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De Calheiros Velozo J, Habets J, George SV, Niemeijer K, Minaeva O, Hagemann N, Herff C, Kuppens P, Rintala A, Vaessen T, Riese H, Delespaul P. Designing daily-life research combining experience sampling method with parallel data. Psychol Med 2024; 54:98-107. [PMID: 36039768 DOI: 10.1017/s0033291722002367] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Ambulatory monitoring is gaining popularity in mental and somatic health care to capture an individual's wellbeing or treatment course in daily-life. Experience sampling method collects subjective time-series data of patients' experiences, behavior, and context. At the same time, digital devices allow for less intrusive collection of more objective time-series data with higher sampling frequencies and for prolonged sampling periods. We refer to these data as parallel data. Combining these two data types holds the promise to revolutionize health care. However, existing ambulatory monitoring guidelines are too specific to each data type, and lack overall directions on how to effectively combine them. METHODS Literature and expert opinions were integrated to formulate relevant guiding principles. RESULTS Experience sampling and parallel data must be approached as one holistic time series right from the start, at the study design stage. The fluctuation pattern and volatility of the different variables of interest must be well understood to ensure that these data are compatible. Data have to be collected and operationalized in a manner that the minimal common denominator is able to answer the research question with regard to temporal and disease severity resolution. Furthermore, recommendations are provided for device selection, data management, and analysis. Open science practices are also highlighted throughout. Finally, we provide a practical checklist with the delineated considerations and an open-source example demonstrating how to apply it. CONCLUSIONS The provided considerations aim to structure and support researchers as they undertake the new challenges presented by this exciting multidisciplinary research field.
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Affiliation(s)
| | - Jeroen Habets
- Department of Neurosurgery, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sandip V George
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Koen Niemeijer
- Department of Psychology and Educational Sciences, Research Group of Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium
| | - Olga Minaeva
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Noëmi Hagemann
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Christian Herff
- Department of Neurosurgery, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Peter Kuppens
- Department of Psychology and Educational Sciences, Research Group of Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium
| | - Aki Rintala
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
- Faculty of Social and Health Care, LAB University of Applied Sciences, Lahti, Finland
| | - Thomas Vaessen
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
- Department of Neurosciences, Mind Body Research, KU Leuven, Leuven, Belgium
| | - Harriëtte Riese
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Brandenbarg P, Hoekstra F, Barakou I, Seves BL, Hettinga FJ, Hoekstra T, van der Woude LHV, Dekker R, Krops LA. Measurement properties of device-based physical activity instruments in ambulatory adults with physical disabilities and/or chronic diseases: a scoping review. BMC Sports Sci Med Rehabil 2023; 15:115. [PMID: 37735403 PMCID: PMC10512652 DOI: 10.1186/s13102-023-00717-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/22/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND People with physical disabilities and/or chronic diseases tend to have an inactive lifestyle. Monitoring physical activity levels is important to provide insight on how much and what types of activities people with physical disabilities and/or chronic diseases engage in. This information can be used as input for interventions to promote a physically active lifestyle. Therefore, valid and reliable physical activity measurement instruments are needed. This scoping review aims 1) to provide a critical mapping of the existing literature and 2) directions for future research on measurement properties of device-based instruments assessing physical activity behavior in ambulant adults with physical disabilities and/or chronic diseases. METHODS Four databases (MEDLINE, CINAHL, Web of Science, Embase) were systematically searched from 2015 to April 16th 2023 for articles investigating measurement properties of device-based instruments assessing physical activity in ambulatory adults with physical disabilities and/or chronic diseases. For the majority, screening and selection of eligible studies were done in duplicate. Extracted data were publication data, study data, study population, device, studied measurement properties and study outcome. Data were synthesized per device. RESULTS One hundred three of 21566 Studies were included. 55 Consumer-grade and 23 research-grade devices were studied on measurement properties, using 14 different physical activity outcomes, in 23 different physical disabilities and/or chronic diseases. ActiGraph (n = 28) and Fitbit (n = 39) devices were most frequently studied. Steps (n = 68) was the most common used physical activity outcome. 97 studies determined validity, 11 studies reliability and 6 studies responsiveness. CONCLUSION This scoping review shows a large variability in research on measurement properties of device-based instruments in ambulatory adults with physical disabilities and/or chronic diseases. The variability highlights a need for standardization of and consensus on research in this field. The review provides directions for future research.
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Affiliation(s)
- Pim Brandenbarg
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands.
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands.
| | - Femke Hoekstra
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, V1V 1V7, Canada
| | - Ioulia Barakou
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Bregje L Seves
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Florentina J Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, NE1 8ST, UK
| | - Trynke Hoekstra
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, 1081 BT, The Netherlands
| | - Lucas H V van der Woude
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Rienk Dekker
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Leonie A Krops
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
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Ginis P, Goris M, De Groef A, Blondeel A, Gilat M, Demeyer H, Troosters T, Nieuwboer A. Validation of Commercial Activity Trackers in Everyday Life of People with Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2023; 23:4156. [PMID: 37112496 PMCID: PMC10144957 DOI: 10.3390/s23084156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/07/2023] [Accepted: 04/18/2023] [Indexed: 06/19/2023]
Abstract
Maintaining physical activity is an important clinical goal for people with Parkinson's disease (PwPD). We investigated the validity of two commercial activity trackers (ATs) to measure daily step counts. We compared a wrist- and a hip-worn commercial AT against the research-grade Dynaport Movemonitor (DAM) during 14 days of daily use. Criterion validity was assessed in 28 PwPD and 30 healthy controls (HCs) by a 2 × 3 ANOVA and intraclass correlation coefficients (ICC2,1). The ability to measure daily step fluctuations compared to the DAM was studied by a 2 × 3 ANOVA and Kendall correlations. We also explored compliance and user-friendliness. Both the ATs and the DAM measured significantly fewer steps/day in PwPD compared to HCs (p < 0.01). Step counts derived from the ATs showed good to excellent agreement with the DAM in both groups (ICC2,1 > 0.83). Daily fluctuations were detected adequately by the ATs, showing moderate associations with DAM-rankings. While compliance was high overall, 22% of PwPD were disinclined to use the ATs after the study. Overall, we conclude that the ATs had sufficient agreement with the DAM for the purpose of promoting physical activity in mildly affected PwPD. However, further validation is needed before clinical use can be widely recommended.
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Affiliation(s)
- Pieter Ginis
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), 3000 Leuven, Belgium
| | - Maaike Goris
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), 3000 Leuven, Belgium
| | - An De Groef
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders (GRID), 3000 Leuven, Belgium
- MOVANT Research Group, Department of Rehabilitation Sciences, University of Antwerp, 2000 Antwerp, Belgium
| | - Astrid Blondeel
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders (GRID), 3000 Leuven, Belgium
- Pulmonary Rehabilitation, Respiratory Department, University Hospitals Gasthuisberg, 3000 Leuven, Belgium
| | - Moran Gilat
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), 3000 Leuven, Belgium
| | - Heleen Demeyer
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders (GRID), 3000 Leuven, Belgium
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
| | - Thierry Troosters
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders (GRID), 3000 Leuven, Belgium
- Pulmonary Rehabilitation, Respiratory Department, University Hospitals Gasthuisberg, 3000 Leuven, Belgium
| | - Alice Nieuwboer
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), 3000 Leuven, Belgium
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Bianchini E, Caliò B, Alborghetti M, Rinaldi D, Hansen C, Vuillerme N, Maetzler W, Pontieri FE. Step-Counting Accuracy of a Commercial Smartwatch in Mild-to-Moderate PD Patients and Effect of Spatiotemporal Gait Parameters, Laterality of Symptoms, Pharmacological State, and Clinical Variables. SENSORS (BASEL, SWITZERLAND) 2022; 23:214. [PMID: 36616812 PMCID: PMC9823757 DOI: 10.3390/s23010214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Commercial smartwatches could be useful for step counting and monitoring ambulatory activity. However, in Parkinson's disease (PD) patients, an altered gait, pharmacological condition, and symptoms lateralization may affect their accuracy and potential usefulness in research and clinical routine. Steps were counted during a 6 min walk in 47 patients with PD and 47 healthy subjects (HS) wearing a Garmin Vivosmart 4 (GV4) on each wrist. Manual step counting was used as a reference. An inertial sensor (BTS G-Walk), placed on the lower back, was used to compute spatial-temporal gait parameters. Intraclass correlation coefficient (ICC) and mean absolute percentage error (MAPE) were used for accuracy evaluation and the Spearman test was used to assess the correlations between variables. The GV4 overestimated steps in PD patients with only a poor-to-moderate agreement. The OFF pharmacological state and wearing the device on the most-affected body side led to an unacceptable accuracy. The GV4 showed an excellent agreement and MAPE in HS at a self-selected speed, but an unacceptable performance at a slow speed. In PD patients, MAPE was not associated with gait parameters and clinical variables. The accuracy of commercial smartwatches for monitoring step counting might be reduced in PD patients and further influenced by the pharmacological condition and placement of the device.
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Affiliation(s)
- Edoardo Bianchini
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
| | - Bianca Caliò
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
| | - Marika Alborghetti
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
| | - Domiziana Rinaldi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
- Santa Lucia Foundation, IRCCS, 00179 Rome, Italy
| | - Clint Hansen
- Department of Neurology, Kiel University, 24105 Kiel, Germany
| | - Nicolas Vuillerme
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France
- LabCom Telecom4Health, Orange Labs & Université Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, 38000 Grenoble, France
- Institut Universitaire de France, 75005 Paris, France
| | - Walter Maetzler
- Department of Neurology, Kiel University, 24105 Kiel, Germany
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
- Santa Lucia Foundation, IRCCS, 00179 Rome, Italy
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Kasparian AM, Badawy SM. Utility of Fitbit devices among children and adolescents with chronic health conditions: a scoping review. Mhealth 2022; 8:26. [PMID: 35928511 PMCID: PMC9343978 DOI: 10.21037/mhealth-21-28] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 05/09/2022] [Indexed: 11/06/2022] Open
Abstract
Background While Fitbit® devices were initially intended for leisurely, consumer use, there has been recent interest among scientific and medical communities in the prospective use of Fitbit devices for clinical and research purposes. Those who have chronic health conditions are often required to spend considerable amounts of money and time undergoing physiological tests and activity monitoring to support, stabilize, and manage their health. This disease burden is only amplified in pediatric populations. Devices that are used to collect these data can be invasive, uncomfortable, and disconcerting. Using the Fitbit tracker to acquire such biometric data could ease this burden. Our scoping review seeks to summarize the research that has been conducted on the utilization of Fitbit devices in studies of children and adolescents with chronic health conditions and the feasibility, accuracy, and potential benefits of doing so. Methods Searches were conducted on PubMed for articles relating pediatric health to Fitbit device usage (using a Boolean search strategy). The eligibility criteria included trials being clinical and/or randomized controlled and articles being in English. Once articles were obtained, they underwent screening and exclusion processes and were charted for their titles, authors, objectives, results, and respective chronic illnesses. In the subsequent full-text review, further charting was conducted, collecting study designs, Fitbit parameters, feasibility, accuracy, and related health and clinical outcomes. Results Fitbit trackers were unanimously demonstrated to be feasible devices in this population for physical activity monitoring and were determined to be potentially beneficial in measuring and improving overall wellbeing and physical health in children with chronic illness. Nevertheless, sufficient evidence was not found in support of Fitbit accuracy. Additional biases were identified against the population of children with chronic health conditions that may further enable inaccurate data. Conclusions While Fitbit devices may be beneficial for those interested in improving physical health, discretion is advised for those seeking to collect accurate and/or medically necessitated data. Given the existing literature evaluated, medical-grade technologies are preferred in instances of the latter, as Fitbit devices have not been found to provide reliably accurate data.
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Affiliation(s)
- Alexandra M. Kasparian
- Department of Biology, Lafayette College, Easton, PA, USA
- Department of Physician Assistant Studies, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Sherif M. Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
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Shokouhi N, Khodakarami H, Fernando C, Osborn S, Horne M. Accuracy of Step Count Estimations in Parkinson’s Disease Can Be Predicted Using Ambulatory Monitoring. Front Aging Neurosci 2022; 14:904895. [PMID: 35783129 PMCID: PMC9244695 DOI: 10.3389/fnagi.2022.904895] [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: 03/26/2022] [Accepted: 05/02/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives There are concerns regarding the accuracy of step count in Parkinson’s disease (PD) when wearable sensors are used. In this study, it was predicted that providing the normal rhythmicity of walking was maintained, the autocorrelation function used to measure step count would provide relatively low errors in step count. Materials and Methods A total of 21 normal walkers (10 without PD) and 27 abnormal walkers were videoed while wearing a sensor [Parkinson’s KinetiGraph (PKG)]. Median step count error rates were observed to be <3% in normal walkers but ≥3% in abnormal walkers. The simultaneous accelerometry data and data from a 6-day PKG were examined and revealed that the 5th percentile of the spectral entropy distribution, among 10-s walking epochs (obtained separately), predicted whether subjects had low error rate on step count with reference to the manual step count from the video recording. Subjects with low error rates had lower Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS III) scores and UPDRS III Q10–14 scores than the high error rate counterparts who also had high freezing of gait scores (i.e., freezing of gait questionnaire). Results Periods when walking occurred were identified in a 6-day PKG from 190 non-PD subjects aged over 60, and 155 people with PD were examined and the 5th percentile of the spectral entropy distribution, among 10-s walking epochs, was extracted. A total of 84% of controls and 72% of people with PD had low predicted error rates. People with PD with low bradykinesia scores (measured by the PKG) had step counts similar to controls, whereas those with high bradykinesia scores had step counts similar to those with high error rates. On subsequent PKGs, step counts increased when bradykinesia was reduced by treatment and decreased when bradykinesia increased. Among both control and people with PD, low error rates were associated with those who spent considerable time making walks of more than 1-min duration. Conclusion Using a measure of the loss of rhythmicity in walking appears to be a useful method for detecting the likelihood of error in step count. Bradykinesia in subjects with low predicted error in their step count is related to overall step count but when the predicted error is high, the step count should be assessed with caution.
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Affiliation(s)
| | | | - Chathurini Fernando
- Parkinson’s Laboratory, Florey Institute of Neurosciences and Mental Health, Parkville, VIC, Australia
- Department of Clinical Neurosciences, St Vincent’s Hospital, Fitzroy, VIC, Australia
| | - Sarah Osborn
- Parkinson’s Laboratory, Florey Institute of Neurosciences and Mental Health, Parkville, VIC, Australia
- Department of Clinical Neurosciences, St Vincent’s Hospital, Fitzroy, VIC, Australia
| | - Malcolm Horne
- Parkinson’s Laboratory, Florey Institute of Neurosciences and Mental Health, Parkville, VIC, Australia
- Department of Clinical Neurosciences, St Vincent’s Hospital, Fitzroy, VIC, Australia
- *Correspondence: Malcolm Horne,
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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: 6] [Impact Index Per Article: 3.0] [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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Jeng B, Cederberg KLJ, Lai B, Sasaki JE, Bamman MM, Motl RW. Wrist-based accelerometer cut-points for quantifying moderate-to-vigorous intensity physical activity in Parkinson's disease. Gait Posture 2022; 91:235-239. [PMID: 34749075 PMCID: PMC8686825 DOI: 10.1016/j.gaitpost.2021.10.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Persons with Parkinson's disease (PD) participate in low levels of physical activity. This has prompted interest in developing interventions targeting physical activity behavior in PD. However, the current cut-points to quantify moderate-to-vigorous physical activity (MVPA) developed for PD have been derived from a single, vertical axis using hip-worn accelerometers, and this cut-point may not be applicable for wrist-worn devices. Wrist-worn devices might improve accessibility and compliance with physical activity monitoring in PD. RESEARCH QUESTION What is the relationship between wrist-based activity counts and energy expenditure during treadmill walking in persons with PD? Do cut-points for quantifying time spent in MVPA differ between persons with PD and controls matched by age and sex? METHODS The sample included 26 persons with mild-to-moderate PD (Hoehn and Yahr stages 2-3) and 27 age- and sex-matched controls. Participants completed three, 6-minute bouts of walking on a treadmill at three increasing speeds. Vector magnitude was measured using ActiGraph GT3X+ accelerometer worn on the more affected side for persons with PD and the non-dominant side for controls. The rate of oxygen consumption, or energy expenditure, was measured using a portable, open-circuit spirometry system. RESULTS Our results indicated a strong association between activity counts and energy expenditure for persons with PD and controls with R2 values of 0.94(0.07) and 0.95(0.06), respectively. Persons with PD had a cut-point of 2883(871) counts·min-1; this was significantly lower than the cut-point of 4389(1844) counts·min-1 for controls. CONCLUSION We generated a PD-specific cut-point for wrist-worn ActiGraph accelerometers among persons with PD, and this was lower than controls. This disease-specific cut-point may provide more accurate measurements of time spent in MVPA in PD.
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Affiliation(s)
- Brenda Jeng
- Department of Physical Therapy, University of Alabama at Birmingham School of Health Professions, 360, 1720 2nd Ave S, Birmingham, AL 35233, United States.
| | - Katie L J Cederberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Byron Lai
- Division of Pediatric Rehabilitation Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jeffer E Sasaki
- Graduate Program in Physical Education, Graduate Program in Physical Education, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Marcas M Bamman
- University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, United States; Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States; Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, United States; Geriatric Research Education and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, United States
| | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham School of Health Professions, 360, 1720 2nd Ave S, Birmingham, AL 35233, United States
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de Carvalho Lana R, Ribeiro de Paula A, Souza Silva AF, Vieira Costa PH, Polese JC. Validity of mHealth devices for counting steps in individuals with Parkinson's disease. J Bodyw Mov Ther 2021; 28:496-501. [PMID: 34776185 DOI: 10.1016/j.jbmt.2021.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/02/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Step quantification is a good way to characterize the mobility and functional status of individuals with some functional disorder. Therefore, a validation study may lead to the feasibility of devices to stimulate an increase in the number of steps and physical activity level of individuals with Parkinson's Disease (PD). AIM To investigate the validity of mHealth devices to estimate the number of steps in individuals with PD and compare the estimate with a standard criterion measure. METHOD An observational study in a university laboratory with 34 individuals with idiopathic PD. The number of steps was measured using mHealth devices (Google Fit, Health, STEPZ, Pacer, and Fitbit INC®), and compared against a criterionstandard measure during the Two-Minute Walk Test using habitual speed. RESULTS Our sample was 82% men with a Hoehn and Yahr mean of 2.3 ± 1.3 and mean walking speed of 1.2 ± 0.2 m/s. Positive and statistically significant associations were found between Google Fit (r = 0.92; p < 0.01), STEPZ (r = 0.91; p < 0.01), Pacer (r = 0.77; p < 0.01), Health (r = 0.54; p < 0.01), and Fitbit Inc® (r = 0.82; p < 0.01) with the criterion-standard measure. CONCLUSIONS GoogleFit, STEPZ, Fitbit Inc.®, Pacer, and Health are valid instruments to measure the number of steps over a given period of time with moderate to high correlation with the criterion-standard in individuals with PD. This result shows that technology such as smartphone applications and activity monitor can be used to assess the number of steps in individuals with PD, and allows the possibility of using this technology for assessment and intervention purposes.
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Affiliation(s)
- Raquel de Carvalho Lana
- Post Graduate Program of Health Sciences, Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - André Ribeiro de Paula
- Post Graduate Program of Health Sciences, Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Flávia Souza Silva
- Post Graduate Program of Health Sciences, Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Pollyana Helena Vieira Costa
- Post Graduate Program of Health Sciences, Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Janaine Cunha Polese
- Post Graduate Program of Health Sciences, Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
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10
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Alberts JL, Rosenfeldt AB, Lopez-Lennon C, Suttman E, Jansen AE, Imrey PB, Dibble LE. Effectiveness of a Long-Term, Home-Based Aerobic Exercise Intervention on Slowing the Progression of Parkinson Disease: Design of the Cyclical Lower Extremity Exercise for Parkinson Disease II (CYCLE-II) Study. Phys Ther 2021; 101:pzab191. [PMID: 34363478 PMCID: PMC8632855 DOI: 10.1093/ptj/pzab191] [Citation(s) in RCA: 3] [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: 09/22/2020] [Revised: 05/03/2021] [Accepted: 07/05/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Previous short duration studies have demonstrated that high-intensity aerobic exercise improves aspects of motor and non-motor function in people with Parkinson disease (PwPD); however, the effectiveness of a long-term exercise intervention on slowing disease progression is unknown. The primary aim of this study is to determine the disease-altering effects of high-intensity aerobic exercise, administered on an upright stationary cycle, on the progression of PD. A secondary aim is to develop a prognostic model for 12-month changes in the Movement Disorder Society Unified Parkinson's Disease Rating Scale III (MDS-UPDRS III) of PwPD undergoing an aerobic exercise intervention. METHODS This pragmatic, multisite, single-rater blinded, randomized controlled trial will recruit PwPD from 2 large, urban, academic medical centers. Participants (N = 250 PwPD) will be randomized to (1) home-based aerobic exercise or (2) usual and customary care. Those in the aerobic exercise arm will be asked to complete in-home aerobic exercise sessions at 60% to 80% of heart rate reserve 3 times per week for 12 months utilizing a commercially available upright exercise cycle. The usual and customary care group will continue normal activity levels. Daily activity will be monitored for both groups throughout the 12-month study period. The primary outcome, both to assess disease-modifying response to aerobic exercise and for prognostic modeling in the aerobic exercise arm, is 12-month rate of change in the MDS-UPDRS III. Clinical and biomechanical measures will also be used to assess upper and lower extremity motor function as well as non-motor functions. IMPACT Should long-term aerobic exercise demonstrate disease-modifying capability, this study will provide evidence that "Exercise is Medicine" for PwPD. Further, the derived prognostic model will inform a patient-specific exercise prescription for PwPD and expected effects on PD progression.
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Affiliation(s)
- Jay L Alberts
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
- Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA
| | - Anson B Rosenfeldt
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
| | - Cielita Lopez-Lennon
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - Erin Suttman
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - A Elizabeth Jansen
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
| | - Peter B Imrey
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
- Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, Cleveland, Ohio, USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Leland E Dibble
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
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11
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Sokas D, Paliakaitė B, Rapalis A, Marozas V, Bailón R, Petrėnas A. Detection of Walk Tests in Free-Living Activities Using a Wrist-Worn Device. Front Physiol 2021; 12:706545. [PMID: 34456748 PMCID: PMC8397518 DOI: 10.3389/fphys.2021.706545] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
Exercise testing to assess the response to physical rehabilitation or lifestyle interventions is administered in clinics thus at best can be repeated only few times a year. This study explores a novel approach to collecting information on functional performance through walk tests, e.g., a 6-min walk test (6MWT), unintentionally performed in free-living activities. Walk tests are detected in step data provided by a wrist-worn device. Only those events of minute-to-minute variation in walking cadence, which is equal or lower than the empirically determined maximal SD (e.g., 5-steps), are considered as walk test candidates. Out of detected walk tests within the non-overlapping sliding time interval (e.g., 1-week), the one with the largest number of steps is chosen as the most representative. This approach is studied on a cohort of 99 subjects, assigned to the groups of patients with cardiovascular disease (CVD) and healthy subjects below and over 40-years-old, who were asked to wear the device while maintaining their usual physical activity regimen. The total wear time was 8,864 subject-days after excluding the intervals of occasionally discontinued monitoring. About 82% (23/28) of patients with CVD and 88% (21/24) of healthy subjects over 40-years-old had at least a single 6MWT over the 1st month of monitoring. About 52% of patients with CVD (12/23) and 91% (19/21) of healthy subjects over 40-years-old exceeded 500 m. Patients with CVD, on average, walked 46 m shorter 6MWT distance (p = 0.04) compared to healthy subjects. Unintentional walk testing is feasible and could be valuable for repeated assessment of functional performance outside the clinical setting.
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Affiliation(s)
- Daivaras Sokas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Birutė Paliakaitė
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Andrius Rapalis
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania.,Faculty of Electrical and Electronics Engineering, Kaunas University of Technology, Kaunas, Lithuania
| | - Vaidotas Marozas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania.,Faculty of Electrical and Electronics Engineering, Kaunas University of Technology, Kaunas, Lithuania
| | - Raquel Bailón
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain
| | - Andrius Petrėnas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania.,Faculty of Electrical and Electronics Engineering, Kaunas University of Technology, Kaunas, Lithuania
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12
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Cederberg KLJ, Jeng B, Sasaki JE, Lai B, Bamman M, Motl RW. Accuracy and precision of wrist-worn actigraphy for measuring steps taken during over-ground and treadmill walking in adults with Parkinson's disease. Parkinsonism Relat Disord 2021; 88:102-107. [PMID: 34171566 DOI: 10.1016/j.parkreldis.2021.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Step counts represent a straight-forward method of measuring physical activity in adults with Parkinson's disease (PD). The present study examined the absolute and relative accuracy and precision of a wrist-worn research-grade accelerometer (i.e., ActiGraph GT3X+) for measuring step counts during over-ground and treadmill walking in adults with PD and controls without PD. METHODS Participants (PD: n = 29; controls: n = 31) wore two ActiGraph GT3X + accelerometers, one on each wrist, and completed an over-ground walking bout followed by a treadmill walking bout at the same speed. Step counts were measured manually using a hand-held tally counter. Accuracy and precision were based on absolute and relative metrics. RESULTS The ActiGraph GT3X + underestimated step counts in both participants with PD (4.7-11% error) and controls without PD (8.8-17% error), with a greater discrepancy in controls. The ActiGraph GT3X + provided more accurate and precise estimates of step counts when placed on the more affected wrist and non-dominant wrist for participants with PD and controls, respectively, and was more accurate and precise during over-ground walking compared with treadmill walking for both groups. CONCLUSIONS Our results suggest that placement of the device (i.e., dominant vs. non-dominant), type of activity (i.e., over-ground vs. treadmill walking), and presence of clinical conditions may impact the accuracy and precision of data when using the research-grade ActiGraph GT3X + accelerometer for measuring step counts.
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Affiliation(s)
- Katie L J Cederberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Brenda Jeng
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeffer E Sasaki
- Department of Sport Sciences, Universidade Federal Do Triângulo Mineiro, Uberaba, MG, Brazil
| | - Byron Lai
- UAB/Lakeshore Foundation Research Collaborative, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marcas Bamman
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
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13
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Bacanoiu MV, Mititelu RR, Danoiu M, Olaru G, Buga AM. Functional Recovery in Parkinson's Disease: Current State and Future Perspective. J Clin Med 2020; 9:jcm9113413. [PMID: 33114424 PMCID: PMC7692963 DOI: 10.3390/jcm9113413] [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: 09/21/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 12/05/2022] Open
Abstract
Parkinson’s disease (PD) is one of the most frequent neurodegenerative disorders, affecting not only the motor function but also limiting the autonomy of affected people. In the last decade, the physical exercises of different intensities carried out by kinetic therapeutic activities, by robotic technologies or with the participation of sensory cues, have become increasingly appreciated in the management of Parkinson’s disease impairments. The aim of this paper was to evaluate the impact of physical exercises with and without physical devices on the motor and cognitive variables of PD patients. In order to achieve our objectives, we performed a systematic review of available original articles based on the impact of kinetic therapeutic activity. Through the search strategy, we selected original papers that were laboriously processed using characteristics related to physical therapy, or the tools used in physiological and psychological rehabilitation strategies for PD patients. In this study, we presented the most current intervention techniques in the rehabilitation programs of patients with Parkinson’s disease, namely the use of assisted devices, virtual imagery or the performing of physical therapies that have the capacity to improve walking deficits, tremor and bradykinesia, to reduce freezing episodes of gait and postural instability, or to improve motor and cognitive functions.
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Affiliation(s)
- Manuela Violeta Bacanoiu
- Department of Physical Therapy and Sports Medicine, University of Craiova, 200207 Craiova, Romania; (M.D.); (G.O.)
- Department of Laboratory Medicine, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
- Correspondence: (M.V.B.); (A.M.B.); Tel.: +40-0351-443-500 (A.M.B.)
| | - Radu Razvan Mititelu
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; or
| | - Mircea Danoiu
- Department of Physical Therapy and Sports Medicine, University of Craiova, 200207 Craiova, Romania; (M.D.); (G.O.)
| | - Gabriela Olaru
- Department of Physical Therapy and Sports Medicine, University of Craiova, 200207 Craiova, Romania; (M.D.); (G.O.)
| | - Ana Maria Buga
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; or
- Correspondence: (M.V.B.); (A.M.B.); Tel.: +40-0351-443-500 (A.M.B.)
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14
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Artusi CA, Imbalzano G, Sturchio A, Pilotto A, Montanaro E, Padovani A, Lopiano L, Maetzler W, Espay AJ. Implementation of Mobile Health Technologies in Clinical Trials of Movement Disorders: Underutilized Potential. Neurotherapeutics 2020; 17:1736-1746. [PMID: 32734442 PMCID: PMC7851293 DOI: 10.1007/s13311-020-00901-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Mobile health technologies (mHealth) are patient-worn or portable devices aimed at increasing the granularity and relevance of clinical measurements. The implementation of mHealth has the potential to decrease sample size, duration, and cost of clinical trials. We performed a review of the ClinicalTrials.gov database using a standardized approach to identify adoption in and usefulness of mHealth in movement disorders interventional clinical trials. Trial phase, geographical area, availability of data captured, constructs of interest, and outcome priority were collected. Eligible trials underwent quality appraisal using an ad hoc 5-point checklist to assess mHealth feasibility, acceptability, correlation with patient-centered outcome measures, and clinical meaningfulness. A total of 29% (n = 54/184) registered trials were using mHealth, mainly in Parkinson's disease and essential tremor (59.3% and 27.8%). In most cases, mHealth were used in phase 2 trials (83.3%) as secondary outcome measures (59.3%). Only five phase 3 trials, representing 9.3% of the total, used mHealth (1 as primary outcome measure, 3 as secondary, and 1 as tertiary). Only 3.7% (n = 2/54) of all trials used mHealth for measuring both motor and non-motor symptoms, and 23.1% (n = 12/52) used mHealth for unsupervised, ecologic outcomes. Our findings suggest that mHealth remain underutilized and largely relegated to phase 2 trials for secondary or tertiary outcome measures. Efforts toward greater alignment of mHealth with patient-centered outcomes and development of a universal, common-language platform to synchronize data from one or more devices will assist future efforts toward the integration of mHealth into clinical trials.
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Affiliation(s)
- Carlo Alberto Artusi
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | - Gabriele Imbalzano
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | - Andrea Sturchio
- Gardner Family Center for Parkinson's disease and Movement Disorders, Department of Neurology, University of Cincinnati Academic Health Center, 260 Stetson St., Suite 2300, Cincinnati, OH, 45267-0525, USA
| | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- FERB Onlus, Ospedale S. Isidoro, Trescore Balneario, Bergamo, Italy
| | - Elisa Montanaro
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Leonardo Lopiano
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | - Walter Maetzler
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Alberto J Espay
- Gardner Family Center for Parkinson's disease and Movement Disorders, Department of Neurology, University of Cincinnati Academic Health Center, 260 Stetson St., Suite 2300, Cincinnati, OH, 45267-0525, USA.
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15
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Jeng B, Cederberg KL, Lai B, Sasaki JE, Bamman MM, Motl RW. Step-rate threshold for physical activity intensity in Parkinson's disease. Acta Neurol Scand 2020; 142:145-150. [PMID: 32255504 DOI: 10.1111/ane.13250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/21/2020] [Accepted: 03/31/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the relationship between step-rate and energy expenditure during treadmill walking in persons with PD and then further develop a step-rate cut-point for moderate-to-vigorous physical activity (MVPA) for persons with PD. MATERIALS AND METHODS The sample consisted of 30 persons with mild-to-moderate PD and 30 controls matched by age and sex. Participants performed a 6-minute bout of over-ground walking at comfortable speed, and then completed three, 6-minute bouts of treadmill walking at 13.4 m/min slower, comfortable, and 13.4 m/min faster than comfortable speeds. The three treadmill speeds were based on the initial over-ground walking speed. The total number of steps per treadmill walking bout was recorded using a hand-tally counter, and energy expenditure was measured using a portable, indirect spirometry system. RESULTS The results indicated a strong association between step-rate and energy expenditure for persons with PD (R2 = .92) and controls (R2 = .92). The analyses further indicated a steeper slope of the association for persons with PD compared with controls (t(58) = -1.87, P < .05), resulting in a lower step-rate threshold (t(58) = 2.19, P < .05) for persons with PD (~80 steps·per minutes) than controls (~93 steps·per minutes). CONCLUSION Collectively, these results support the application of this disease-specific step-rate threshold for MVPA among persons with PD. This has important implications for physical activity promotion, prescription, and monitoring using accelerometers and pedometers for persons with PD to manage health and symptoms of PD.
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Affiliation(s)
- Brenda Jeng
- Department of Physical Therapy School of Health Professions University of Alabama at Birmingham Birmingham AL USA
| | - Katie L. Cederberg
- Department of Physical Therapy School of Health Professions University of Alabama at Birmingham Birmingham AL USA
| | - Byron Lai
- Department of Physical Therapy School of Health Professions University of Alabama at Birmingham Birmingham AL USA
| | - Jeffer E. Sasaki
- Graduate Program in Physical Education Federal University of Triângulo Mineiro Uberaba Brazil
| | - Marcas M. Bamman
- UAB Center for Exercise Medicine University of Alabama at Birmingham Birmingham AL USA
- Departments of Cell, Developmental, and Integrative Biology; Medicine; and Neurology University of Alabama at Birmingham Birmingham AL USA
- Geriatric Research, Education, and Clinical Center Birmingham VA Medical Center Birmingham AL USA
| | - Robert W. Motl
- Department of Physical Therapy School of Health Professions University of Alabama at Birmingham Birmingham AL USA
- UAB Center for Exercise Medicine University of Alabama at Birmingham Birmingham AL USA
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