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Chamradova K, Batalik L, Winnige P, Dosbaba F, Hartman M, Batalikova K, Janikova A, Nehyba S, Felsoci M, Pepera G, Su JJ. Effects of home-based exercise with telehealth guidance in lymphoma cancer survivors entering cardio-oncology rehabilitation: rationale and design of the tele@home study. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2024; 10:46. [PMID: 39080734 PMCID: PMC11289918 DOI: 10.1186/s40959-024-00249-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/19/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Participation in cardio-oncological rehabilitation is low, and the effects incline to decrease after the initial rehabilitation term. Home-based exercise has the potential to enhance involvement in cardio-oncology rehabilitation and was demonstrated to be feasible, safe, and helpful in increasing short-term cardiorespiratory fitness. The lasting effects on cardiorespiratory fitness and physical activity are uncertain. Hence, a novel approach via telehealth management based on objectively measured exercise at home was proposed. OBJECTIVES To improve self-monitoring, such as self-confidence, behavioral change, and goal setting for individual exercise, and afterward, increase long-term effects concerning cardiorespiratory fitness. DESIGN This randomized controlled trial compares a 12-week guided home exercise telehealth intervention with a center-based exercise intervention of the same duration and intensity of exercise in lymphoma cancer survivors entering cardio-oncology rehabilitation after treatment. Participants will be instructed to exercise gradually at 60-85% of their maximum heart rate for 30-50 min 3 times a week. Participants will receive individual remote guidance (feedback about frequency, duration, and exercise intensity) by preferred contact (phone call, text message) once a week based on shared exercise data through the web platform. The primary outcome is a change in cardiorespiratory fitness expressed as maximal oxygen uptake assessed through cardiopulmonary exercise test at baseline, 12 weeks, and 1 year. Secondary objectives are quality of life, muscle strength, body composition, incidence of adverse events, and exercise adherence. This study will determine whether a telehealth model is effective and safe compared to a center-based model in cancer survivors and whether exercise prescriptions are followed by participants. Additionally, an overview of the long-term effectiveness of telehealth cardio-oncology rehabilitation will be provided. This approach aligns with the trend of moving non-complex healthcare services into the patients' home environment. TRIAL REGISTRATION ClinicalTrials.Gov Identifier: NCT05779605.
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Affiliation(s)
- Katerina Chamradova
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic.
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Petr Winnige
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Martin Hartman
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Katerina Batalikova
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
| | - Andrea Janikova
- Department of Internal Medicine-Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | - Svatopluk Nehyba
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic
| | - Marian Felsoci
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic
| | - Garyfallia Pepera
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Jing Jing Su
- School of Nursing, Tung Wah College, Hong Kong, China.
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Jacko T, Bartsch J, von Diecken C, Ueberschär O. Validity of Current Smartwatches for Triathlon Training: How Accurate Are Heart Rate, Distance, and Swimming Readings? SENSORS (BASEL, SWITZERLAND) 2024; 24:4675. [PMID: 39066072 PMCID: PMC11281193 DOI: 10.3390/s24144675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
Smartwatches are one of the most relevant fitness trends of the past two decades, and they collect increasing amounts of health and movement data. The accuracy of these data may be questionable and requires further investigation. Therefore, the aim of the present study is to validate smartwatches for use in triathlon training. Ten different smartwatches were tested for accuracy in measuring heart rates, distances (via global navigation satellite systems, GNSSs), swim stroke rates and the number of swim laps in a 50 m Olympic-size pool. The optical heart rate measurement function of each smartwatch was compared to that of a chest strap. Thirty participants (15 females, 15 males) ran five 3 min intervals on a motorised treadmill to evaluate the accuracy of the heart rate measurements. Moreover, for each smartwatch, running and cycling distance tracking was tested over six runs of 4000 m on a 400 m tartan stadium track, six hilly outdoor runs over 3.4 km, and four repetitions of a 36.8 km road bike course, respectively. Three swimming protocols ranging from 200 m to 400 m were performed in triplicate in a 50 m Olympic-size pool, evaluating the tracked distance and the detected number of strokes. The mean absolute percentage errors (MAPEs) for the average heart rate measurements varied between 3.1% and 8.3%, with the coefficient of determination ranging from 0.22 to 0.79. MAPE results ranged from 0.8% to 12.1% for the 4000 m run on the 400 m track, from 0.2% to 7.5% for the 3.4 km outdoor run, and from 0.0% to 4.2% for the 36.8 km bike ride. For the swimming tests, in contrast, the deviations from the true distance varied greatly, starting at a 0.0% MAPE for the 400 m freestyle and reaching 91.7% for the 200 m medley with style changes every 25 m. In summary, for some of the smartwatches, the measurement results deviated substantially from the true values. Measurements taken while road cycling over longer distances with only a few curves were in relative terms more accurate than those taken during outdoor runs and even more accurate than those taken on the 400 m track. In the swimming exercises, the accuracy of the measured distances was severely deteriorated by the medley changes among the majority of the smartwatches. Altogether, the results of this study should help in assessing the accuracy and thus the suitability of smartwatches for general triathlon training.
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Affiliation(s)
- Tobias Jacko
- Department for Health Sciences, Medicine and Research, Faculty of Health and Medicine, Danube University Krems, 3500 Krems an der Donau, Austria;
| | - Julia Bartsch
- Department of Engineering and Industrial Design, Magdeburg-Stendal University of Applied Sciences, 39114 Magdeburg, Germany; (J.B.)
| | - Carlo von Diecken
- Department of Engineering and Industrial Design, Magdeburg-Stendal University of Applied Sciences, 39114 Magdeburg, Germany; (J.B.)
| | - Olaf Ueberschär
- Department of Engineering and Industrial Design, Magdeburg-Stendal University of Applied Sciences, 39114 Magdeburg, Germany; (J.B.)
- Department of Biomechanics and Sports Technology, Institute for Applied Training Science, 04109 Leipzig, Germany
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Baumann M, Hill C, Camic C, Chomentowski P, Siqueira V, Petruzzello S, Sebastião E. An Investigation of the Sled-Push Exercise Using a Resisted Sled Machine in Apparently Healthy Older Adults: An Exploratory Study. J Aging Phys Act 2024; 32:416-427. [PMID: 38340712 DOI: 10.1123/japa.2023-0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 11/14/2023] [Accepted: 12/05/2023] [Indexed: 02/12/2024]
Abstract
Physical function is regarded as the cornerstone of healthy aging, and exercise is an important determinant of healthy aging. This study examined the feasibility and physiological (heart rate, blood pressure, blood lactate, and rate of perceived exertion) and psychological (enjoyment) response resulting from an acute progressive sled-push (SLP) exercise session using the novel XPO Sled Trainer in older adults and compared that with walking (WKC) condition. The exercise session comprised six exercise bouts at 75%, 85%, 100% (2×), and 125% (2×) of normal velocity with a 2-min rest between bouts. Thirty-six older adults were randomly allocated into either the SLP or WKC conditions. No adverse events were observed during the exercise session, and all participants completed the exercise protocol as prescribed. One-third of the participants in the SLP group reported minimal body discomfort. Significantly higher responses were observed for all physiological variables as the intensity of the exercise increased in the SLP group compared with the WKC group (p < .001). The SLP group presented a decline in enjoyment as the intensity of the exercise increased (during), but similar enjoyment level than the WKC group for the overall exercise session (p = .711). Our findings support the viability and safety of SLP exercise using the XPO Sled Trainer in older adults. Such exercise demonstrated an intensity-driven modality that may have potential to elucidate positive adaptations in the cardiovascular system of older adults with acceptable levels of enjoyment.
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Affiliation(s)
- Micheal Baumann
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL, USA
| | - Christopher Hill
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL, USA
| | - Clayton Camic
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL, USA
| | - Peter Chomentowski
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL, USA
| | - Vitor Siqueira
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL, USA
| | - Steven Petruzzello
- Department of Kinesiology and Community, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Emerson Sebastião
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL, USA
- Department of Kinesiology and Community, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Buckley JP, Terada T, Lion A, Reed JL. Is breathing frequency a potential means for monitoring exercise intensity in people with atrial fibrillation and coronary heart disease when heart rate is mitigated? Eur J Appl Physiol 2024:10.1007/s00421-024-05487-2. [PMID: 38703192 DOI: 10.1007/s00421-024-05487-2] [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: 03/06/2023] [Accepted: 04/05/2024] [Indexed: 05/06/2024]
Abstract
PURPOSE Moderate-intensity aerobic exercise is safe and beneficial in atrial fibrillation (AF) and coronary heart disease (CHD). Irregular or rapid heart rates (HR) in AF and other heart conditions create a challenge to using HR to monitor exercise intensity. The purpose of this study was to assess the potential of breathing frequency (BF) to monitor exercise intensity in people with AF and CHD without AF. METHODS This observational study included 30 AF participants (19 Male, 70.7 ± 8.7 yrs) and 67 non-AF CHD participants (38 Male, 56.9 ± 11.4 yrs). All performed an incremental maximal exercise test with pulmonary gas exchange. RESULTS Peak aerobic power in AF ( V ˙ O2peak; 17.8 ± 5.0 ml.kg-1.min-1) was lower than in CHD (26.7 ml.kg-1.min-1) (p < .001). BF responses in AF and CHD were similar (BF peak: AF 34.6 ± 5.4 and CHD 36.5 ± 5.0 breaths.min-1; p = .106); at the 1st ventilatory threshold (BF@VT-1: AF 23.2 ± 4.6; CHD 22.4 ± 4.6 breaths.min-1; p = .240). % V ˙ O2peak at VT-1 were similar in AF and CHD (AF: 59%; CHD: 57%; p = .656). CONCLUSION With the use of wearable technologies on the rise, that now include BF, this first study provides an encouraging potential for BF to be used in AF and CHD. As the supporting data are based on incremental ramp protocol results, further research is required to assess BF validity to manage exercise intensity during longer bouts of exercise.
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Affiliation(s)
- John P Buckley
- School of Allied Health Professions, Keele University, Staffordshire, ST5 5BG, UK.
| | - Tasuku Terada
- University of Ottawa Heart Institute, Ottawa, ON, Canada
- Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Anna Lion
- Rehabilitation Technologies Network+, Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Jennifer L Reed
- University of Ottawa Heart Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Zhou F, Luo B, Zou X, Zou C, Wu D, Wang Z, Bai Y, Zhao M. A Wearable Sandwich Heterostructure Multimode Fiber Optic Microbend Sensor for Vital Signal Monitoring. SENSORS (BASEL, SWITZERLAND) 2024; 24:2209. [PMID: 38610420 PMCID: PMC11014310 DOI: 10.3390/s24072209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024]
Abstract
This work proposes a highly sensitive sandwich heterostructure multimode optical fiber microbend sensor for heart rate (HR), respiratory rate (RR), and ballistocardiography (BCG) monitoring, which is fabricated by combining a sandwich heterostructure multimode fiber Mach-Zehnder interferometer (SHMF-MZI) with a microbend deformer. The parameters of the SHMF-MZI sensor and the microbend deformer were analyzed and optimized in detail, and then the new encapsulated method of the wearable device was put forward. The proposed wearable sensor could greatly enhance the response to the HR signal. The performances for HR, RR, and BCG monitoring were as good as those of the medically approved commercial monitors. The sensor has the advantages of high sensitivity, easy fabrication, and good stability, providing the potential for application in the field of daily supervision and health monitoring.
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Affiliation(s)
- Fumin Zhou
- Chongqing Key Laboratory of Optical Fiber Sensor and Photoelectric Detection, Chongqing University of Technology, Chongqing 400054, China; (F.Z.); (C.Z.); (D.W.); (Z.W.); (Y.B.); (M.Z.)
| | - Binbin Luo
- Chongqing Key Laboratory of Optical Fiber Sensor and Photoelectric Detection, Chongqing University of Technology, Chongqing 400054, China; (F.Z.); (C.Z.); (D.W.); (Z.W.); (Y.B.); (M.Z.)
| | - Xue Zou
- Chongqing Key Laboratory of Optical Fiber Sensor and Photoelectric Detection, Chongqing University of Technology, Chongqing 400054, China; (F.Z.); (C.Z.); (D.W.); (Z.W.); (Y.B.); (M.Z.)
- School of Communications and Information Engineering, Chongqing University of Posts and Telecommunications, Chongqing 400065, China
| | - Chaoke Zou
- Chongqing Key Laboratory of Optical Fiber Sensor and Photoelectric Detection, Chongqing University of Technology, Chongqing 400054, China; (F.Z.); (C.Z.); (D.W.); (Z.W.); (Y.B.); (M.Z.)
| | - Decao Wu
- Chongqing Key Laboratory of Optical Fiber Sensor and Photoelectric Detection, Chongqing University of Technology, Chongqing 400054, China; (F.Z.); (C.Z.); (D.W.); (Z.W.); (Y.B.); (M.Z.)
| | - Zhijun Wang
- Chongqing Key Laboratory of Optical Fiber Sensor and Photoelectric Detection, Chongqing University of Technology, Chongqing 400054, China; (F.Z.); (C.Z.); (D.W.); (Z.W.); (Y.B.); (M.Z.)
| | - Yunfang Bai
- Chongqing Key Laboratory of Optical Fiber Sensor and Photoelectric Detection, Chongqing University of Technology, Chongqing 400054, China; (F.Z.); (C.Z.); (D.W.); (Z.W.); (Y.B.); (M.Z.)
| | - Mingfu Zhao
- Chongqing Key Laboratory of Optical Fiber Sensor and Photoelectric Detection, Chongqing University of Technology, Chongqing 400054, China; (F.Z.); (C.Z.); (D.W.); (Z.W.); (Y.B.); (M.Z.)
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Khushhal AA, Mohamed AA, Elsayed ME. Accuracy of Apple Watch to Measure Cardiovascular Indices in Patients with Chronic Diseases: A Cross Sectional Study. J Multidiscip Healthc 2024; 17:1053-1063. [PMID: 38496326 PMCID: PMC10941792 DOI: 10.2147/jmdh.s449071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/04/2024] [Indexed: 03/19/2024] Open
Abstract
Background The validity of the Apple Watch to measure the heart rate (HR) and oxygen saturation (Spo2) for patients with chronic diseases such as diabetes mellitus (DM), dyslipidemia, and hypertension is still unclear. Therefore, this study aims to investigate the accuracy of the Apple Watch in measuring the Spo2 and HR in patients with chronic diseases. Methods Forty-one patients with chronic diseases, including 20 with hypertension, 10 with diabetes, and 11 with dyslipidemia, completed a cross-sectional study. All participants used the Apple Watch against the Polar chest strap and the pulse oximeter at rest and during moderate intensity exercise sessions to measure HR and the SpO2 at rest for 5 minutes, during exercise for 16 minutes, and followed by 3 minutes of rest. The HR was measured during all previous periods, but evaluation of the Spo2 included 5 measures, done only before and after exercise, with a minute interval between each measure. Results Overall, a strong correlation exists between measuring the SpO2 using the Apple Watch against the pulse oximeter (Contec) at rest (r = 0.92, p < 0.001) and after exercise (r = 0.86, p < 0.001) in all patients. The HR had a very strong correlation between the Apple Watch and the Polar chest strap (r = 0.99, p < 0.001) in all patients. There was no significant difference (p = 0.76) between the twenty-seven white and fourteen brown-skinned patients. Conclusion The Apple Watch is valid to measure the HR and SpO2 in patients with chronic diseases. Clinical Trial Registration No NCT05271864.
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Affiliation(s)
- Alaa Abdulhafiz Khushhal
- Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ashraf Abdelaal Mohamed
- Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Physical Therapy for Cardiovascular/ Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Mahmoud Elshahat Elsayed
- Cardiology Department, Umm Al-Qura University Medical Center, Umm Al-Qura University, Makkah, Saudi Arabia
- Cardiology Department, Faculty of Medicine, Al Azhar University, Cairo, Egypt
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Ibrahim NS, Rampal S, Lee WL, Pek EW, Suhaimi A. Evaluation of Wrist-Worn Photoplethysmography Trackers with an Electrocardiogram in Patients with Ischemic Heart Disease: A Validation Study. Cardiovasc Eng Technol 2024; 15:12-21. [PMID: 37973701 DOI: 10.1007/s13239-023-00693-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Photoplethysmography measurement of heart rate with wrist-worn trackers has been introduced in healthy individuals. However, additional consideration is necessary for patients with ischemic heart disease, and the available evidence is limited. The study aims to evaluate the validity and reliability of heart rate measures by a wrist-worn photoplethysmography (PPG) tracker compared to an electrocardiogram (ECG) during incremental treadmill exercise among patients with ischemic heart disease. METHODS Fifty-one participants performed the standard incremental treadmill exercise in a controlled laboratory setting with 12-lead ECG attached to the patient's body and wearing wrist-worn PPG trackers. RESULTS At each stage, the absolute percentage error of the PPG was within 10% of the standard acceptable range. Further analysis using a linear mixed model, which accounts for individual variations, revealed that PPG yielded the best performance at the baseline low-intensity exercise. As the stages progressed, heart rate validity decreased but was regained during recovery. The reliability was moderate to excellent. CONCLUSIONS Low-cost trackers AMAZFIT Cor and Bip validity and reliability were within acceptable ranges, especially during low-intensity exercise among patients with ischemic heart disease recovering from cardiac procedures. Though using the tracker as part of the diagnosis tool still requires more supporting studies, it can potentially be used as a self-monitoring tool with precautions.
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Affiliation(s)
- Nur Syazwani Ibrahim
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Sanjay Rampal
- Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Wan Ling Lee
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Eu Way Pek
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Anwar Suhaimi
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
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Li K, Cardoso C, Moctezuma-Ramirez A, Elgalad A, Perin E. Heart Rate Variability Measurement through a Smart Wearable Device: Another Breakthrough for Personal Health Monitoring? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7146. [PMID: 38131698 PMCID: PMC10742885 DOI: 10.3390/ijerph20247146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/06/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
Heart rate variability (HRV) is a measurement of the fluctuation of time between each heartbeat and reflects the function of the autonomic nervous system. HRV is an important indicator for both physical and mental status and for broad-scope diseases. In this review, we discuss how wearable devices can be used to monitor HRV, and we compare the HRV monitoring function among different devices. In addition, we have reviewed the recent progress in HRV tracking with wearable devices and its value in health monitoring and disease diagnosis. Although many challenges remain, we believe HRV tracking with wearable devices is a promising tool that can be used to improve personal health.
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Affiliation(s)
- Ke Li
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Cristiano Cardoso
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Angel Moctezuma-Ramirez
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Abdelmotagaly Elgalad
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Emerson Perin
- Center for Clinical Research, The Texas Heart Institute, Houston, TX 77030, USA
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Koerber D, Khan S, Shamsheri T, Kirubarajan A, Mehta S. Accuracy of Heart Rate Measurement with Wrist-Worn Wearable Devices in Various Skin Tones: a Systematic Review. J Racial Ethn Health Disparities 2023; 10:2676-2684. [PMID: 36376641 PMCID: PMC9662769 DOI: 10.1007/s40615-022-01446-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/21/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Wearable consumer technology allows for the collection of a growing amount of personal health data. Through the analysis of reflected LED light on the skin, heart rate measurement and arrhythmia detection can be performed. Given that melanin alters skin light absorption, this study seeks to summarize the accuracy of cardiac data from wrist-worn wearable devices for participants of varying skin tones. METHODS We conducted a systematic review, searching Embase, MEDLINE, CINAHL, and Cochrane for original studies that stratified heart rate and rhythm data for consumer wearable technology according to participant race and/or skin tone. RESULTS A total of 10 studies involving 469 participants met inclusion criteria. The frequency-weighted Fitzpatrick score for skin tone was reported in six studies (n = 293), with a mean participant score of 3.5 (range 1-6). Overall, four of the ten studies reported a significant reduction in accuracy of heart rate measurement with wearable devices in darker-skinned individuals, compared to participants with lighter skin tones. Four studies noted no effect of user skin tone on accuracy. The remaining two studies showed mixed results. CONCLUSIONS Preliminary evidence is inconclusive, but some studies suggest that wearable devices may be less accurate for detecting heart rate in participants with darker skin tones. Higher quality evidence is necessary, with larger sample sizes and more objective stratification of participants by skin tone, in order to characterize potential racial bias in consumer devices.
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Affiliation(s)
- Daniel Koerber
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Shawn Khan
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Tahmina Shamsheri
- Department of Interdisciplinary Studies, McMaster University, Hamilton, Canada
| | - Abirami Kirubarajan
- Faculty of Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada
| | - Sangeeta Mehta
- Faculty of Medicine, University of Toronto, Toronto, Canada.
- Department of Medicine, Interdepartmental Division of Critical Care Medicine, Sinai Health System, University of Toronto, Toronto, Canada.
- Mount Sinai Hospital, 600 University Ave, Suite 18-216, Toronto, ON, Canada.
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Hilu R, Haskiah F, Khaskia A, Assali A, Baron I, Gabarin M, Chen J, Pereg D. Effectiveness and Safety of Remote Cardiac Rehabilitation for Patients After Acute Coronary Syndrome. Am J Cardiol 2023; 207:54-58. [PMID: 37722202 DOI: 10.1016/j.amjcard.2023.08.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/19/2023] [Accepted: 08/25/2023] [Indexed: 09/20/2023]
Abstract
Cardiac rehabilitation improves cardiovascular outcomes in patients after acute coronary syndrome (ACS). Recently there has been a growing interest in remote cardiac rehabilitation (RCR) programs. We aimed to evaluate the effectiveness of RCR compared with center-based cardiac rehabilitation (CBCR). This is an observational study including patients after hospital admission for ACS. The study group included patients at low-to-moderate risk for cardiovascular complications who were referred for RCR. The control group included patients at similar risk who participated in CBCR. The primary end points were the improvement of at least 10% to 25% in exercise capacity after 6 months of cardiac rehabilitation. Included were 305 patients who completed 6 months of cardiac rehabilitation. Of them, 107 patients participated in RCR and 198 in CBCR. RCR patients were younger and more frequently males. Improvement of ≥10% in exercise capacity after 6 months was achieved more frequently in patients participating in RCR compared with CBCR (69.3% and 55% respectively, p = 0.03). A similar trend was observed for improvement of ≥25% in exercise capacity after 6 months (33.8% and 22.7% in RCR and CBCR, respectively, p = 0.05). While weight reduction and the increase in muscle mass were similar in the 2 groups, fat percent reduction was significantly greater in the RCR compared with the CBCR (2.5% and 1.4% respectively, p <0.005). We conclude that RCR program is an effective and safe option for low-risk patients after hospital admission for ACS. It enables optimizing the utilization of this important service for patients with coronary artery disease.
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Affiliation(s)
- Ranin Hilu
- Cardiology Department, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Feras Haskiah
- Cardiology Department, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Abid Khaskia
- Cardiology Department, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Abid Assali
- Cardiology Department, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Igal Baron
- Cardiology Department, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Mustafa Gabarin
- Cardiology Department, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jacob Chen
- Cardiology Department, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - David Pereg
- Cardiology Department, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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11
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Turcu AM, Ilie AC, Ștefăniu R, Țăranu SM, Sandu IA, Alexa-Stratulat T, Pîslaru AI, Alexa ID. The Impact of Heart Rate Variability Monitoring on Preventing Severe Cardiovascular Events. Diagnostics (Basel) 2023; 13:2382. [PMID: 37510126 PMCID: PMC10378206 DOI: 10.3390/diagnostics13142382] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
The increase in the incidence of cardiovascular diseases worldwide raises concerns about the urgent need to increase definite measures for the self-determination of different parameters, especially those defining cardiac function. Heart rate variability (HRV) is a non-invasive method used to evaluate autonomic nervous system modulation on the cardiac sinus node, thus describing the oscillations between consecutive electrocardiogram R-R intervals. These fluctuations are undetectable except when using specialized devices, with ECG Holter monitoring considered the gold standard. HRV is considered an independent biomarker for measuring cardiovascular risk and for screening the occurrence of both acute and chronic heart diseases. Also, it can be an important predictive factor of frailty or neurocognitive disorders, like anxiety and depression. An increased HRV is correlated with rest, exercise, and good recovery, while a decreased HRV is an effect of stress or illness. Until now, ECG Holter monitoring has been considered the gold standard for determining HRV, but the recent decade has led to an accelerated development of technology using numerous devices that were created specifically for the pre-hospital self-monitoring of health statuses. The new generation of devices is based on the use of photoplethysmography, which involves the determination of blood changes at the level of blood vessels. These devices provide additional information about heart rate (HR), blood pressure (BP), peripheral oxygen saturation (SpO2), step counting, physical activity, and sleep monitoring. The most common devices that have this technique are smartwatches (used on a large scale) and chest strap monitors. Therefore, the use of technology and the self-monitoring of heart rate and heart rate variability can be an important first step in screening cardiovascular pathology and reducing the pressure on medical services in a hospital. The use of telemedicine can be an alternative, especially among elderly patients who are associated with walking disorders, frailty, or neurocognitive disorders.
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Affiliation(s)
- Ana-Maria Turcu
- Department of Medical Specialties II, Grigore T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adina Carmen Ilie
- Department of Medical Specialties II, Grigore T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ramona Ștefăniu
- Department of Medical Specialties II, Grigore T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Sabinne Marie Țăranu
- Department of Medical Specialties II, Grigore T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ioana Alexandra Sandu
- Department of Medical Specialties II, Grigore T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Teodora Alexa-Stratulat
- Department of Medical Oncology-Radiotherapy, Faculty of Medicine, Grigore T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Anca Iuliana Pîslaru
- Department of Medical Specialties II, Grigore T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ioana Dana Alexa
- Department of Medical Specialties II, Grigore T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
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12
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A non-invasive wearable stress patch for real-time cortisol monitoring using a pseudoknot-assisted aptamer. Biosens Bioelectron 2023; 227:115097. [PMID: 36858023 DOI: 10.1016/j.bios.2023.115097] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/29/2022] [Accepted: 01/19/2023] [Indexed: 01/30/2023]
Abstract
Stress is part of everyone's life and is exacerbated by traumatic events such as pandemics, disasters, violence, lifestyle changes, and health disorders. Chronic stress has many detrimental health effects and can even be life-threatening. Long-term stress monitoring outside of a hospital is often accomplished by measuring heart rate variability. While easy to measure, this digital biomarker has low specificity, greatly limiting its utility. To address this shortcoming, we report a non-invasive, wearable biomolecular sensor to monitor cortisol levels in sweat. Cortisol is a neuroendocrine hormone that regulates homeostasis as part of the stress pathway. Cortisol is detected using an electrochemical sensor functionalized with a pseudoknot-assisted aptamer and a flexible microfluidic sweat sampling system. The skin-worn microfluidic sampler provides rapid sweat collection while separating old and new sweat. The conformation-switching aptamer provides high specificity towards cortisol while being regenerable, allowing it to monitor temporal changes continuously. The aptamer was engineered to add a pseudoknot, restricting it to only two states, thus minimizing the background signal and enabling high sensitivity. An electrochemical pH sensor allows pH-corrected amperometric measurements. Device operation was demonstrated invitro with a broad linear dynamic range (1 pM - 1 μM) covering the physiological range and a sub-picomolar (0.2 pM) limit of detection in sweat. Real-time, on-body measurements were collected from human subjects using an induced stress protocol, demonstrating in-situ signal regeneration and the ability to detect dynamic cortisol fluctuations continuously for up to 90 min. The reported device has the potential to improve prognosis and enable personalized treatments.
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13
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Pineda-Alpizar F, Arriola-Valverde S, Vado-Chacón M, Sossa-Rojas D, Liu H, Zheng D. Real-Time Evaluation of Time-Domain Pulse Rate Variability Parameters in Different Postures and Breathing Patterns Using Wireless Photoplethysmography Sensor: Towards Remote Healthcare in Low-Resource Communities. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094246. [PMID: 37177450 PMCID: PMC10181559 DOI: 10.3390/s23094246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023]
Abstract
Photoplethysmography (PPG) signals have been widely used in evaluating cardiovascular biomarkers, however, there is a lack of in-depth understanding of the remote usage of this technology and its viability for underdeveloped countries. This study aims to quantitatively evaluate the performance of a low-cost wireless PPG device in detecting ultra-short-term time-domain pulse rate variability (PRV) parameters in different postures and breathing patterns. A total of 30 healthy subjects were recruited. ECG and PPG signals were simultaneously recorded in 3 min using miniaturized wearable sensors. Four heart rate variability (HRV) and PRV parameters were extracted from ECG and PPG signals, respectively, and compared using analysis of variance (ANOVA) or Scheirer-Ray-Hare test with post hoc analysis. In addition, the data loss was calculated as the percentage of missing sampling points. Posture did not present statistical differences across the PRV parameters but a statistical difference between indicators was found. Strong variation was found for the RMSSD indicator in the standing posture. The sitting position in both breathing patterns demonstrated the lowest data loss (1.0 ± 0.6 and 1.0 ± 0.7) and the lowest percentage of different factors for all indicators. The usage of commercial PPG and BLE devices can allow the reliable extraction of the PPG signal and PRV indicators in real time.
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Affiliation(s)
- Felipe Pineda-Alpizar
- Industrial Design Engineering Department, Costa Rica Institute of Technology, Cartago 7050, Costa Rica
| | - Sergio Arriola-Valverde
- Electronics Engineering Department, Costa Rica Institute of Technology, Cartago 7050, Costa Rica
| | - Mitzy Vado-Chacón
- Respiratory Therapy Department, Santa Paula University, San Jose 2633, Costa Rica
| | - Diego Sossa-Rojas
- Respiratory Therapy Department, Santa Paula University, San Jose 2633, Costa Rica
| | - Haipeng Liu
- Center of Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
| | - Dingchang Zheng
- Center of Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
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14
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Angelucci A, Greco M, Canali S, Marelli G, Avidano G, Goretti G, Cecconi M, Aliverti A. Fitbit Data to Assess Functional Capacity in Patients Before Elective Surgery: Pilot Prospective Observational Study. J Med Internet Res 2023; 25:e42815. [PMID: 37052980 PMCID: PMC10141298 DOI: 10.2196/42815] [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: 09/19/2022] [Revised: 02/03/2023] [Accepted: 02/22/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Preoperative assessment is crucial to prevent the risk of complications of surgical operations and is usually focused on functional capacity. The increasing availability of wearable devices (smartwatches, trackers, rings, etc) can provide less intrusive assessment methods, reduce costs, and improve accuracy. OBJECTIVE The aim of this study was to present and evaluate the possibility of using commercial smartwatch data, such as those retrieved from the Fitbit Inspire 2 device, to assess functional capacity before elective surgery and correlate such data with the current gold standard measure, the 6-Minute Walk Test (6MWT) distance. METHODS During the hospital visit, patients were evaluated in terms of functional capacity using the 6MWT. Patients were asked to wear the Fitbit Inspire 2 for 7 days (with flexibility of -2 to +2 days) after the hospital visit, before their surgical operation. Resting heart rate and daily steps data were retrieved directly from the smartwatch. Feature engineering techniques allowed the extraction of heart rate over steps (HROS) and a modified version of Non-Exercise Testing Cardiorespiratory Fitness. All measures were correlated with 6MWT. RESULTS In total, 31 patients were enrolled in the study (n=22, 71% men; n=9, 29% women; mean age 76.06, SD 4.75 years). Data were collected between June 2021 and May 2022. The parameter that correlated best with the 6MWT was the Non-Exercise Testing Cardiorespiratory Fitness index (r=0.68; P<.001). The average resting heart rate over the whole acquisition period for each participant had r=-0.39 (P=.03), even if some patients did not wear the device at night. The correlation of the 6MWT distance with the HROS evaluated at 1% quantile was significant, with Pearson coefficient of -0.39 (P=.04). Fitbit step count had a fair correlation of 0.59 with 6MWT (P<.001). CONCLUSIONS Our study is a promising starting point for the adoption of wearable technology in the evaluation of functional capacity of patients, which was strongly correlated with the gold standard. The study also identified limitations in the availability of metrics, variability of devices, accuracy and quality of data, and accessibility as crucial areas of focus for future studies.
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Affiliation(s)
- Alessandra Angelucci
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
| | - Massimiliano Greco
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Department of Anesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Stefano Canali
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
- META - Social Sciences and Humanities for Science and Technology, Politecnico di Milano, Milano, Italy
| | - Giovanni Marelli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
| | - Gaia Avidano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Giulia Goretti
- Department of Anesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Maurizio Cecconi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Department of Anesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
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15
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Magal M, Franklin BA, Dwyer GB, Riebe D. Back to Basics. ACSM'S HEALTH & FITNESS JOURNAL 2023. [DOI: 10.1249/fit.0000000000000847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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16
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Callihan M, Cole H, Stokley H, Gunter J, Clamp K, Martin A, Doherty H. Comparison of Slate Safety Wearable Device to Ingestible Pill and Wearable Heart Rate Monitor. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23020877. [PMID: 36679676 PMCID: PMC9865127 DOI: 10.3390/s23020877] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND With the increase in concern for deaths and illness related to the increase in temperature globally, there is a growing need for real-time monitoring of workers for heat stress indicators. The purpose of this study was to determine the usability of the Slate Safety (SS) wearable physiological monitoring system. METHODS Twenty nurses performed a common task in a moderate or hot environment while wearing the SS device, the Polar 10 monitor, and having taken the e-Celsius ingestible pill. Data from each device was compared for correlation and accuracy. RESULTS High correlation was determined between the SS wearable device and the Polar 10 system (0.926) and the ingestible pill (0.595). The SS was comfortable to wear and easily monitored multiple participants from a distance. CONCLUSIONS The Slate Safety wearable device demonstrated accuracy in measuring core temperature and heart rate while not restricting the motion of the worker, and provided a remote monitoring platform for physiological parameters.
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17
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Li M, Miao C, Zou M, Guo J, Wang H, Gao M, Zhang H, Deng Z. The development of stretchable and self-repairing materials applied to electronic skin. Front Chem 2023; 11:1198067. [PMID: 37188092 PMCID: PMC10175680 DOI: 10.3389/fchem.2023.1198067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
Flexible electronic devices play a key role in the fields of flexible batteries, electronic skins, and flexible displays, which have attracted more and more attention in the past few years. Among them, the application areas of electronic skin in new energy, artificial intelligence, and other high-tech applications are increasing. Semiconductors are an indispensable part of electronic skin components. The design of semiconductor structure not only needs to maintain good carrier mobility, but also considers extensibility and self-healing capability, which is always a challenging work. Though flexible electronic devices are important for our daily life, the research on this topic is quite rare in the past few years. In this work, the recently published work regarding to stretchable semiconductors as well as self-healing conductors are reviewed. In addition, the current shortcomings, future challenges as well as an outlook of this technology are discussed. The final goal is to outline a theoretical framework for the design of high-performance flexible electronic devices that can at the same time address their commercialization challenges.
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Affiliation(s)
- Mei Li
- National and Local Joint Engineering Laboratory for Slag Comprehensive Utilization and Environmental Technology, School of Materials Science and Engineering, Shaanxi University of Technology (SNUT), Hanzhong, Shaanxi, China
| | - Chuanqi Miao
- Key Laboratory of Rubber–Plastic of Ministry of Education (QUST), School of Polymer Science and Engineering, Qingdao University of Science and Technology, Qingdao, China
| | - Muhua Zou
- Key Laboratory of Rubber–Plastic of Ministry of Education (QUST), School of Polymer Science and Engineering, Qingdao University of Science and Technology, Qingdao, China
| | - Jiahu Guo
- Key Laboratory of Rubber–Plastic of Ministry of Education (QUST), School of Polymer Science and Engineering, Qingdao University of Science and Technology, Qingdao, China
| | - Hongzhen Wang
- Key Laboratory of Rubber–Plastic of Ministry of Education (QUST), School of Polymer Science and Engineering, Qingdao University of Science and Technology, Qingdao, China
| | - Miao Gao
- CART Tire Co., Ltd, Qilu SEZ, Krong Svay Rieng, Svay Rieng, Cambodia
| | - Haichang Zhang
- Key Laboratory of Rubber–Plastic of Ministry of Education (QUST), School of Polymer Science and Engineering, Qingdao University of Science and Technology, Qingdao, China
- *Correspondence: Haichang Zhang, ; Zhifeng Deng,
| | - Zhifeng Deng
- National and Local Joint Engineering Laboratory for Slag Comprehensive Utilization and Environmental Technology, School of Materials Science and Engineering, Shaanxi University of Technology (SNUT), Hanzhong, Shaanxi, China
- *Correspondence: Haichang Zhang, ; Zhifeng Deng,
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18
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Alugubelli N, Abuissa H, Roka A. Wearable Devices for Remote Monitoring of Heart Rate and Heart Rate Variability-What We Know and What Is Coming. SENSORS (BASEL, SWITZERLAND) 2022; 22:8903. [PMID: 36433498 PMCID: PMC9695982 DOI: 10.3390/s22228903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/27/2022] [Accepted: 11/15/2022] [Indexed: 05/26/2023]
Abstract
Heart rate at rest and exercise may predict cardiovascular risk. Heart rate variability is a measure of variation in time between each heartbeat, representing the balance between the parasympathetic and sympathetic nervous system and may predict adverse cardiovascular events. With advances in technology and increasing commercial interest, the scope of remote monitoring health systems has expanded. In this review, we discuss the concepts behind cardiac signal generation and recording, wearable devices, pros and cons focusing on accuracy, ease of application of commercial and medical grade diagnostic devices, which showed promising results in terms of reliability and value. Incorporation of artificial intelligence and cloud based remote monitoring have been evolving to facilitate timely data processing, improve patient convenience and ensure data security.
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Affiliation(s)
| | | | - Attila Roka
- Division of Cardiology, Creighton University and CHI Health, 7500 Mercy Rd, Omaha, NE 68124, USA
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19
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Coulby G, Clear AK, Jones O, McDonald S, Godfrey A. A protocol for longitudinal monitoring of individual building occupants and their environments. PLoS One 2022; 17:e0274015. [PMID: 36149866 PMCID: PMC9506647 DOI: 10.1371/journal.pone.0274015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 08/19/2022] [Indexed: 11/18/2022] Open
Abstract
Buildings account for approximately 40% of the energy consumption across the European Union, so there is a requirement to strive for better energy performance to reduce the global impact of urbanised societies. However, energy performant buildings can negatively impact building occupants (e.g., comfort, health and/or wellbeing) due to a trade-off between airtightness and air circulation. Thus, there is a need to monitor Indoor Environmental Quality (IEQ) to inform how it impacts occupants and hence redefine value within building performance metrics. An individualised study design would enable researchers to gain new insights into the effects of environmental changes on individuals for more targeted e.g., health interventions or nuanced and improved building design(s). This paper presents a protocol to conduct longitudinal monitoring of an individual and their immediate environment. Additionally, a novel approach to environmental perception gathering is proposed that will monitor environmental factors at an individual level to investigate subjective survey data pertaining to the participant’s perceptions of IEQ (e.g., perceived air quality, thermal conditions, light, and noise). This protocol has the potential to expose time-differential phenomena between environmental changes and an individual’s behavioural and physiological responses. This could be used to support building performance monitoring by providing an interventional assessment of building performance renovations. In the future it could also provide building scientists with a scalable approach for environmental monitoring that focuses specifically on individual health and wellbeing.
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Affiliation(s)
- Graham Coulby
- Faculty of Engineering and Environment, Department of Computer and Information Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | - Adrian K. Clear
- School of Computer Science, College of Science and Engineering, National University of Ireland Galway, Galway, Ireland
| | - Oliver Jones
- Ryder Architecture, Newcastle Upon Tyne, United Kingdom
| | - Suzanne McDonald
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
- General Practice Clinical Unit, The University of Queensland, Brisbane, QLD, Australia
| | - Alan Godfrey
- Faculty of Engineering and Environment, Department of Computer and Information Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom
- * E-mail:
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20
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Giggins OM, Doyle J, Smith S, Crabtree DR, Fraser M. Measurement of Heart Rate Using the Withings ScanWatch Device During Free-living Activities: Validation Study. JMIR Form Res 2022; 6:e34280. [PMID: 36048505 PMCID: PMC9478823 DOI: 10.2196/34280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 04/26/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Wrist-worn devices that incorporate photoplethysmography (PPG) sensing represent an exciting means of measuring heart rate (HR). A number of studies have evaluated the accuracy of HR measurements produced by these devices in controlled laboratory environments. However, it is also important to establish the accuracy of measurements produced by these devices outside the laboratory, in real-world, consumer use conditions. Objective This study sought to examine the accuracy of HR measurements produced by the Withings ScanWatch during free-living activities. Methods A sample of convenience of 7 participants volunteered (3 male and 4 female; mean age 64, SD 10 years; mean height 164, SD 4 cm; mean weight 77, SD 16 kg) to take part in this real-world validation study. Participants were instructed to wear the ScanWatch for a 12-hour period on their nondominant wrist as they went about their day-to-day activities. A Polar H10 heart rate sensor was used as the criterion measure of HR. Participants used a study diary to document activities undertaken during the 12-hour study period. These activities were classified according to the 11 following domains: desk work, eat or drink, exercise, gardening, household activities, self-care, shopping, sitting, sleep, travel, and walking. Validity was assessed using the Bland-Altman analysis, concordance correlation coefficient (CCC), and mean absolute percentage error (MAPE). Results Across all activity domains, the ScanWatch measured HR with MAPE values <10%, except for the shopping activity domain (MAPE=10.8%). The activity domains that were more sedentary in nature (eg, desk work, eat or drink, and sitting) produced the most accurate HR measurements with a small mean bias and MAPE values <5%. Moderate to strong correlations (CCC=0.526-0.783) were observed between devices for all activity domains, except during the walking activity domain, which demonstrated a weak correlation (CCC=0.164) between devices. Conclusions The results of this study show that the ScanWatch measures HR with a degree of accuracy that is acceptable for general consumer use; however, it would not be suitable in circumstances where more accurate measurements of HR are required, such as in health care or in clinical trials. Overall, the ScanWatch was less accurate at measuring HR during ambulatory activities (eg, walking, gardening, and household activities) compared to more sedentary activities (eg, desk work, eat or drink, and sitting). Further larger-scale studies examining this device in different populations and during different activities are required.
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Affiliation(s)
- Oonagh M Giggins
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Julie Doyle
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Suzanne Smith
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Daniel R Crabtree
- Division of Biomedical Sciences, University of the Highlands and Islands, Inverness, United Kingdom
| | - Matthew Fraser
- Division of Biomedical Sciences, University of the Highlands and Islands, Inverness, United Kingdom
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21
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Vidal-Almela S, Terada T, Cole CA, O’Neill CD, Comeau K, Marçal IR, Pipe AL, Reed JL. A case series of acute responses to high-intensity interval training in four males with permanent atrial fibrillation. Eur Heart J Case Rep 2022; 6:ytac320. [PMID: 35965609 PMCID: PMC9366644 DOI: 10.1093/ehjcr/ytac320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/08/2022] [Accepted: 07/29/2022] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Atrial fibrillation (AF) is a serious medical condition and a burgeoning patient population. Chronic exercise training, including high-intensity interval training (HIIT), has been shown to improve symptoms and quality of life in patients with AF. Yet, the acute responses to HIIT in this population remain understudied, leaving clinicians and patients hesitant about prescribing and engaging in high-intensity exercise, respectively.
Case summary
This case series describes acute exercise responses [i.e. power output, heart rate (HR), blood pressure (BP), ratings of perceived exertion (RPE), symptoms] to 10 weeks (3 days/week) of HIIT. Participants were four white males (58–80 years old) with permanent AF, co-morbidities (diabetes, coronary artery disease, Parkinson’s disease), and physical limitations. The increases in HR and BP during HIIT were modest across all participants, regardless of age and medication use. Differences in RPE were observed; the oldest participant perceived the sessions as more challenging despite a lower HR response. All patients complied with the HIIT prescription of 80–100% of peak power output by week 4. No adverse events were reported.
Discussion
Patients’ concerns regarding high-intensity exercise may discourage them from participating in HIIT, our results demonstrated no abnormal HR or BP (e.g. hypotension) responses during HIIT or cool-down. These findings align with the typical exercise responses noted in other cardiovascular populations. Notwithstanding the high metabolic demands of HIIT, male patients with permanent AF tolerated HIIT without problem. Further investigation of HIIT as an approach to enable those with AF to recover physical capacity and minimize symptomatology is warranted.
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Affiliation(s)
- Sol Vidal-Almela
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute , Ottawa, 40 Ruskin Street, Ontario , Canada K1Y 4W7
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa , Ottawa , Canada K1Y 4W7
| | - Tasuku Terada
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute , Ottawa, 40 Ruskin Street, Ontario , Canada K1Y 4W7
| | - Christie A Cole
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute , Ottawa, 40 Ruskin Street, Ontario , Canada K1Y 4W7
| | - Carley D O’Neill
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute , Ottawa, 40 Ruskin Street, Ontario , Canada K1Y 4W7
| | - Katelyn Comeau
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute , Ottawa, 40 Ruskin Street, Ontario , Canada K1Y 4W7
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa , Ottawa , Canada K1Y 4W7
| | - Isabela R Marçal
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute , Ottawa, 40 Ruskin Street, Ontario , Canada K1Y 4W7
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa , Ottawa , Canada K1Y 4W7
| | - Andrew L Pipe
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute , Ottawa, 40 Ruskin Street, Ontario , Canada K1Y 4W7
- School of Medicine, Faculty of Medicine, University of Ottawa , Ottawa , Canada K1H 8M5
| | - Jennifer L Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute , Ottawa, 40 Ruskin Street, Ontario , Canada K1Y 4W7
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa , Ottawa , Canada K1Y 4W7
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa , Ottawa , Canada K1H 8M5
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22
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DE Lima AP, Pereira DG, Nascimento IO, Martins TH, Oliveira AC, Nogueira TS, Britto RR. Cardiac telerehabilitation in a middle-income country: analysis of adherence, effectiveness and cost through a randomized clinical trial. Eur J Phys Rehabil Med 2022; 58:598-605. [PMID: 35634888 PMCID: PMC9980526 DOI: 10.23736/s1973-9087.22.07340-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The benefits of cardiac rehabilitation (CR) are already well established; however, such intervention has been underused, mainly in low- and middle-income countries. AIM To compare adherence, effectiveness, and cost of a home CR with the traditional CR (TCR) in a middle-income country (MIC). DESIGN Single-blind randomized control trial. SETTING A university hospital. POPULATION Individuals with coronary disease that were eligible were invited to participate. A randomized sample of 51 individuals was selected, where two participants were not included by not meeting inclusion criteria. METHODS The home-CR group participated in health education activities, carried out two supervised exercise sessions, and was instructed to carry out 58 sessions at home. Weekly telephone calls were made. The TCR group held 24 supervised exercise sessions and were instructed to carry out 36 sessions at home. RESULTS 49 individuals (42 male, 56.37±10.35years) participated in the study, 23 in the home-CR group and 26 in the TCR group. After the intervention, adherence in the home-CR and TCR groups was 94.18% and 79.08%, respectively, with no significant difference (P=0.191). Both protocols were effective for the other variables, with no differences. The cost per patient for the service was lower in the home-CR (US$ 59.31) than in the TCR group (US$ 135.05). CONCLUSIONS CR performed at home in an MIC demonstrated similar adherence and effectiveness compared to the TCR program, but with a lower cost for the service. The results corroborate the possibility of using home CR programs, even in MICs, after exercise risk stratification and under remote supervision. CLINICAL REHABILITATION IMPACT Home-CR can contribute to overcome participants' barriers with compatible cost. Home-CR is effective in improving functional capacity and risk factors control. Perform risk stratification and remote supervision are essential to offer Home-CR.
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Affiliation(s)
- Ana P DE Lima
- University Center of Belo Horizonte (Uni-BH), Belo Horizonte, Brazil
| | - Danielle G Pereira
- Department of Physiotherapy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil -
| | - Isabella O Nascimento
- Department of Physiotherapy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Thiago H Martins
- Department of Physiotherapy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Anne C Oliveira
- Department of Physiotherapy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Tiago S Nogueira
- Department of Physiotherapy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Raquel R Britto
- Department of Physiotherapy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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23
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Kim C, Kim SH, Suh MR. Accuracy and Validity of Commercial Smart Bands for Heart Rate Measurements During Cardiopulmonary Exercise Test. Ann Rehabil Med 2022; 46:209-218. [PMID: 36071003 PMCID: PMC9452288 DOI: 10.5535/arm.22050] [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: 05/04/2022] [Accepted: 07/01/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the accuracies and validities of popular smart bands for heart rate (HR) measurement in cardiovascular disease (CVD) patients during a graded exercise test (GXT). METHODS Seventy-eight patients were randomly assigned to wear two different smart bands out of three possible choices: Samsung Galaxy Fit 2, Xiaomi Mi Band 5, or Partron PWB-250 on each wrist. A 12-lead exercise electrocardiogram (ECG) and patch-type single-lead ECG were used to assess the comparative HR accuracy of the smart bands. The HR was recorded during the GXT using the modified Bruce protocol. RESULTS The concordance correlation coefficients (rc) were calculated to provide a measure of agreement between each device and the ECG. In all conditions, the Mi Band 5 and Galaxy Fit 2' correlations were rc>0.90, while the PWB-250 correlation was rc=0.58 at rest. When evaluating the accuracy according to the magnitude of HR, all smart bands performed well (rc>0.90) when the HR was below 100 but accuracy tended to decrease with higher HR values. CONCLUSION This study showed that the three smart bands had a high level of accuracy for HR measurements during low-intensity exercise. However, during moderate-intensity and high-intensity exercise, all the three smart bands performed less accurately. Further studies are needed to find a more optimal smart band for HR measurement that can be used for precise HR monitoring during formal cardiac rehabilitation exercise training, including at high and maximal intensity (Clinical Trial Registration No. cris.nih.go.kr/KCT0007036).
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Affiliation(s)
- Chul Kim
- Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Seung Hyoun Kim
- Department of Rehabilitation Medicine, Sanggye Paik Hospital, Seoul, Korea
| | - Mi Rim Suh
- Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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24
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Nagatomi Y, Ide T, Higuchi T, Nezu T, Fujino T, Tohyama T, Nagata T, Higo T, Hashimoto T, Matsushima S, Shinohara K, Yokoyama T, Eguchi A, Ogusu A, Ikeda M, Ishikawa Y, Yamashita F, Kinugawa S, Tsutsui H. Home-based cardiac rehabilitation using information and communication technology for heart failure patients with frailty. ESC Heart Fail 2022; 9:2407-2418. [PMID: 35534907 PMCID: PMC9288767 DOI: 10.1002/ehf2.13934] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 01/30/2022] [Accepted: 04/04/2022] [Indexed: 12/30/2022] Open
Abstract
AIMS Cardiac rehabilitation (CR) is an evidence-based, secondary preventive strategy that improves mortality and morbidity rates in patients with heart failure (HF). However, the implementation and continuation of CR remains unsatisfactory, particularly for outpatients with physical frailty. This study investigated the efficacy and safety of a comprehensive home-based cardiac rehabilitation (HBCR) programme that combines patient education, exercise guidance, and nutritional guidance using information and communication technology (ICT). METHODS AND RESULTS This study was a single-centre, open-label, randomized, controlled trial. Between April 2020 and November 2020, 30 outpatients with chronic HF (New York Heart Association II-III) and physical frailty were enrolled. The control group (n = 15) continued with standard care, while the HBCR group (n = 15) also received comprehensive, individualized CR, including ICT-based exercise and nutrition guidance using ICT via a Fitbit® device for 3 months. The CR team communicated with each patient in HBCR group once a week via the application messaging tool and planned the training frequency and intensity of training individually for the next week according to each patient's symptoms and recorded pulse data during exercise. Dietitians conducted a nutritional assessment and then provided individual nutritional advice using the picture-posting function of the application. The primary outcome was the change in the 6 min walking distance (6MWD). The participants' mean age was 63.7 ± 10.1 years, 53% were male, and 87% had non-ischaemic heart disease. The observed change in the 6MWD was significantly greater in the HBCR group (52.1 ± 43.9 m vs. -4.3 ± 38.8 m; P < 0.001) at a 73% of adherence rate. There was no significant change in adverse events in either group. CONCLUSIONS Our comprehensive HBCR programme using ICT for HF patients with physical frailty improved exercise tolerance and improved lower extremity muscle strength in our sample, suggesting management with individualized ICT-based programmes as a safe and effective approach. Considering the increasing number of HF patients with frailty worldwide, our approach provides an efficient method to keep patients engaged in physical activity in their daily life.
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Affiliation(s)
- Yuta Nagatomi
- Department of Rehabilitation Medicine, Kyushu University Hospital, Fukuoka, Japan.,Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tae Higuchi
- Department of Rehabilitation Medicine, Kyushu University Hospital, Fukuoka, Japan.,Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Tomoyuki Nezu
- Department of Rehabilitation Medicine, Kyushu University Hospital, Fukuoka, Japan.,Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Takeshi Tohyama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan
| | - Takuya Nagata
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Center for Clinical and Translational Research of Kyushu University Hospital, Fukuoka, Japan
| | - Taiki Higo
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Department of Advanced Cardiopulmonary Failure, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Tomiko Yokoyama
- Department of Nutrition, Kyushu University Hospital, Fukuoka, Japan
| | - Aika Eguchi
- Department of Nutrition, Kyushu University Hospital, Fukuoka, Japan
| | - Ayumi Ogusu
- Department of Nutrition, Kyushu University Hospital, Fukuoka, Japan
| | - Masataka Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Ishikawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Fumika Yamashita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan.,Division of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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25
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Lee GH, Kang H, Chung JW, Lee Y, Yoo H, Jeong S, Cho H, Kim JY, Kang SG, Jung JY, Hahm SG, Lee J, Jeong IJ, Park M, Park G, Yun IH, Kim JY, Hong Y, Yun Y, Kim SH, Choi BK. Stretchable PPG sensor with light polarization for physical activity-permissible monitoring. SCIENCE ADVANCES 2022; 8:eabm3622. [PMID: 35417230 PMCID: PMC9007514 DOI: 10.1126/sciadv.abm3622] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 02/24/2022] [Indexed: 05/26/2023]
Abstract
Skin-attachable sensors, which represent the ultimate form of wearable electronic devices that ensure conformal contact with skin, suffer from motion artifact limitations owing to relative changes in position between the sensor and skin during physical activities. In this study, a polarization-selective structure of a skin-conformable photoplethysmographic (PPG) sensor was developed to decrease the amount of scattered light from the epidermis, which is the main cause of motion artifacts. The motion artifacts were suppressed more than 10-fold in comparison with those of rigid sensors. The developed sensor-with two orthogonal polarizers-facilitated successful PPG signal monitoring during wrist angle movements corresponding to high levels of physical activity, enabling continuous monitoring of daily activities, even while exercising for personal health care.
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Affiliation(s)
- Gae Hwang Lee
- Organic Material Lab., Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon 16678, Korea
| | - Hyunbum Kang
- Organic Material Lab., Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon 16678, Korea
| | - Jong Won Chung
- Organic Material Lab., Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon 16678, Korea
| | - Yeongjun Lee
- Organic Material Lab., Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon 16678, Korea
| | - Hyunjun Yoo
- Department of Electrical and Computer Engineering, Seoul National University, Seoul 08826, Korea
| | - Sujin Jeong
- Department of Electrical and Computer Engineering, Seoul National University, Seoul 08826, Korea
| | - Hyeon Cho
- Department of Electrical and Computer Engineering, Seoul National University, Seoul 08826, Korea
| | - Joo-Young Kim
- Organic Material Lab., Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon 16678, Korea
| | - Sung-Gyu Kang
- Organic Material Lab., Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon 16678, Korea
| | - Ji Young Jung
- Organic Material Lab., Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon 16678, Korea
| | - Suk Gyu Hahm
- Organic Material Lab., Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon 16678, Korea
| | - Jeahyuck Lee
- Health H/W R&D Group, Communications Business, Samsung Electronics, Suwon 16677, Korea
| | - In-Jo Jeong
- Health H/W R&D Group, Communications Business, Samsung Electronics, Suwon 16677, Korea
| | - Minho Park
- Health H/W R&D Group, Communications Business, Samsung Electronics, Suwon 16677, Korea
| | - Gunkuk Park
- Health H/W R&D Group, Communications Business, Samsung Electronics, Suwon 16677, Korea
| | - In Ho Yun
- Health H/W R&D Group, Communications Business, Samsung Electronics, Suwon 16677, Korea
| | - Justin Younghyun Kim
- Health H/W R&D Group, Communications Business, Samsung Electronics, Suwon 16677, Korea
| | - Yongtaek Hong
- Department of Electrical and Computer Engineering, Seoul National University, Seoul 08826, Korea
| | - Youngjun Yun
- Organic Material Lab., Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon 16678, Korea
| | - Sung-Han Kim
- Organic Material Lab., Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon 16678, Korea
| | - Byoung Ki Choi
- Organic Material Lab., Samsung Advanced Institute of Technology (SAIT), Samsung Electronics, Suwon 16678, Korea
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26
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Chevance G, Golaszewski NM, Tipton E, Hekler EB, Buman M, Welk GJ, Patrick K, Godino JG. Accuracy and Precision of Energy Expenditure, Heart Rate, and Steps Measured by Combined-Sensing Fitbits Against Reference Measures: Systematic Review and Meta-analysis. JMIR Mhealth Uhealth 2022; 10:e35626. [PMID: 35416777 PMCID: PMC9047731 DOI: 10.2196/35626] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/27/2022] [Accepted: 02/10/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Although it is widely recognized that physical activity is an important determinant of health, assessing this complex behavior is a considerable challenge. OBJECTIVE The purpose of this systematic review and meta-analysis is to examine, quantify, and report the current state of evidence for the validity of energy expenditure, heart rate, and steps measured by recent combined-sensing Fitbits. METHODS We conducted a systematic review and Bland-Altman meta-analysis of validation studies of combined-sensing Fitbits against reference measures of energy expenditure, heart rate, and steps. RESULTS A total of 52 studies were included in the systematic review. Among the 52 studies, 41 (79%) were included in the meta-analysis, representing 203 individual comparisons between Fitbit devices and a criterion measure (ie, n=117, 57.6% for heart rate; n=49, 24.1% for energy expenditure; and n=37, 18.2% for steps). Overall, most authors of the included studies concluded that recent Fitbit models underestimate heart rate, energy expenditure, and steps compared with criterion measures. These independent conclusions aligned with the results of the pooled meta-analyses showing an average underestimation of -2.99 beats per minute (k comparison=74), -2.77 kcal per minute (k comparison=29), and -3.11 steps per minute (k comparison=19), respectively, of the Fitbit compared with the criterion measure (results obtained after removing the high risk of bias studies; population limit of agreements for heart rate, energy expenditure, and steps: -23.99 to 18.01, -12.75 to 7.41, and -13.07 to 6.86, respectively). CONCLUSIONS Fitbit devices are likely to underestimate heart rate, energy expenditure, and steps. The estimation of these measurements varied by the quality of the study, age of the participants, type of activities, and the model of Fitbit. The qualitative conclusions of most studies aligned with the results of the meta-analysis. Although the expected level of accuracy might vary from one context to another, this underestimation can be acceptable, on average, for steps and heart rate. However, the measurement of energy expenditure may be inaccurate for some research purposes.
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Affiliation(s)
| | - Natalie M Golaszewski
- Herbert Wertheim School of Public Health and Longevity Science, University of California, San Diego, La Jolla, CA, United States
- Center for Wireless & Population Health Systems, University of California, San Diego, La Jolla, CA, United States
| | - Elizabeth Tipton
- Department of Statistics, Northwestern University, Evanston, IL, United States
| | - Eric B Hekler
- Herbert Wertheim School of Public Health and Longevity Science, University of California, San Diego, La Jolla, CA, United States
- Center for Wireless & Population Health Systems, University of California, San Diego, La Jolla, CA, United States
- Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, CA, United States
| | - Matthew Buman
- School of Nutrition & Health Promotion, Arizona State University, Phoenix, AZ, United States
| | - Gregory J Welk
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Kevin Patrick
- Center for Wireless & Population Health Systems, University of California, San Diego, La Jolla, CA, United States
| | - Job G Godino
- Herbert Wertheim School of Public Health and Longevity Science, University of California, San Diego, La Jolla, CA, United States
- Center for Wireless & Population Health Systems, University of California, San Diego, La Jolla, CA, United States
- Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, CA, United States
- Laura Rodriguez Research Institute, Family Health Centers of San Diego, San Diego, CA, United States
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27
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Tavares C, Leitão C, Lo Presti D, Domingues MF, Alberto N, Silva H, Antunes P. Respiratory and heart rate monitoring using an FBG 3D-printed wearable system. BIOMEDICAL OPTICS EXPRESS 2022; 13:2299-2311. [PMID: 35519242 PMCID: PMC9045939 DOI: 10.1364/boe.452115] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/27/2022] [Accepted: 02/01/2022] [Indexed: 05/30/2023]
Abstract
This work proposes a 3D-printed sensor based on fiber Bragg grating (FBG) technology for respiratory rate (RR) and heart rate (HR) monitoring. Each sensor is composed of a single FBG fully encapsulated into a 3D-printable Flexible, during the printing process. Sensors with different material thicknesses and infill densities were tested. The sensor with the best metrological properties was selected and preliminary assessed in terms of capability of monitoring RR and HR on three users. Preliminary results proved that the developed sensor can be a valuable easy-to-fabricate solution, with high reproducibility and high strain sensitivity to chest wall deformations due to breathing and heart beating.
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Affiliation(s)
- Cátia Tavares
- Department of Physics & I3N, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
- Instituto de Telecomunicações and University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Cátia Leitão
- Department of Physics & I3N, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
- Instituto de Telecomunicações and University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Daniela Lo Presti
- Unit of Measurements and Biomedical Instrumentation, Departmental Faculty of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - M. F. Domingues
- Instituto de Telecomunicações and University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Nélia Alberto
- Instituto de Telecomunicações and University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Hugo Silva
- Instituto de Telecomunicações, Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal
- PLUX - Wireless Biosignals, S.A, Lisboa, Portugal
| | - Paulo Antunes
- Department of Physics & I3N, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
- Instituto de Telecomunicações and University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
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28
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Martenstyn JA, Jeacocke NA, Pittman J, Touyz S, Maguire S. Treatment Considerations for Compulsive Exercise in High-Performance Athletes with an Eating Disorder. SPORTS MEDICINE - OPEN 2022; 8:30. [PMID: 35239063 PMCID: PMC8894522 DOI: 10.1186/s40798-022-00425-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/13/2022] [Indexed: 01/11/2023]
Abstract
Compulsive exercise is linked with poorer treatment outcomes in people with eating disorder (EDs). High-performance athletes represent a growing and complex subcomponent of the broader ED population, and emergent evidence indicates that different conceptualisations of compulsive exercise are needed in this population. Existing randomised controlled trials in ED populations have demonstrated small treatment effects on compulsive exercise compared with control groups; however, athletes were sparsely sampled across these studies. Thus, the extent to which current treatments for compulsive exercise in EDs are also effective in high-performance athletes is unknown. For this opinion paper, we sought representation from high-performance sports leadership, someone with lived experience of both an ED and high-performance athletics, and ED clinical experts. We discuss the utility of recommending exercise abstinence in ED treatment with athletes, as well as a number of other treatment strategies with some evidence in other contexts for further consideration and research in this population. These include using mindfulness-based interventions as an adjunct to cognitive-behavioural therapies, using wearable technologies and self-reported fatigue to inform training decisions, and incorporating greater exercise variation into training programs. We also offer practical considerations for clinicians seeking to apply foundational elements of cognitive-behavioural interventions (e.g., exposure and response prevention, cognitive restructuring, behavioural experiments) into an ED treatment program for a high-performance athlete. Future research is needed to examine characteristics of pathological compulsive exercise in athletes and whether available treatments are both feasible and effective in the treatment of compulsive exercise in athletes with an ED.
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Affiliation(s)
- Jordan A Martenstyn
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, NSW, Australia. .,InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
| | | | - Jana Pittman
- School of Medicine, Blacktown Hospital, Western Sydney University, Sydney, NSW, Australia
| | - Stephen Touyz
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, NSW Health, St Leonards, Sydney, NSW, Australia
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29
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Uomoto JM, Skopp N, Jenkins-Guarnieri M, Reini J, Thomas D, Adams RJ, Tsui M, Miller SR, Scott BR, Pasquina PF. Assessing the Clinical Utility of a Wearable Device for Physiological Monitoring of Heart Rate Variability in Military Service Members with Traumatic Brain Injury. Telemed J E Health 2022; 28:1496-1504. [PMID: 35231193 DOI: 10.1089/tmj.2021.0627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Autonomic dysfunction has been implicated as a consequence of traumatic brain injury (TBI). Heart rate variability (HRV) may be a viable measure of autonomic dysfunction that could enhance rehabilitative interventions for individuals with TBI. This pilot study sought to assess the feasibility and validity of using the Zeriscope™ platform system in a real-world clinical setting to measure HRV in active-duty service members with TBI who were participating in an intensive outpatient program. Methods: Twenty-five service members with a history of mild, moderate, or severe TBI were recruited from a military treatment facility. A baseline assessment was conducted in the cardiology clinic where point validity data were obtained by comparing a 5-min recording of a standard 12-lead electrocardiogram (ECG) output against the Zeriscope platform data. Results: Compared with the ECG device, the Zeriscope device had a concordance coefficient (rc) of 0.16, falling below the standard deemed to represent acceptable accuracy in HR measurement (i.e., 0.80). Follow-up analyses excluding outliers did not significantly improve the concordance coefficient to an acceptable standard for the total participant sample. System Usability Survey responses showed that participants rated the Zeriscope system as easy to use and something that most people would learn to use quickly. Conclusions: This study demonstrated promise in ambulatory HRV measurement in a representative military TBI sample. Future research should include further refinement of such ambulatory devices to meet the specifications required for use in a military active-duty TBI population.
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Affiliation(s)
- Jay M Uomoto
- Traumatic Brain Injury Center of Excellence Research and Engineering Directorate, Defense Health Agency-Joint Base Lewis-McChord, General Dynamics Information Technology, Tacoma, Washington, USA
| | - Nancy Skopp
- Psychological Health Center of Excellence Research and Engineering Directorate, Defense Health Agency, Tacoma, Washington, USA
| | - Michael Jenkins-Guarnieri
- Mental Health Service, Department of Veterans Affairs, Robley Rex VA Medical Center, Louisville, Kentucky, USA
| | - Josh Reini
- The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA.,Center for Rehabilitation Sciences Research at the Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Drew Thomas
- Madigan Army Medical Center, Tacoma, Washington, USA
| | - Robert J Adams
- Department of Neurology, Medical University of South Carolina Neurology, Charleston, South Carolina, USA
| | - Megan Tsui
- The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA.,Center for Rehabilitation Sciences Research at the Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Shaun R Miller
- Department of Cardiology, Madigan Army Medical Center, Tacoma, Washington, USA
| | | | - Paul F Pasquina
- Center for Rehabilitation Sciences Research at the Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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Does Connected Health Technology Improve Health-Related Outcomes in Rural Cardiac Populations? Systematic Review Narrative Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042302. [PMID: 35206493 PMCID: PMC8871734 DOI: 10.3390/ijerph19042302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 12/01/2022]
Abstract
Individuals living in rural areas are more likely to experience cardiovascular diseases (CVD) and have increased barriers to regular physical activity in comparison to those in urban areas. This systematic review aimed to understand the types and effects of home-based connected health technologies, used by individuals living in rural areas with CVD. The inclusion criteria included technology deployed at the participant’s home and could be an mHealth (smart device, fitness tracker or app) or telehealth intervention. Nine electronic databases were searched across the date range January 1990–June 2021. A total of 207 full texts were screened, of which five studies were included, consisting of 603 participants. Of the five studies, four used a telehealth intervention and one used a form of wearable technology. All interventions which used a form of telehealth found a reduction in overall healthcare utilisation, and one study found improvements in CVD risk factors. Acceptability of the technologies was mixed, in some studies barriers and challenges were cited. Based on the findings, there is great potential for implementing connected health technologies, but due to the low number of studies which met the inclusion criteria, further research is required within rural areas for those living with cardiovascular disease.
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Avina-Bravo EG, Cassirame J, Escriba C, Acco P, Fourniols JY, Soto-Romero G. Smart Electrically Assisted Bicycles as Health Monitoring Systems: A Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:468. [PMID: 35062429 PMCID: PMC8780236 DOI: 10.3390/s22020468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/24/2021] [Accepted: 01/05/2022] [Indexed: 05/03/2023]
Abstract
This paper aims to provide a review of the electrically assisted bicycles (also known as e-bikes) used for recovery of the rider's physical and physiological information, monitoring of their health state, and adjusting the "medical" assistance accordingly. E-bikes have proven to be an excellent way to do physical activity while commuting, thus improving the user's health and reducing air pollutant emissions. Such devices can also be seen as the first step to help unhealthy sedentary people to start exercising with reduced strain. Based on this analysis, the need to have e-bikes with artificial intelligence (AI) systems that recover and processe a large amount of data is discussed in depth. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to complete the relevant papers' search and selection in this systematic review.
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Affiliation(s)
- Eli Gabriel Avina-Bravo
- Laboratory for Analysis and Architecture of Systems (LAAS), University of Toulouse, F-31077 Toulouse, France
| | - Johan Cassirame
- EA4660, Culture, Sport, Health and Society Department and Exercise Performance, University of Bourgogne-France Comté, 25000 Besançon, France
- EA7507, Laboratoire Performance Santé Métrologie Société, 51100 Reims, France
- Société Mtraining, R&D Division, 25480 Ecole Valentin, France
| | - Christophe Escriba
- Laboratory for Analysis and Architecture of Systems (LAAS), University of Toulouse, F-31077 Toulouse, France
| | - Pascal Acco
- Laboratory for Analysis and Architecture of Systems (LAAS), University of Toulouse, F-31077 Toulouse, France
| | - Jean-Yves Fourniols
- Laboratory for Analysis and Architecture of Systems (LAAS), University of Toulouse, F-31077 Toulouse, France
| | - Georges Soto-Romero
- Laboratory for Analysis and Architecture of Systems (LAAS), University of Toulouse, F-31077 Toulouse, France
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Giggins OM, Doyle J, Sojan N, Moran O, Crabtree DR, Fraser M, Muggeridge DJ. Accuracy of Wrist-Worn Photoplethysmography Devices at Measuring Heart Rate in the Laboratory and During Free-Living Activities. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:6970-6973. [PMID: 34892707 DOI: 10.1109/embc46164.2021.9629522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study compared heart rate (HR) measurements taken from two wrist-worn devices; the Empatica E4 and the Apple Watch Series 5, to that taken from a Polar H10 chest strap. Ten healthy adult volunteers took part in a laboratory validation study and performed a treadmill exercise protocol. A single-subject validity study was also conducted to evaluate the accuracy of continuous HR measurements obtained during free-living activities. The participant wore both wrist devices, as well as the Polar H10 for 12-hours, as she continued her habitual daily activities. The key findings of the laboratory study were that the Apple Watch was accurate at assessing HR compared to the Polar H10 with Mean Absolute Percentage Error (MAPE) values < 5% during treadmill exercise. The accuracy of the E4 however was generally poor with MAPE values > 15%. Findings from the single-subject validity study indicate that the Apple Watch produces accurate measurements of HR, whereas the E4 device overestimated HR, except for during the more strenuous activities undertaken where HR was underestimated.Clinical Relevance- The Apple Watch has acceptable accuracy in measuring HR during treadmill exercise and during free-living activities in healthy adult volunteers.
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Current and Potential Applications of Wearables in Sports Cardiology. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021; 23. [DOI: 10.1007/s11936-021-00942-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Nachman D, Rahamim E, Kolben Y, Mengesha B, Elbaz-Greener G, Amir O, Asleh R. In Search of Clinical Impact: Advanced Monitoring Technologies in Daily Heart Failure Care. J Clin Med 2021; 10:jcm10204692. [PMID: 34682813 PMCID: PMC8537939 DOI: 10.3390/jcm10204692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 01/19/2023] Open
Abstract
Despite significant advances in the management of heart failure (HF), further improvement in the outcome of this chronic and progressive disease is still considered a major unmet need. Recurrent hospitalizations due to decompensated HF frequently occur, resulting in increased morbidity and mortality rates. Past attempts at early detection of clinical deterioration were mainly based on monitoring of signs and symptoms of HF exacerbation, which have mostly given disappointing results. Extensive research of the pathophysiology of HF decompensation has indicated that hemodynamic alterations start days prior to clinical manifestation. Novel technologies aim to monitor these minute hemodynamic changes, allowing time for therapeutic interventions to prevent hemodynamic derangement and HF exacerbation. The latest noticeable advancements include assessment of lung fluid volume, wearable devices with integrated sensors, and microelectromechanical systems-based implantable devices for continuous measurement of cardiac filling pressures. This manuscript will review the rationale for monitoring HF patients and discuss previous and ongoing attempts to develop clinically meaningful monitoring devices to improve daily HF health care, with particular emphasis on the recent advances and clinical trials relevant to this evolving field.
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Affiliation(s)
- Dean Nachman
- Hadassah Medical Center, Faculty of Medicine, Heart Institute, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (E.R.); (B.M.); (G.E.-G.); (O.A.)
- Correspondence: (D.N.); (R.A.); Tel.: +972-2-6757657 (D.N.); +972-2-6775266 (R.A.)
| | - Eldad Rahamim
- Hadassah Medical Center, Faculty of Medicine, Heart Institute, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (E.R.); (B.M.); (G.E.-G.); (O.A.)
| | - Yotam Kolben
- Hadassah Medical Center, Department of Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
| | - Bethlehem Mengesha
- Hadassah Medical Center, Faculty of Medicine, Heart Institute, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (E.R.); (B.M.); (G.E.-G.); (O.A.)
| | - Gabby Elbaz-Greener
- Hadassah Medical Center, Faculty of Medicine, Heart Institute, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (E.R.); (B.M.); (G.E.-G.); (O.A.)
| | - Offer Amir
- Hadassah Medical Center, Faculty of Medicine, Heart Institute, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (E.R.); (B.M.); (G.E.-G.); (O.A.)
- Azrieli Faculty of Medicine, Bar-Ilan University, Ramat-Gan 5290002, Israel
| | - Rabea Asleh
- Hadassah Medical Center, Faculty of Medicine, Heart Institute, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (E.R.); (B.M.); (G.E.-G.); (O.A.)
- Correspondence: (D.N.); (R.A.); Tel.: +972-2-6757657 (D.N.); +972-2-6775266 (R.A.)
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Stephenson AC, Willis R, Alford C. Using in-seat electrical potential sensors for non-contact monitoring of heart rate, heart rate variability, and heart rate recovery. Int J Psychophysiol 2021; 169:1-10. [PMID: 34481872 DOI: 10.1016/j.ijpsycho.2021.08.005] [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: 04/25/2021] [Revised: 08/05/2021] [Accepted: 08/27/2021] [Indexed: 10/20/2022]
Abstract
Detecting transient changes in heart rate and heart rate variability during experimental simulated autonomous driving scenarios can indicate participant arousal and cognitive load, providing valuable insights into the relationship between human and vehicle autonomy. Successfully detecting such parameters unobtrusively may assist these experimental situations as well as naturalistic driver monitoring systems within an autonomous vehicle. However, non-contact sensors must collect reliable and accurate signals. This study aims to compare the in-seat, non-contact Plessey EPIC sensor to the gold standard, contact Biopac sensor. Thirty participants took part in five-minute simulated autonomous vehicle journeys in a city environment and a rural environment, and a five-minute resting condition. To ensure the seat sensor was sensitive to elevated heart rate values, heart rate was also collected following the energetic Harvard Step Test. Lin concordance coefficients and Bland-Altman analyses were employed to assess the level of agreement between the non-contact Plessey EPIC sensor and the contact Biopac sensor for heart rate and heart rate variability. Analyses revealed a high level of agreement (rc > 0.96) between both sensors for one-minute averaged heart rate and five-minute averaged heart rate variability during simulated autonomous driving and rest, and one-minute averaged heart rate following the Harvard Step Test. In addition, the non-contact sensor was sensitive to significant differences during tasks. This proof of principle study demonstrates the feasibility of using the non-contact Plessey EPIC sensor to accurately detect heart rate and heart rate variability during simulated autonomous driving environments.
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Affiliation(s)
- Alice C Stephenson
- Health and Applied Sciences, University of the West of England, Bristol BS16 1QY, United Kingdom.
| | - Rachel Willis
- Health and Applied Sciences, University of the West of England, Bristol BS16 1QY, United Kingdom
| | - Chris Alford
- Health and Applied Sciences, University of the West of England, Bristol BS16 1QY, United Kingdom
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Vidal-Almela S, Way KL, Terada T, Tulloch HE, Keast ML, Pipe AL, Chirico D, Reed JL. Sex differences in physical and mental health following high-intensity interval training in adults with cardiovascular disease who completed cardiac rehabilitation. Appl Physiol Nutr Metab 2021; 47:1-9. [PMID: 34375540 DOI: 10.1139/apnm-2021-0265] [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: 11/22/2022]
Abstract
This pre-post study examined sex-differences in peak aerobic power (V̇O2peak) and physical- and mental-health outcomes in adults with cardiovascular disease who completed high-intensity interval training (HIIT)-based cardiac rehabilitation. HIIT consisted of 25 minutes of alternating higher- (4×4 minutes 85-95% heart rate peak (HRpeak)) and lower- (3×3 minutes 60-70% HRpeak) intensity intervals twice weekly for 10 weeks. V̇O2peak estimated from a graded exercise test using the American College of Sports Medicine equation, body mass index (BMI), waist circumference, blood pressure, blood biomarkers and anxiety and depression were assessed at baseline and follow-up. Linear mixed-effects models for repeated measures were performed to examine differences over time between sexes. Of 140 participants (mean ± standard deviation: 58 ± 9 years), 40 were female. Improvements in V̇O2peak did not differ between sexes (interaction: p = 0.273, females: 28.4 ± 6.4 to 30.9 ± 7.6; males: 34.3 ± 6.3 to 37.4 ± 6.0 mL/kg/min). None of the time by sex interactions were significant. Significant main effects of time showed reductions in waist circumference, triglycerides, low-density lipoprotein (LDL), total cholesterol (TC)/high-density lipoprotein (HDL) and anxiety, and increases in V̇O2peak and HDL from baseline to follow-up. Significant main effects of sex revealed smaller V̇O2peak, BMI and waist circumference, and higher LDL, TC and HDL in females than males. HIIT led to similar improvements in estimated V̇O2peak (females: 8.8%, males: 9.0%) and additional health outcomes between sexes. Novelty: HIIT-based cardiac rehabilitation led to similar improvements in estimated V̇O2peak and other physical and mental health outcomes between sexes. The number of sessions attended was high (>70%) and did not differ by sex. Both sexes showed good compliance with the exercise protocol (HR target).
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Affiliation(s)
- Sol Vidal-Almela
- Exercise Physiology and Cardiovascular Health lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
- Institut du savoir Montfort, Hôpital Montfort, Ottawa, ON, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Kimberley L Way
- Exercise Physiology and Cardiovascular Health lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Tasuku Terada
- Exercise Physiology and Cardiovascular Health lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Heather E Tulloch
- School of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Marja-Leena Keast
- Exercise Physiology and Cardiovascular Health lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Andrew L Pipe
- School of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Daniele Chirico
- Exercise Physiology and Cardiovascular Health lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
- TotalCardiologyTM Rehabilitation and Risk Reduction, Calgary, AB, Canada
| | - Jennifer L Reed
- Exercise Physiology and Cardiovascular Health lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Bayoumy K, Gaber M, Elshafeey A, Mhaimeed O, Dineen EH, Marvel FA, Martin SS, Muse ED, Turakhia MP, Tarakji KG, Elshazly MB. Smart wearable devices in cardiovascular care: where we are and how to move forward. Nat Rev Cardiol 2021; 18:581-599. [PMID: 33664502 PMCID: PMC7931503 DOI: 10.1038/s41569-021-00522-7] [Citation(s) in RCA: 224] [Impact Index Per Article: 74.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 01/31/2023]
Abstract
Technological innovations reach deeply into our daily lives and an emerging trend supports the use of commercial smart wearable devices to manage health. In the era of remote, decentralized and increasingly personalized patient care, catalysed by the COVID-19 pandemic, the cardiovascular community must familiarize itself with the wearable technologies on the market and their wide range of clinical applications. In this Review, we highlight the basic engineering principles of common wearable sensors and where they can be error-prone. We also examine the role of these devices in the remote screening and diagnosis of common cardiovascular diseases, such as arrhythmias, and in the management of patients with established cardiovascular conditions, for example, heart failure. To date, challenges such as device accuracy, clinical validity, a lack of standardized regulatory policies and concerns for patient privacy are still hindering the widespread adoption of smart wearable technologies in clinical practice. We present several recommendations to navigate these challenges and propose a simple and practical 'ABCD' guide for clinicians, personalized to their specific practice needs, to accelerate the integration of these devices into the clinical workflow for optimal patient care.
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Affiliation(s)
- Karim Bayoumy
- Department of Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Mohammed Gaber
- Department of Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | | | - Omar Mhaimeed
- Department of Medical Education, Weill Cornell Medicine, Doha, Qatar
| | - Elizabeth H Dineen
- Department of Cardiovascular Medicine, University of California Irvine, Irvine, CA, USA
| | - Francoise A Marvel
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | - Seth S Martin
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | - Evan D Muse
- Scripps Research Translational Institute and Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA, USA
| | - Mintu P Turakhia
- Center for Digital Health, Stanford University, Stanford, CA, USA
- VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Khaldoun G Tarakji
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mohamed B Elshazly
- Department of Medical Education, Weill Cornell Medicine, Doha, Qatar.
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA.
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
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Wan EY, Ghanbari H, Akoum N, Itzhak Attia Z, Asirvatham SJ, Chung EH, Dagher L, Al-Khatib SM, Stuart Mendenhall G, McManus DD, Pathak RK, Passman RS, Peters NS, Schwartzman DS, Svennberg E, Tarakji KG, Turakhia MP, Trela A, Yarmohammadi H, Marrouche NF. HRS White Paper on Clinical Utilization of Digital Health Technology. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2021; 2:196-211. [PMID: 35265910 PMCID: PMC8890053 DOI: 10.1016/j.cvdhj.2021.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This collaborative statement from the Digital Health Committee of the Heart Rhythm Society provides everyday clinical scenarios in which wearables may be utilized by patients for cardiovascular health and arrhythmia management. We describe herein the spectrum of wearables that are commercially available for patients, and their benefits, shortcomings and areas for technological improvement. Although wearables for rhythm diagnosis and management have not been examined in large randomized clinical trials, undoubtedly the usage of wearables has quickly escalated in clinical practice. This document is the first of a planned series in which we will update information on wearables as they are revised and released to consumers.
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Affiliation(s)
- Elaine Y. Wan
- Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | | | | | | | | | | | - Lilas Dagher
- Tulane Research Innovation for Arrhythmia Discoveries (TRIAD), Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA, USA
| | | | | | | | - Rajeev K. Pathak
- Cardiac Electrophysiology Unit, Department of Cardiology, Canberra Hospital and Health Services, Australian National University, Canberra, Australia
| | - Rod S. Passman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | - Emma Svennberg
- Karolinska Institutet, Department of Medicine Huddinge, Karolinska University Hospital, Stockholm, Sweden
| | - Khaldoun G. Tarakji
- Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Mintu P. Turakhia
- Department of Medicine, Stanford University, Stanford, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California, and Center for Digital Health, Stanford, CA, USA
| | - Anthony Trela
- Lucile Packard Children’s Hospital, Pediatric Cardiology, Palo Alto, CA, USA
| | - Hirad Yarmohammadi
- Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - Nassir F. Marrouche
- Tulane Research Innovation for Arrhythmia Discoveries (TRIAD), Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA, USA
- Address reprint requests and correspondence: Dr Nassir F. Marrouche, Cardiac Electrophysiology, Tulane University School of Medicine, 1430 Tulane Avenue, Box 8548, New Orleans, LA 70112.
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Baka T, Simko F. Monitoring Non-dipping Heart Rate by Consumer-Grade Wrist-Worn Devices: An Avenue for Cardiovascular Risk Assessment in Hypertension. Front Cardiovasc Med 2021; 8:711417. [PMID: 34368261 PMCID: PMC8342801 DOI: 10.3389/fcvm.2021.711417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
- Tomas Baka
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Fedor Simko
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,3rd Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
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Pettitt RW, Fretti SK, Kantor MA, Gubler C. Using wearable technology to monitor exercise intensity and predict V ˙ O 2 m a x . Mhealth 2021; 7:19. [PMID: 33898588 PMCID: PMC8063012 DOI: 10.21037/mhealth.2020.01.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 01/07/2020] [Indexed: 11/06/2022] Open
Affiliation(s)
- Robert W. Pettitt
- Office of Research & Sponsored Projects, Rocky Mountain University of Health Professions, Provo, Utah, USA
| | - Sarah K. Fretti
- Office of Research & Sponsored Projects, Rocky Mountain University of Health Professions, Provo, Utah, USA
| | - Michael A. Kantor
- Office of Research & Sponsored Projects, Rocky Mountain University of Health Professions, Provo, Utah, USA
| | - Coral Gubler
- Department of Physical Therapy, Rocky Mountain University of Health Professions, Provo, Utah, USA
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Batalik L, Winnige P, Dosbaba F, Vlazna D, Janikova A. Home-Based Aerobic and Resistance Exercise Interventions in Cancer Patients and Survivors: A Systematic Review. Cancers (Basel) 2021; 13:cancers13081915. [PMID: 33921141 PMCID: PMC8071485 DOI: 10.3390/cancers13081915] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023] Open
Abstract
Cancer is a chronic disease requiring long-term treatment. Exercise interventions are increasingly being recognized as an important part of treatment and supportive cancer care for patients and survivors. Previous reviews have evaluated the benefits of exercise interventions in populations of patients under supervision at a center, but none have explored the possibilities of a home-based (HB) approach in exercise during cancer rehabilitation and the period immediately following the end of cancer treatment. The aim of this descriptive systematic review was to identify the literature focusing on the health effects of HB exercise interventions in cancer survivors and to evaluate the methodological quality of the examined studies. Relevant studies were identified by a systematic search of PubMed and the Web of Science until January 2021. Nine randomized controlled trials were included. Most studies were on aerobic and resistance exercises, and the frequency, duration, intensity, and modality varied across the different interventions. Improvements in cardiorespiratory fitness (CRF), physical activity (PA) levels, fatigue, health-related quality of life (HRQOL), and body composition have been reported. However, all the studies were limited in methodology and the reporting of results. Nevertheless, the evidence in this new area, despite the methodological limitations of the studies, suggests that HB exercise interventions are feasible, and may provide physiological and psychological benefits for cancer survivors during the rehabilitation period. A methodologically rigorous design for future research is essential for making progress in this field of study.
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Affiliation(s)
- Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic; (P.W.); (F.D.); (D.V.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
- Correspondence:
| | - Petr Winnige
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic; (P.W.); (F.D.); (D.V.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic; (P.W.); (F.D.); (D.V.)
| | - Daniela Vlazna
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic; (P.W.); (F.D.); (D.V.)
- Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Department of Neurology, University Hospital Brno, 62500 Brno, Czech Republic
| | - Andrea Janikova
- Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Department of Internal Medicine–Hematology and Oncology, University Hospital Brno, 62500 Brno, Czech Republic
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Goroso DG, Watanabe WT, Napoleone F, da Silva DP, Salinet JL, da Silva RR, Puglisi JL. Remote monitoring of heart rate variability for obese children. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Shumate T, Link M, Furness J, Kemp-Smith K, Simas V, Climstein M. Validity of the Polar Vantage M watch when measuring heart rate at different exercise intensities. PeerJ 2021; 9:e10893. [PMID: 33614295 PMCID: PMC7879937 DOI: 10.7717/peerj.10893] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/12/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The use of wrist worn wearable fitness trackers has been growing rapidly over the last decade. The growing popularity can be partly attributed to the improvements in technology, making activity trackers more affordable, comfortable and convenient for use in different fitness and environmental applications. Fitness trackers typically monitor activity level, track steps, distance, heart rate (HR), sleep, peripheral capillary oxygen saturation and more, as the technology continuously is advancing. In terms of measuring HR, photoplethysmography (PPG) is a relatively new technology utilised in wearables. PPG estimates HR through an optical technique that monitors changes in blood volume beneath the skin. With these new products becoming available it is important that the validity of these devices be evaluated. Therefore, the aim of this study was to assess the validity of the Polar Vantage M (PVM) watch to measure HR compared to medical grade ECG on a healthy population during a range of treadmill exercise intensities. METHODS A total of 30 healthy participants (n = 17 males, n = 13 females) were recruited for this study. The validity of the PVM watch to measure HR was compared against the gold standard 5-lead ECG. The study was conducted on 2 separate testing days with 24-48 h between sessions. Participants completed the Bruce Treadmill Protocol, and HR was measured every 30 s. Validation of the PVM watch in comparison to the ECG was measured with an Intraclass Correlation Coefficient (ICC) and associated 95% confidence intervals (CI) and levels of agreement were identified with Bland-Altman plots with 90% limits of agreement. Linear regression analysis was performed to calculate the value of r 2 computing the variation of HR obtained by the PVM watch and ECG. RESULTS In total, 30 participants completed the protocol, with data from 28 participants utilised for statistical analysis (16 males, 14 females, 26.10 ± 3.39 years, height 52.36 m ± 7.40 cm, mass 73.59 ± 11.90 kg). A strong and significant correlation was found between the PVM watch and ECG, demonstrating good criterion validity (p < 0.05, r 2 = 0.87). Good validity was seen for day 1 and day 2 for stage 0 (ICC = 0.83; 95% CI [0.63-0.92], ICC = 0.74; 95% CI [0.37-0.88]), stage 1 (ICC = 0.78; 95% CI [0.52-0.90], ICC = 0.88; 95% CI [0.74-0.95]), and stage 2 (ICC = 0.88; 95% CI [0.73-0.94], ICC = 0.80; 95% CI [0.40-0.92]). Poor validity was demonstrated on day 1 and day 2 for stages 3-5 (ICC < 0.50). CONCLUSION This study revealed that the PVM watch had a strong correlation with the ECG throughout the entire Bruce Protocol, however the level of agreement (LoA) becomes widely dispersed as exercise intensities increased. Due to the large LoA between the ECG and PVM watch, it is not advisable to use this device in clinical populations in which accurate HR measures are essential for patient safety; however, the watch maybe used in settings where less accurate HR is not critical to an individual's safety while exercising.
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Affiliation(s)
- Tricia Shumate
- Department of Physiotherapy, Faculty of Health Science and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Magdalen Link
- Department of Physiotherapy, Faculty of Health Science and Medicine, Bond University, Gold Coast, QLD, Australia
| | - James Furness
- Department of Physiotherapy, Faculty of Health Science and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond University, Gold Coast, QLD, Australia
| | - Kevin Kemp-Smith
- Department of Physiotherapy, Faculty of Health Science and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond University, Gold Coast, QLD, Australia
| | - Vini Simas
- Department of Physiotherapy, Faculty of Health Science and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond University, Gold Coast, QLD, Australia
| | - Mike Climstein
- Water Based Research Unit, Bond University, Gold Coast, QLD, Australia
- Clinical Exercise Physiology, School of Health and Human Sciences, Southern Cross University, Bilinga, QLD, Australia
- Physical Activity, Lifestyle, Ageing and Wellbeing, Faculty Research Group, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
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Rahimy E, Usoz M, von Eyben R, Fujimoto D, Watanabe D, Karam A, Jairam-Thodla A, Mills M, Dorigo O, Diver EJ, Teng N, English D, Kidd E. Phase II trial evaluating efficacy of a Fitbit program for improving the health of endometrial cancer survivors. Gynecol Oncol 2021; 161:275-281. [PMID: 33551199 DOI: 10.1016/j.ygyno.2021.01.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite the favorable prognosis of early stage endometrial cancer, mortality from cardiovascular disease is high. We aimed to evaluate the efficacy of a Fitbit program to improve physical activity in endometrial cancer survivors. METHODS Eligible patients were diagnosed with stage IA-IIIA endometrial adenocarcinoma, ≥3 months out from treatment. Participants received a Fitbit Alta and were randomized to receive communication via telephone or electronic methods (email/text). Communication was every two weeks for two months, then once during months four and five. Average daily steps were assessed weekly for nine months. RESULTS The 46 analyzable patients demonstrated a baseline of 5641 median daily average steps. Average steps increased by 22% at 6 months but decreased to baseline by nine months. Baseline activity level (daily steps and walks per week) was the greatest predictor of activity level. Only the telephone intervention participants demonstrated increased activity level at several timepoints, although not maintained by nine months. BMI was unchanged. There was mild improvement in physical and social well-being in those with low baseline well-being (p = 0.009 and 0.014, respectively), regardless of intervention group. Emotional well-being correlated with step count (p = 0.005). CONCLUSIONS Activity level was low and mildly improved on the Fitbit program with the telephone intervention, but effects did not persist by study completion. The program had the greatest impact on a select group of telephone intervention patients with high baseline walking frequency and low baseline step count. Others may require more intense intervention to promote more robust/persistent lifestyle changes.
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Affiliation(s)
- Elham Rahimy
- Department of Radiation Oncology, Stanford University, Stanford, CA, USA.
| | - Melissa Usoz
- Duke University School of Medicine, Durham, NC, USA
| | - Rie von Eyben
- Department of Radiation Oncology, Stanford University, Stanford, CA, USA
| | - Dylann Fujimoto
- University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - Darla Watanabe
- Department of Gynecologic Oncology, Stanford University, Stanford, CA, USA
| | - Amer Karam
- Department of Gynecologic Oncology, Stanford University, Stanford, CA, USA
| | | | - Margaret Mills
- Department of Gynecologic Oncology, Stanford University, Stanford, CA, USA
| | - Oliver Dorigo
- Department of Gynecologic Oncology, Stanford University, Stanford, CA, USA
| | | | - Nelson Teng
- Department of Gynecologic Oncology, Stanford University, Stanford, CA, USA
| | - Diana English
- Department of Gynecologic Oncology, University of South Florida, Tampa, FL, USA
| | - Elizabeth Kidd
- Department of Radiation Oncology, Stanford University, Stanford, CA, USA
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Mühlen JM, Stang J, Lykke Skovgaard E, Judice PB, Molina-Garcia P, Johnston W, Sardinha LB, Ortega FB, Caulfield B, Bloch W, Cheng S, Ekelund U, Brønd JC, Grøntved A, Schumann M. Recommendations for determining the validity of consumer wearable heart rate devices: expert statement and checklist of the INTERLIVE Network. Br J Sports Med 2021; 55:767-779. [PMID: 33397674 PMCID: PMC8273688 DOI: 10.1136/bjsports-2020-103148] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2020] [Indexed: 01/06/2023]
Abstract
Assessing vital signs such as heart rate (HR) by wearable devices in a lifestyle-related environment provides widespread opportunities for public health related research and applications. Commonly, consumer wearable devices assessing HR are based on photoplethysmography (PPG), where HR is determined by absorption and reflection of emitted light by the blood. However, methodological differences and shortcomings in the validation process hamper the comparability of the validity of various wearable devices assessing HR. Towards Intelligent Health and Well-Being: Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The consortium was founded in 2019 and strives towards developing best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice validation protocol for consumer wearables assessing HR by PPG. The recommendations were developed through the following multi-stage process: (1) a systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, (2) an unstructured review of the wider literature pertaining to factors that may introduce bias during the validation of these devices and (3) evidence-informed expert opinions of the INTERLIVE Network. A total of 44 articles were deemed eligible and retrieved through our systematic literature review. Based on these studies, a wider literature review and our evidence-informed expert opinions, we propose a validation framework with standardised recommendations using six domains: considerations for the target population, criterion measure, index measure, testing conditions, data processing and the statistical analysis. As such, this paper presents recommendations to standardise the validity testing and reporting of PPG-based HR wearables used by consumers. Moreover, checklists are provided to guide the validation protocol development and reporting. This will ensure that manufacturers, consumers, healthcare providers and researchers use wearables safely and to its full potential.
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Affiliation(s)
- Jan M Mühlen
- Institute of Cardiovascular Research and Sports Medicine, Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Julie Stang
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Esben Lykke Skovgaard
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Pedro B Judice
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal.,CIDEFES - Centro de Investigação em Desporto, Educação Física e Exercício e Saúde, Universidade Lusófona, Lisboa, Portugal
| | - Pablo Molina-Garcia
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - William Johnston
- SFI Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland.,School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Cruz-Quebrada Dafundo, Portugal
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
| | - Brian Caulfield
- SFI Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland.,School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Wilhelm Bloch
- Institute of Cardiovascular Research and Sports Medicine, Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Sulin Cheng
- Institute of Cardiovascular Research and Sports Medicine, Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany.,Exercise Translational Medicine Centre, the Key Laboratory of Systems Biomedicine, Ministry of Education, and Exercise, Health and Technology Centre, Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jan Christian Brønd
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Anders Grøntved
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Moritz Schumann
- Institute of Cardiovascular Research and Sports Medicine, Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany .,Exercise Translational Medicine Centre, the Key Laboratory of Systems Biomedicine, Ministry of Education, and Exercise, Health and Technology Centre, Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
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Abstract
Palpitations are a common presenting symptom in primary care, yet their cause can be difficult to diagnose due to their intermittent and sometimes infrequent nature. All patients presenting with a chief complaint of palpitations should undergo a detailed history, physical examination, and electrocardiogram (ECG). This alone can yield a probable diagnosis. Limited laboratory testing, ambulatory ECG monitoring, and cardiology referral are sometimes indicated. This article reviews current data and guidelines on how to evaluate palpitations in the primary care setting.
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Affiliation(s)
- Clara Weinstock
- University of Connecticut School of Medicine, 263 Farmington Avenue, Outpatient Pavilion- 2nd Floor East, Farmington, CT 06030, USA.
| | - Hilary Wagner
- University of Connecticut School of Medicine, 263 Farmington Avenue, Outpatient Pavilion- 2nd Floor East, Farmington, CT 06030, USA
| | - Meghan Snuckel
- University of Connecticut School of Medicine, 263 Farmington Avenue, Outpatient Pavilion- 2nd Floor East, Farmington, CT 06030, USA
| | - Marilyn Katz
- University of Connecticut School of Medicine, 263 Farmington Avenue, Outpatient Pavilion- 2nd Floor East, Farmington, CT 06030, USA
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48
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Exercise Training in Patients With Heart Failure With Preserved Ejection Fraction: A Community Hospital Pilot Study. J Cardiovasc Nurs 2020; 36:124-130. [PMID: 32740221 DOI: 10.1097/jcn.0000000000000737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Patients with heart failure with preserved ejection fraction (HFpEF) experience poor exercise tolerance and quality of life. Little is known about the feasibility or effects of HFpEF exercise training (ET) in a community hospital setting. OBJECTIVE The aim of this study was to examine the feasibility and pilot data of a community-based HFpEF ET intervention. METHODS This was a single-group (n = 16), pretest-posttest, 9-week ET intervention. The Minnesota Living With Heart Failure Questionnaire, Patient Health Questionnaire-9, cardiopulmonary exercise test (peak VO2), and 6-minute walk test were used for evaluation. RESULTS Participants (n = 16) attended 88% of prescribed ET sessions and 94% completed all pretest-posttest assessments. Significant improvements in Minnesota Living With Heart Failure Questionnaire (P = .01), Patient Health Questionnaire-9 (P ≤ .01), exercise test time (P = .01) and 6-minute walk test (P = .001), but not in peak VO2 (P = .16), were found. CONCLUSIONS The ET intervention was feasible and safe, and findings support improved quality of life, depressive symptoms, and exercise tolerance. Larger controlled trials are warranted.
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De Cannière H, Corradi F, Smeets CJP, Schoutteten M, Varon C, Van Hoof C, Van Huffel S, Groenendaal W, Vandervoort P. Wearable Monitoring and Interpretable Machine Learning Can Objectively Track Progression in Patients during Cardiac Rehabilitation. SENSORS (BASEL, SWITZERLAND) 2020; 20:E3601. [PMID: 32604829 PMCID: PMC7349532 DOI: 10.3390/s20123601] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/12/2020] [Accepted: 06/22/2020] [Indexed: 12/17/2022]
Abstract
Cardiovascular diseases (CVD) are often characterized by their multifactorial complexity. This makes remote monitoring and ambulatory cardiac rehabilitation (CR) therapy challenging. Current wearable multimodal devices enable remote monitoring. Machine learning (ML) and artificial intelligence (AI) can help in tackling multifaceted datasets. However, for clinical acceptance, easy interpretability of the AI models is crucial. The goal of the present study was to investigate whether a multi-parameter sensor could be used during a standardized activity test to interpret functional capacity in the longitudinal follow-up of CR patients. A total of 129 patients were followed for 3 months during CR using 6-min walking tests (6MWT) equipped with a wearable ECG and accelerometer device. Functional capacity was assessed based on 6MWT distance (6MWD). Linear and nonlinear interpretable models were explored to predict 6MWD. The t-distributed stochastic neighboring embedding (t-SNE) technique was exploited to embed and visualize high dimensional data. The performance of support vector machine (SVM) models, combining different features and using different kernel types, to predict functional capacity was evaluated. The SVM model, using chronotropic response and effort as input features, showed a mean absolute error of 42.8 m (±36.8 m). The 3D-maps derived using the t-SNE technique visualized the relationship between sensor-derived biomarkers and functional capacity, which enables tracking of the evolution of patients throughout the CR program. The current study showed that wearable monitoring combined with interpretable ML can objectively track clinical progression in a CR population. These results pave the road towards ambulatory CR.
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Affiliation(s)
- Hélène De Cannière
- Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, 3500 Hasselt, Belgium; (C.J.P.S.); (M.S.); (P.V.)
- Future Health Department, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
| | - Federico Corradi
- imec the Netherlands/Holst Centre, 5656AE Eindhoven, The Netherlands; (F.C.); (W.G.)
| | - Christophe J. P. Smeets
- Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, 3500 Hasselt, Belgium; (C.J.P.S.); (M.S.); (P.V.)
- Future Health Department, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
- imec the Netherlands/Holst Centre, 5656AE Eindhoven, The Netherlands; (F.C.); (W.G.)
| | - Melanie Schoutteten
- Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, 3500 Hasselt, Belgium; (C.J.P.S.); (M.S.); (P.V.)
- Future Health Department, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
| | - Carolina Varon
- KU Leuven, Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, 3001 Leuven, Belgium; (C.V.); (C.V.H.); (S.V.H.)
- TU Delft, Department of Microelectronics, Circuits and Systems (CAS), 2600AA Delft, The Netherlands
| | - Chris Van Hoof
- KU Leuven, Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, 3001 Leuven, Belgium; (C.V.); (C.V.H.); (S.V.H.)
- imec vzw Belgium, 3001 Leuven, Belgium
| | - Sabine Van Huffel
- KU Leuven, Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, 3001 Leuven, Belgium; (C.V.); (C.V.H.); (S.V.H.)
| | - Willemijn Groenendaal
- imec the Netherlands/Holst Centre, 5656AE Eindhoven, The Netherlands; (F.C.); (W.G.)
| | - Pieter Vandervoort
- Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, 3500 Hasselt, Belgium; (C.J.P.S.); (M.S.); (P.V.)
- Future Health Department, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
- Department of Cardiology, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
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50
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Zhang Y, Weaver RG, Armstrong B, Burkart S, Zhang S, Beets MW. Validity of Wrist-Worn photoplethysmography devices to measure heart rate: A systematic review and meta-analysis. J Sports Sci 2020; 38:2021-2034. [PMID: 32552580 DOI: 10.1080/02640414.2020.1767348] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Heart rate (HR), when combined with accelerometry, can dramatically improve estimates of energy expenditure and sleep. Advancements in technology, via the development and introduction of small, low-cost photoplethysmography devices embedded within wrist-worn consumer wearables, have made the collection of heart rate (HR) under free-living conditions more feasible. This systematic review and meta-analysis compared the validity of wrist-worn HR estimates to a criterion measure of HR (electrocardiography ECG or chest strap). Searches of PubMed/Medline, Web of Science, EBSCOhost, PsycINFO, and EMBASE resulted in a total of 44 articles representing 738 effect sizes across 15 different brands. Multi-level random effects meta-analyses resulted in a small mean difference (beats per min, bpm) of -0.40 bpm (95 confidence interval (CI) -1.64 to 0.83) during sleep, -0.01 bpm (-0.02 to 0.00) during rest, -0.51 bpm (-1.60 to 0.58) during treadmill activities (walking to running), while the mean difference was larger during resistance training (-7.26 bpm, -10.46 to -4.07) and cycling (-4.55 bpm, -7.24 to -1.87). Mean difference increased by 3 bpm (2.5 to 3.5) per 10 bpm increase of HR for resistance training. Wrist-worn devices that measure HR demonstrate acceptable validity compared to a criterion measure of HR for most common activities.
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Affiliation(s)
- Yanan Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina , Columbia, SC, USA
| | - R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina , Columbia, SC, USA
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina , Columbia, SC, USA
| | - Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina , Columbia, SC, USA
| | - Shuxin Zhang
- School of Public Health, Nanjing Medical University , Nanjing, China
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina , Columbia, SC, USA
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