mexico
| | - Claudia Lerma
- Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico;
| | - Daniel Castillo-Castillo
- Servicio de Geriatría, Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico;
| | - Rosa M. Quispe-Siccha
- Unidad de Investigación y Desarrollo Tecnológico, Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico; (R.M.Q.-S.); (A.P.-P.); (J.R.-S.)
| | - Argelia Pérez-Pacheco
- Unidad de Investigación y Desarrollo Tecnológico, Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico; (R.M.Q.-S.); (A.P.-P.); (J.R.-S.)
| | - Jesús Rivera-Sánchez
- Unidad de Investigación y Desarrollo Tecnológico, Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico; (R.M.Q.-S.); (A.P.-P.); (J.R.-S.)
| | - Ruben Fossion
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City 04510, Mexico
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México (UNAM), Mexico City 04510, Mexico
- Correspondence: ; Tel.: +52-55-5622-4672 (ext. 5104)
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