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Jørgensen LB, Bricca A, Bernhardt A, Juhl CB, Tang LH, Mortensen SR, Eriksen JA, Walløe S, Skou ST. Objectively measured physical activity levels and adherence to physical activity guidelines in people with multimorbidity-A systematic review and meta-analysis. PLoS One 2022; 17:e0274846. [PMID: 36223336 PMCID: PMC9555650 DOI: 10.1371/journal.pone.0274846] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/06/2022] [Indexed: 11/05/2022] Open
Abstract
Objective To determine levels of objectively measured physical activity (PA) and the proportion of adults with multimorbidity that adheres to PA guidelines. Methods All studies, where PA was measured at baseline using an activity monitor in an adult (≥18 years) multimorbid (≥80% of the population had ≥2 chronic conditions) population. A systematic literature search was performed in Medline, EMBASE, CINAHL, CENTRAL, ClinicalTrials.gov, opengrey.eu and google.com from inception up until 18th of January 2022. Risk of bias was assessed with a modified version of the Quality Assessment Tool for Quantitative Studies. A random-effects meta-analyses was performed to estimate daily minutes of sedentary behavior (SB), light PA (LPA), moderate PA (MPA), moderate to vigorous PA (MVPA) and steps. Proportions adhering to PA guidelines was narratively synthesized. Certainty of evidence was determined using The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Fifteen studies (2,172 participants) were included. The most frequent combination of conditions were type 2 diabetes and hypertension (six studies). Participants spent a daily average of 500.5 (95% CI: 407.1 to 593.9) minutes in SB, 325.6 (95% CI: 246.4 to 404.7 minutes in LPA and 32.7 (95% CI: 20.2 to 45.3) minutes in MVPA. The mean daily number of steps was 5,145 (95% CI: 4264 to 6026) for people in free-living conditions. The proportion adhering to PA guidelines ranged widely (7.4% to 43%). All studies were rated as at high risk of bias and the certainty of evidence was very low. Conclusions PA levels and adherence varied from low to above guideline recommended levels for adults with chronic conditions, depending on PA intensity. The very low certainty of evidence calls for high quality studies focusing on detailed descriptions of PA behavior in people with multimorbidity. PROSPERO registration number CRD42020172456.
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Affiliation(s)
- Lars Bo Jørgensen
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Physiotherapy and Occupational Therapy, Zealand University Hospital, Roskilde, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Alessio Bricca
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
| | - Anna Bernhardt
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
| | - Carsten B. Juhl
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
| | - Lars Hermann Tang
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- The Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Sofie Rath Mortensen
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Jonas Ahler Eriksen
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
| | - Sisse Walløe
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark
| | - Søren T. Skou
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
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Matsuda M, Saito N, Miyawaki I. Effectiveness of daily activity record-based self-monitoring intervention for patients with chronic heart failure: A study protocol. Contemp Clin Trials Commun 2022; 30:101017. [PMID: 36276263 PMCID: PMC9583036 DOI: 10.1016/j.conctc.2022.101017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 08/17/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022] Open
Abstract
Background The prevention of recurrent readmission among heart failure (HF) patients requires support for appropriate self-care behaviors to prevent exacerbation of HF and self-monitoring to allow for patients’ early perception of physical changes during exacerbations. Such support may enable patients to seek early consultation. This study developed a self-monitoring intervention that aimed at increasing the perception of patient-unique physical sensations caused by HF, based on daily activity records of patients. Method A parallel two-arm randomized controlled trial is being conducted with 68 HF patients early after their discharge. Participants in both groups wear a wristwatch activity tracker from time-of-discharge. Participants in the self-monitoring intervention group receive support to reflect on their actual daily activities and the associated physical sensations they experienced, based on their daily activity records. The primary outcome is participants’ “Asking for Help” dimension of self-care behavior, measured using the European Heart Failure Self-Care Behavior Scale at one month follow-up after intervention. Conclusion This study is the first trial to use an activity tracker as a tool for symptom perception among HF patients. The problem of delayed consultations during exacerbations may be resolved by assisting patients in improving their perception of their unique physical sensations associated with specific daily activities, based on their daily activity records. If the effect is clarified, it could lead to the construction of new nursing interventions for continuous disease management that aim towards re-hospitalization prevention. This is the first trial using an activity tracker for symptom perception in HF. Intervention focuses on physical sensations perception along with daily activities. Trial will test intervention's effect on early consultation behavior and readmission.
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Affiliation(s)
- Misako Matsuda
- Department of Nursing, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan,Corresponding author.
| | - Nao Saito
- School of Nursing, Public University Corporation Miyagi University, 1-1 Gakuen, Taiwa-cho, Kurokawa-gun, Miyagi, 981-3298, Japan
| | - Ikuko Miyawaki
- Department of Nursing, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan
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Mortensen SR, Kristensen PL, Grøntved A, Ried-Larsen M, Lau C, Skou ST. Determinants of physical activity among 6856 individuals with diabetes: a nationwide cross-sectional study. BMJ Open Diabetes Res Care 2022; 10:10/4/e002935. [PMID: 35977754 PMCID: PMC9389096 DOI: 10.1136/bmjdrc-2022-002935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/15/2022] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION The aims of this cross-sectional study were to (1) describe habitual physical activity and adherence to WHO recommendations, and (2) investigate the association of comorbidity, obesity, stress, and health-related quality of life (HRQoL) with moderate to vigorous physical activity (MVPA) among individuals with diabetes. RESEARCH DESIGN AND METHODS This study included 6856 participants with diabetes from the Danish National Health Survey from 2017. The primary outcome measure was weekly MVPA. Exposures included self-reported number of conditions, body mass index (BMI), perceived stress, and HRQoL. Mean difference in MVPA across exposures was estimated by multiple linear regression analyses. RESULTS Forty per cent of individuals with diabetes were not adherent to WHO recommendations for physical activity. Individuals with diabetes had higher BMI, more comorbidities, higher perceived stress, and lower HRQoL. Individuals with three or more comorbidities were significantly associated with lower weekly MVPA (-0.48 hours/week, 95% CI -0.88 to -0.07) compared with individuals with no comorbidity. Furthermore, overweight or obese (class I-III) individuals engaged in significantly less weekly MVPA (obese class III vs normal weight: -1.98 hours/week, 95% CI -2.49 to -1.47). Higher perceived stress was significantly associated with lower weekly MVPA (-1.76 hours/week, 95% CI -2.18 to -1.34) versus low perceived stress. Finally, having low physical and mental HRQoL was associated with lower weekly MVPA (-0.93 hours/week, 95% CI -1.19 to -0.66 and -0.39 hours/week, 95% CI -0.71 to -0.08 respectively vs moderate or high HRQoL). CONCLUSIONS We found that 40% of individuals with diabetes do not engage regularly in adequate physical activity. Comorbidities, higher BMI, higher perceived stress, and lower HRQoL were associated with less engagement in physical activity. This study suggests that subgroups of individuals with diabetes are at higher risk of physical inactivity.
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Affiliation(s)
- Sofie Rath Mortensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Peter Lund Kristensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anders Grøntved
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mathias Ried-Larsen
- Centre for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Cathrine Lau
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Søren T Skou
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
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Carmona-Torres JM, Cobo-Cuenca AI, Pozuelo-Carrascosa DP, Latorre-Román PÁ, Párraga-Montilla JA, Laredo-Aguilera JA. Physical Activity, Mental Health and Consumption of Medications in Pre-Elderly People: The National Health Survey 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031100. [PMID: 33530650 PMCID: PMC7908116 DOI: 10.3390/ijerph18031100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 12/12/2022]
Abstract
Background: The promotion of Physical Activity (PA) is an important public health goal to reduce comorbidity and diseases associated with aging such as anxiety and depression. Aim: To investigate the association between level of PA, mental health and the consumption of medications among a representative cohort of Spanish pre-elderly people. Methods: Cross-sectional study with 5977 participants aged 50 to 64 years who participated in the National Health Survey in Spain 2017. The levels of PA were evaluated using the International Physical Activity Questionnaire and the mental conditions were measured by the Goldberg Health Questionnaire-12 (GHQ-12). The chi-square test was used for qualitative variables; Pearson’s correlation was conducted between GHQ-12 score with different quantitative variables; and a logistic regression was used to determine the association between PA and mental health with the sociodemographic characteristics. Results: The participants were 51.9% women and 48.1% men with a mean age of 56.79 years, and 35.5% of participants had a low level of PA. A low level of PA was associated with cases of mental health vulnerability, anxiety and depression (in women), the consumption of more medications and greater multimorbidity. Conclusion: It is important that people reach old age with an optimal health status in order to reduce age-related disability and morbidity. More than a third of the Spanish pre-elderly do not reach the levels of PA recommended by the WHO. People who had low level of PA consumed more medications and had higher mental health vulnerability and greater multimorbidity.
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Affiliation(s)
- Juan Manuel Carmona-Torres
- Facultad de Fisioterapia y Enfermería, Campus de Fábrica de Armas, Universidad de Castilla-La Mancha, Av de Carlos III, nº 21, 45071 Toledo, Spain; (J.M.C.-T.); (A.I.C.-C.); (J.A.L.-A.)
- Grupo de Investigación Multidisciplinar en Cuidados (IMCU), Campus de Fábrica de Armas, Universidad de Castilla-La Mancha, Av de Carlos III, nº 21, 45071 Toledo, Spain
| | - Ana Isabel Cobo-Cuenca
- Facultad de Fisioterapia y Enfermería, Campus de Fábrica de Armas, Universidad de Castilla-La Mancha, Av de Carlos III, nº 21, 45071 Toledo, Spain; (J.M.C.-T.); (A.I.C.-C.); (J.A.L.-A.)
- Grupo de Investigación Multidisciplinar en Cuidados (IMCU), Campus de Fábrica de Armas, Universidad de Castilla-La Mancha, Av de Carlos III, nº 21, 45071 Toledo, Spain
| | - Diana P. Pozuelo-Carrascosa
- Facultad de Fisioterapia y Enfermería, Campus de Fábrica de Armas, Universidad de Castilla-La Mancha, Av de Carlos III, nº 21, 45071 Toledo, Spain; (J.M.C.-T.); (A.I.C.-C.); (J.A.L.-A.)
- Grupo de Investigación Multidisciplinar en Cuidados (IMCU), Campus de Fábrica de Armas, Universidad de Castilla-La Mancha, Av de Carlos III, nº 21, 45071 Toledo, Spain
- Correspondence: ; Tel.: +928-268-800 (ext. 4684)
| | - Pedro Ángel Latorre-Román
- Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Universidad de Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain; (P.Á.L.-R.); (J.A.P.-M.)
| | - Juan Antonio Párraga-Montilla
- Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Universidad de Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain; (P.Á.L.-R.); (J.A.P.-M.)
| | - José Alberto Laredo-Aguilera
- Facultad de Fisioterapia y Enfermería, Campus de Fábrica de Armas, Universidad de Castilla-La Mancha, Av de Carlos III, nº 21, 45071 Toledo, Spain; (J.M.C.-T.); (A.I.C.-C.); (J.A.L.-A.)
- Grupo de Investigación Multidisciplinar en Cuidados (IMCU), Campus de Fábrica de Armas, Universidad de Castilla-La Mancha, Av de Carlos III, nº 21, 45071 Toledo, Spain
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Vetrovsky T, Clark CCT, Bisi MC, Siranec M, Linhart A, Tufano JJ, Duncan MJ, Belohlavek J. Advances in accelerometry for cardiovascular patients: a systematic review with practical recommendations. ESC Heart Fail 2020; 7:2021-2031. [PMID: 32618431 PMCID: PMC7524133 DOI: 10.1002/ehf2.12781] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/24/2020] [Accepted: 04/28/2020] [Indexed: 12/11/2022] Open
Abstract
Aims Accelerometers are becoming increasingly commonplace for assessing physical activity; however, their use in patients with cardiovascular diseases is relatively substandard. We aimed to systematically review the methods used for collecting and processing accelerometer data in cardiology, using the example of heart failure, and to provide practical recommendations on how to improve objective physical activity assessment in patients with cardiovascular diseases by using accelerometers. Methods and results Four electronic databases were searched up to September 2019 for observational, interventional, and validation studies using accelerometers to assess physical activity in patients with heart failure. Study and population characteristics, details of accelerometry data collection and processing, and description of physical activity metrics were extracted from the eligible studies and synthesized. To assess the quality and completeness of accelerometer reporting, the studies were scored using 12 items on data collection and processing, such as the placement of accelerometer, days of data collected, and criteria for non‐wear of the accelerometer. In 60 eligible studies with 3500 patients (of those, 536 were heart failure with preserved ejection fraction patients), a wide variety of accelerometer brands (n = 27) and models (n = 46) were used, with Actigraph being the most frequent (n = 12), followed by Fitbit (n = 5). The accelerometer was usually worn on the hip (n = 32), and the most prevalent wear period was 7 days (n = 22). The median wear time required for a valid day was 600 min, and between two and five valid days was required for a patient to be included in the analysis. The most common measures of physical activity were steps (n = 20), activity counts (n = 15), and time spent in moderate‐to‐vigorous physical activity (n = 14). Only three studies validated accelerometers in a heart failure population, showing that their accuracy deteriorates at slower speeds. Studies failed to report between one and six (median 4) of the 12 scored items, with non‐wear time criteria and valid day definition being the most underreported items. Conclusions The use of accelerometers in cardiology lacks consistency and reporting on data collection, and processing methods need to be improved. Furthermore, calculating metrics based on raw acceleration and machine learning techniques is lacking, opening the opportunity for future exploration. Therefore, we encourage researchers and clinicians to improve the quality and transparency of data collection and processing by following our proposed practical recommendations for using accelerometers in patients with cardiovascular diseases, which are outlined in the article.
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Affiliation(s)
- Tomas Vetrovsky
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Cain C T Clark
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Maria Cristina Bisi
- Department of Electrical, Electronic and Information Engineering 'Guglielmo Marconi', DEI, University of Bologna, Bologna, Italy
| | - Michal Siranec
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Ales Linhart
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - James J Tufano
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Michael J Duncan
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Jan Belohlavek
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Rajoo Y, Wong J, Cooper G, Raj IS, Castle DJ, Chong AH, Green J, Kennedy GA. The relationship between physical activity levels and symptoms of depression, anxiety and stress in individuals with alopecia Areata. BMC Psychol 2019; 7:48. [PMID: 31337438 PMCID: PMC6651906 DOI: 10.1186/s40359-019-0324-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 07/17/2019] [Indexed: 01/28/2023] Open
Abstract
Background Alopecia Areata (AA) is an autoimmune condition that is characterised by non-scarring hair loss. Its aesthetic repercussions can lead to profound changes in psychological well-being. Although physical activity (PA) has been associated with better mental health outcomes in diverse populations, the association in individuals with AA has not been established. The aim of this study was to examine the associations between PA and mental health outcomes in individuals with AA to inform intervention strategies for this specific population. Methods A cross-sectional study was conducted among individuals who were diagnosed with AA. A total of 83 respondents aged (40.95 ± 13.24 years) completed a self-report questionnaire consisting of International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Depression and Anxiety Stress Scale (DASS-21). Three-way contingency Chi-square analyses were used to determine the associations between PA, mental health outcomes and participants with hair loss of more than 50% on the scalp. Results 81.9% of the participants did not meet PA guidelines. Participants with hair loss of more than 50% on the scalp, and who did not meet PA guidelines, were significantly more likely to experience symptoms of severe depression (p = .003), moderate anxiety (p = .04) and mild stress (p = .003) than those who met guidelines Conclusion Findings suggest that increased PA participation in AA individuals with severe hair loss is associated with improved mental health status. Intervention efforts for this specific population should consider barriers and enablers to PA participation as they face challenges that differ from the general population.
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Affiliation(s)
- Y Rajoo
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.
| | - J Wong
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.,School of Education, RMIT University, Melbourne, Australia
| | - G Cooper
- School of Education, RMIT University, Melbourne, Australia
| | - I S Raj
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - D J Castle
- Department of Psychological Sciences and Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.,Department of Psychiatry, St. Vincent's Mental Health, Melbourne, Victoria, Australia
| | - A H Chong
- Department of Medicine (Dermatology), St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - J Green
- Western Dermatology, Melbourne, Victoria, Australia
| | - G A Kennedy
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.,Institute for Breathing and Sleep, Austin Hospital, Melbourne, Victoria, Australia
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Tan MKH, Wong JKL, Bakrania K, Abdullahi Y, Harling L, Casula R, Rowlands AV, Athanasiou T, Jarral OA. Can activity monitors predict outcomes in patients with heart failure? A systematic review. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2019; 5:11-21. [PMID: 30215706 DOI: 10.1093/ehjqcco/qcy038] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 09/11/2018] [Indexed: 12/12/2022]
Abstract
Actigraphy is increasingly incorporated into clinical practice to monitor intervention effectiveness and patient health in congestive heart failure (CHF). We explored the prognostic impact of actigraphy-quantified physical activity (AQPA) on CHF outcomes. PubMed and Medline databases were systematically searched for cross-sectional studies, cohort studies or randomised controlled trials from January 2007 to December 2017. We included studies that used validated actigraphs to predict outcomes in adult HF patients. Study selection and data extraction were performed by two independent reviewers. A total of 17 studies (15 cohort, 1 cross-sectional, 1 randomised controlled trial) were included, reporting on 2,759 CHF patients (22-89 years, 27.7% female). Overall, AQPA showed a strong inverse relationship with mortality and predictive utility when combined with established risk scores, and prognostic roles in morbidity, predicting cognitive function, New York Heart Association functional class and intercurrent events (e.g. hospitalisation), but weak relationships with health-related quality of life scores. Studies lacked consensus regarding device choice, time points and thresholds of PA measurement, which rendered quantitative comparisons between studies difficult. AQPA has a strong prognostic role in CHF. Multiple sampling time points would allow calculation of AQPA changes for incorporation into risk models. Consensus is needed regarding device choice and AQPA thresholds, while data management strategies are required to fully utilise generated data. Big data and machine learning strategies will potentially yield better predictive value of AQPA in CHF patients.
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Affiliation(s)
- Matthew K H Tan
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Joanna K L Wong
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Kishan Bakrania
- Diabetes Research Centre, University of Leceister, Leicester General Hospital, Gwendolen Road, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Gwendolen Road, Leicester, UK
| | - Yusuf Abdullahi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Leanne Harling
- Diabetes Research Centre, University of Leceister, Leicester General Hospital, Gwendolen Road, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Gwendolen Road, Leicester, UK.,Division of Health Sciences, Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, City East Campus, Adelaide SA, Australia
| | - Roberto Casula
- Diabetes Research Centre, University of Leceister, Leicester General Hospital, Gwendolen Road, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Gwendolen Road, Leicester, UK.,Division of Health Sciences, Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, City East Campus, Adelaide SA, Australia
| | - Alex V Rowlands
- Diabetes Research Centre, University of Leceister, Leicester General Hospital, Gwendolen Road, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Gwendolen Road, Leicester, UK.,Division of Health Sciences, Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, City East Campus, Adelaide SA, Australia
| | - Thanos Athanasiou
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Omar A Jarral
- Department of Surgery and Cancer, Imperial College London, London, UK
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Leth S, Hansen J, Nielsen OW, Dinesen B. Evaluation of Commercial Self-Monitoring Devices for Clinical Purposes: Results from the Future Patient Trial, Phase I. SENSORS 2017; 17:s17010211. [PMID: 28117736 PMCID: PMC5298782 DOI: 10.3390/s17010211] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/16/2017] [Accepted: 01/17/2017] [Indexed: 01/16/2023]
Abstract
Commercial self-monitoring devices are becoming increasingly popular, and over the last decade, the use of self-monitoring technology has spread widely in both consumer and medical markets. The purpose of this study was to evaluate five commercially available self-monitoring devices for further testing in clinical applications. Four activity trackers and one sleep tracker were evaluated based on step count validity and heart rate validity. Methods: The study enrolled 22 healthy volunteers in a walking test. Volunteers walked a 100 m track at 2 km/h and 3.5 km/h. Steps were measured by four activity trackers and compared to gyroscope readings. Two trackers were also tested on nine subjects by comparing pulse readings to Holter monitoring. Results: The lowest average systematic error in the walking tests was −0.2%, recorded on the Garmin Vivofit 2 at 3.5 km/h; the highest error was the Fitbit Charge HR at 2 km/h with an error margin of 26.8%. Comparisons of pulse measurements from the Fitbit Charge HR revealed a margin error of −3.42% ± 7.99% compared to the electrocardiogram. The Beddit sleep tracker measured a systematic error of −3.27% ± 4.60%. Conclusion: The measured results revealed the current functionality and limitations of the five self-tracking devices, and point towards a need for future research in this area.
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Affiliation(s)
- Soren Leth
- Laboratory of Welfare Technologies-Telehealth & Telerehabilitation, SMI, Department of Health Science and Technology, Aalborg University, Aalborg 9100, Denmark.
| | - John Hansen
- Laboratory of Welfare Technologies-Telehealth & Telerehabilitation, SMI, Department of Health Science and Technology, Aalborg University, Aalborg 9100, Denmark.
- Medical Informatics Group, Department of Health Science and Technology, Aalborg University, Aalborg 9100, Denmark.
| | - Olav W Nielsen
- Department of Cardiology, Copenhagen University Hospital Bispebjerg, Copenhagen NV 2400, Denmark.
| | - Birthe Dinesen
- Laboratory of Welfare Technologies-Telehealth & Telerehabilitation, SMI, Department of Health Science and Technology, Aalborg University, Aalborg 9100, Denmark.
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Izawa KP, Watanabe S, Oka K, Kasahara Y, Morio Y, Hiraki K, Hirano Y, Omori Y, Suzuki N, Kida K, Suzuki K, Akashi YJ. Sarcopenia and physical activity in older male cardiac patients. Int J Cardiol 2016; 222:457-461. [DOI: 10.1016/j.ijcard.2016.07.167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 07/27/2016] [Indexed: 12/25/2022]
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Haseba S, Sakakima H, Kubozono T, Nakao S, Ikeda S. Combined effects of repeated sauna therapy and exercise training on cardiac function and physical activity in patients with chronic heart failure. Disabil Rehabil 2015; 38:409-15. [DOI: 10.3109/09638288.2015.1044032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tully PJ, Selkow T, Bengel J, Rafanelli C. A dynamic view of comorbid depression and generalized anxiety disorder symptom change in chronic heart failure: the discrete effects of cognitive behavioral therapy, exercise, and psychotropic medication. Disabil Rehabil 2014; 37:585-92. [PMID: 24981015 DOI: 10.3109/09638288.2014.935493] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE No previous study has reported upon comorbid depression and anxiety disorders and their treatment in heart failure (HF), which the current study has sought to document. MATERIALS AND METHODS Total 29 HF patients under psychiatric management underwent primary depression cognitive behavioral therapy (CBT; n = 15) or primary generalized anxiety disorder (GAD) CBT (n = 14), and participated in a community exercise program and standard physician care. Repeated measures analysis of variance assessed Patient Health Questionnaire (PHQ-9) and GAD-7 symptom change pre- and post-CBT treatment, and assessed the interaction effects of treatment type, exercise, anti-depressant and anxiolytic. RESULTS There was a significant time and treatment interaction effect that favored the primary GAD CBT group for reduction in PHQ symptoms (F(1, 24) = 4.52, p = 0.04). Analysis of PHQ-somatic symptoms also showed a significant main effect for participation in the exercise program (F(1, 24) = 4.21, p = 0.05) and a significant time and anxiolytic interaction (F(1, 24) = 3.98, p = 0.05). The average number of cardiac hospital readmissions favored the primary GAD CBT group (p = 0.05). CONCLUSION The findings support the use of multifaceted interventions in the rehabilitation of HF patients with comorbid psychiatric needs. Implications for Rehabilitation Comorbid depression and anxiety disorders are a clinical and research focus that deserves more attention in the treatment of heart failure patients. Cognitive behavioral therapy, exercise, and anxiolytic use was associated with significant changes in depression and anxiety though discrete effects were evident. Multifaceted interventions are most likely to be successful in the rehabilitation of HF patients with psychiatric needs.
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Affiliation(s)
- Phillip J Tully
- Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide , Adelaide , Australia
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