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Chrisman M, Chesnut SR, Thompson M, Hopper A, Lasiter S. Physical activity and sedentary behavior in middle-aged intensive care unit survivors discharged home: A systematic review. Intensive Crit Care Nurs 2024; 81:103608. [PMID: 38155051 DOI: 10.1016/j.iccn.2023.103608] [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: 05/27/2023] [Revised: 11/21/2023] [Accepted: 12/15/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES The purpose of this study was to review literature on physical activity and sedentary behavior of middle-aged adults post-discharge from the intensive care unit, with a particular focus on studies using wearable activity trackers. METHODOLOGY Systematic review conducted using correlational, cohort, and intervention studies of physical activity and sedentary behavior of intensive care unit survivors' post-discharge. Literature in PubMed, Embase, and CINAHL was searched using keywords derived from patient status, activity, and activity monitoring. Two independent reviewers used the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies to assess quality of articles and potential biases in study design. MAIN OUTCOME MEASURES Physical activity and sedentary behavior assessed via wearable activity trackers. RESULTS Two hundred and fifty-six studies met inclusion criteria; six studies comprising 265 participants were retained. Outcomes varied widely and were not synthesized, but instead discussed individually. Average steps/day ranged from 1278 to 4958 and average minutes of activity ranged from 26 to 45 min/day. One study reported 12 hours and 17 min/day spent in sedentary activity and another reported 90 % of hospitalization was in sedentary behavior compared to 58 % post-discharge. CONCLUSION Few studies have examined physical activity and sedentary levels of middle-aged intensive care unit survivors wearing activity trackers. Findings are limited in generalizability, and no randomized controlled trials were included here. Eliciting support from clinical and post-discharge care teams to encourage activity and/or attend prescribed therapy or rehabilitation sessions is important. IMPLICATIONS FOR CLINICAL PRACTICE Clinicians should emphasize the importance of physical activity throughout the day to decrease sedentary time during a hospital stay and to continue being active after discharge to home. Physical activity is valuable, even in short spurts, from hospital stay through discharge. Interventions to increase physical activity and decrease sedentary time are needed to improve intensive care unit survivor recovery and quality of life post-discharge.
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Affiliation(s)
- Matthew Chrisman
- University of Missouri-Kansas City, School of Nursing and Health Studies, 2464 Charlotte St., Kansas City, MO 64108, United States.
| | - Steven R Chesnut
- University of Missouri-Kansas City, School of Nursing and Health Studies, 2464 Charlotte St., Kansas City, MO 64108, United States
| | - Marie Thompson
- University of Missouri-Kansas City, Health Sciences Library, 2411 Holmes, Kansas City, MO 64108, United States
| | - Amelia Hopper
- University of Missouri-Kansas City, School of Nursing and Health Studies, 2464 Charlotte St., Kansas City, MO 64108, United States
| | - Sue Lasiter
- University of Missouri-Kansas City, School of Nursing and Health Studies, 2464 Charlotte St., Kansas City, MO 64108, United States
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Duncan L, Zhu S, Pergolotti M, Giri S, Salsabili H, Faezipour M, Ostadabbas S, Mirbozorgi SA. Camera-Based Short Physical Performance Battery and Timed Up and Go Assessment for Older Adults With Cancer. IEEE Trans Biomed Eng 2023; 70:2529-2539. [PMID: 37028022 DOI: 10.1109/tbme.2023.3253061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
This paper presents an automatic camera-based device to monitor and evaluate the gait speed, standing balance, and 5 times sit-stand (5TSS) tests of the Short Physical Performance Battery (SPPB) and the Timed Up and Go (TUG) test. The proposed design measures and calculates the parameters of the SPPB tests automatically. The SPPB data can be used for physical performance assessment of older patients under cancer treatment. This stand-alone device has a Raspberry Pi (RPi) computer, three cameras, and two DC motors. The left and right cameras are used for gait speed tests. The center camera is used for standing balance, 5TSS, and TUG tests and for angle positioning of the camera platform toward the subject using DC motors by turning the camera left/right and tilting it up/down. The key algorithm for operating the proposed system is developed using Channel and Spatial Reliability Tracking in the cv2 module in Python. Graphical User Interfaces (GUIs) in the RPi are developed to run tests and adjust cameras, controlled remotely via smartphone and its Wi-Fi hotspot. We have tested the implemented camera setup prototype and extracted all SPPB and TUG parameters by conducting several experiments on a human subject population of 8 volunteers (male and female, light and dark complexions) in 69 test runs. The measured data and calculated outputs of the system consist of tests of gait speed (0.041 to 1.92 m/s with average accuracy of >95%), and standing balance, 5TSS, TUG, all with average time accuracy of >97%.
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Uninterrupted Actigraphy Recording to Quantify Physical Activity and Sedentary Behaviors in Mechanically Ventilated Adults: A Feasibility Prospective Observational Study. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2022. [DOI: 10.1097/jat.0000000000000193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Weeden M, Desai N, Sriram S, Swami Palaniswami M, Wang B, Talbot L, Deane A, Bellomo R, Yan B. A pilot study of high frequency accelerometry-based sedation and agitation monitoring in critically ill patients. CRIT CARE RESUSC 2020; 22:245-252. [PMID: 32900331 PMCID: PMC10699079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The degree of sedation or agitation in critically ill patients is typically assessed with the Richmond Agitation and Sedation Scale (RASS). However, this approach is intermittent and subject to unrecognised variation between assessments. High frequency accelerometry may assist in achieving a quantitative and continuous assessment of sedation while heralding imminent agitation. DESIGN We undertook a prospective, observational pilot study. SETTING An adult tertiary intensive care unit in Melbourne, Australia. PARTICIPANTS 20 patients with an admission diagnosis of trauma. MAIN OUTCOME MEASURES Accelerometers were applied to patients' wrists and used to continuously record patient movement. Video data of patient behaviour were simultaneously collected, and observers blinded to accelerometry data were adjudicated the RASS score every 30 seconds. Exploratory analyses were undertaken. RESULTS Patients were enrolled for a median duration of 9.7 hours (interquartile range [IQR], 0-22.8) and a total of 160 hours. These patients had a median RASS score of 0 (IQR, -4 to 0). A 2-minute moving window of amplitude variance was seen to reflect contemporaneous fluctuations in motor activity and was proportional to the RASS score. Furthermore, the moving window of amplitude variance was observed to spike immediately before ≥ 2 point increases in the RASS score. CONCLUSIONS We describe a novel approach to the analysis of wrist accelerometry data in critically ill patients. This technique not only appears to provide novel and continuous information about the depth of sedation or degree of agitation, it is also notable in its aptitude to anticipate impending transitions to higher RASS values.
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Affiliation(s)
- Mark Weeden
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia.
| | - Nandakishor Desai
- Department of Electrical and Electronic Engineering, The University of Melbourne, Melbourne, VIC, Australia
| | - Shyamala Sriram
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | | | - Bo Wang
- Melbourne Brain Centre at Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Lachlan Talbot
- Department of Neuroscience, University of Melbourne, Melbourne, VIC, Australia
| | - Adam Deane
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Rinaldo Bellomo
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Bernard Yan
- Melbourne Brain Centre at Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
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Moore CC, McCullough AK, Aguiar EJ, Ducharme SW, Tudor-Locke C. Toward Harmonized Treadmill-Based Validation of Step-Counting Wearable Technologies: A Scoping Review. J Phys Act Health 2020; 17:840-852. [PMID: 32652514 PMCID: PMC7855895 DOI: 10.1123/jpah.2019-0205] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 02/17/2020] [Accepted: 05/08/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The authors conducted a scoping review as a first step toward establishing harmonized (ie, consistent and compatible), empirically based best practices for validating step-counting wearable technologies. PURPOSE To catalog studies validating step-counting wearable technologies during treadmill ambulation. METHODS The authors searched PubMed and SPORTDiscus in August 2019 to identify treadmill-based validation studies that employed the criterion of directly observed (including video recorded) steps and cataloged study sample characteristics, protocol details, and analytical procedures. Where reported, speed- and wear location-specific mean absolute percentage error (MAPE) values were tabulated. Weighted median MAPE values were calculated by wear location and a 0.2-m/s speed increment. RESULTS Seventy-seven eligible studies were identified: most had samples averaging 54% (SD = 5%) female and 27 (5) years of age, treadmill protocols consisting of 3 to 5 bouts at speeds of 0.8 (0.1) to 1.6 (0.2) m/s, and reported measures of bias. Eleven studies provided MAPE values at treadmill speeds of 1.1 to 1.8 m/s; their weighted median MAPE values were 7% to 11% for wrist-worn, 1% to 4% for waist-worn, and ≤1% for thigh-worn devices. CONCLUSIONS Despite divergent study methodologies, the authors identified common practices and summarized MAPE values representing device step-count accuracy during treadmill walking. These initial empirical findings should be further refined to ultimately establish harmonized best practices for validating wearable technologies.
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Svarre FR, Jensen MM, Nielsen J, Villumsen M. The validity of activity trackers is affected by walking speed: the criterion validity of Garmin Vivosmart ® HR and StepWatch ™ 3 for measuring steps at various walking speeds under controlled conditions. PeerJ 2020; 8:e9381. [PMID: 32742766 PMCID: PMC7367048 DOI: 10.7717/peerj.9381] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/28/2020] [Indexed: 12/17/2022] Open
Abstract
Introduction The use of activity trackers has increased both among private consumers and in healthcare. It is therefore relevant to consider whether a consumer-graded activity tracker is comparable to or may substitute a research-graded activity tracker, which could further increase the use of activity trackers in healthcare and rehabilitation. Such use will require knowledge of their accuracy as the clinical implications may be significant. Studies have indicated that activity trackers are not sufficiently accurate, especially at lower walking speeds. The present study seeks to inform decision makers and healthcare personnel considering implementing physical activity trackers in clinical practice. This study investigates the criterion validity of the consumer-graded Garmin Vivosmart® HR and the research-graded StepWatch™ 3 compared with manual step count (gold standard) at different walking speeds under controlled conditions. Methods Thirty participants, wearing Garmin Vivosmart® HR at the wrist and StepWatch™ 3 at the ankle, completed six trials on a treadmill at different walking speeds: 1.6 km/h, 2.4 km/h, 3.2 km/h, 4.0 km/h, 4.8 km/h, and 5.6 km/h. The participants were video recorded, and steps were registered by manual step count. Medians and inter-quartile ranges (IQR) were calculated for steps and differences in steps between manually counted steps and the two devices. In order to assess the clinical relevance of the tested devices, the mean absolute percentage error (MAPE) was determined at each speed. A MAPE ≤3% was considered to be clinically irrelevant. Furthermore, differences between manually counted steps and steps recorded by the two devices were presented in Bland-Altman style plots. Results The median of differences in steps between Garmin Vivosmart® HR and manual step count ranged from -49.5 (IQR = 101) at 1.6 km/h to -1 (IQR = 4) at 4.0 km/h. The median of differences in steps between StepWatch™ 3 and manual step count were 4 (IQR = 14) at 1.6 km/h and 0 (IQR = 1) at all other walking speeds. The results of the MAPE showed that differences in steps counted by Garmin Vivosmart® HR were clinically irrelevant at walking speeds 3.2-4.8 km/h (MAPE: 0.61-1.27%) as the values were below 3%. Differences in steps counted by StepWatch™ 3 were clinically irrelevant at walking speeds 2.4-5.6 km/h (MAPE: 0.08-0.35%). Conclusion Garmin Vivosmart® HR tended to undercount steps compared with the manual step count, and StepWatch™ 3 slightly overcounted steps compared with the manual step count. Both the consumer-graded activity tracker (Garmin Vivosmart® HR) and the research-graded (StepWatch™ 3) are valid in detecting steps at selected walking speeds in healthy adults under controlled conditions. However, both activity trackers miscount steps at slow walking speeds, and the consumer graded activity tracker also miscounts steps at fast walking speeds.
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Affiliation(s)
- Frederik Rose Svarre
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark.,Department of Health and Movement, Jammerbugt Municipality, Pandrup, Denmark
| | - Mads Møller Jensen
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark.,Department of Physiotherapy, Aalborg University Hospital, Hobro, Denmark
| | - Josephine Nielsen
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
| | - Morten Villumsen
- Department of Elderly and Health, Section of Training and Activity, Aalborg Municipality, Aalborg, Denmark.,Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Silva PBD, Santos LJD. Patient functionality and walking speed after discharge from the intensive care unit. Rev Bras Ter Intensiva 2020; 31:529-535. [PMID: 31967228 PMCID: PMC7009006 DOI: 10.5935/0103-507x.20190066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 07/15/2019] [Indexed: 01/14/2023] Open
Abstract
Objective To measure and compare the functionality of patients after discharge from the intensive care unit and at the time of hospital discharge. Methods Quantitative study of a prospective cohort performed between August of 2016 and December of 2017 at a university hospital. A 10-meter walk test was performed at 2 timepoints: after discharge from the intensive care unit and prior to hospital discharge. The data were analyzed using Student's t-test and Pearson or Spearman correlation. Statistical Package for Social Science (SPSS) version 21.0 was used for the analysis, and p ≤ 0.05 was adopted as the level of significance. Results Forty patients, with a mean age of 57.1 ± 12.2 years and with a predominance of males (60%), were evaluated. For the post-intensive care unit test, a mean speed of 0.48m/s was observed, and for the pre-hospital discharge test, there was an increase to 0.71m/s, evidencing functional evolution during the hospital stay (p < 0.001). Conclusion There was significant improvement in walking speed at the time of hospital discharge when compared to the walking speed at the time of intensive care unit discharge.
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Affiliation(s)
- Priscila Becker da Silva
- Residência Multiprofissional em Saúde do Adulto e Idoso, Universidade Luterana do Brasil - Canoas (RS), Brasil
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Estrup S, Kjer CKW, Vilhelmsen F, Poulsen LM, Gøgenur I, Mathiesen O. Physical function and actigraphy in intensive care survivors-A prospective 3-month follow-up cohort study. Acta Anaesthesiol Scand 2019; 63:647-652. [PMID: 30623414 DOI: 10.1111/aas.13317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/22/2018] [Accepted: 11/16/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Impaired physical function after intensive care unit (ICU) stay is common. We aimed to study the association between activity levels in the ward after discharge from ICU and physical function at 3-month follow-up. METHODS Prospective cohort study of adult patients admitted to the ICU for more than 24 hours. Patients wore an accelerometer for up to 7 days at the ward. At discharge from ICU and at 3-month follow-up, patients were tested with the Chelsea Critical Care Physical Assessment Tool (CPAx). RESULTS We screened 66 consecutive, eligible patients; 41 completed actigraphy and 19 patients were visited at 3 months. The median CPAx increased from 31 (IQR 23-41) at discharge from ICU to 47 (IQR 44-49) at follow-up (P < 0.0001). Mean daily activity for the first week was correlated with CPAx at ICU discharge (R2 = 0.14, P = 0.017; all 41 patients). For the 19 visited patients, we found no significant correlation for activity levels with CPAx at ICU discharge (R2 = 0.12, P = 0.14) nor at visit (R2 = 0.2, P = 0.058). CONCLUSION We found improved physical function for most patients 3 months after ICU treatment. Activity levels for 1 week after ICU discharge at the ward were not associated with better physical function at 3-month follow-up.
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Affiliation(s)
- Stine Estrup
- Department of Anaesthesiology, Centre for Anaesthesiological Research Zealand University Hospital Køge Køge Denmark
| | - Cilia K. W. Kjer
- Department of Anaesthesiology, Centre for Anaesthesiological Research Zealand University Hospital Køge Køge Denmark
| | - Frederik Vilhelmsen
- Department of Anaesthesiology, Centre for Anaesthesiological Research Zealand University Hospital Køge Køge Denmark
| | - Lone M. Poulsen
- Department of Anaesthesiology, Centre for Anaesthesiological Research Zealand University Hospital Køge Køge Denmark
| | - Ismail Gøgenur
- Department of Gastrointestinal Surgery, Center for Surgical Science Zealand University Hospital Køge Køge Denmark
| | - Ole Mathiesen
- Department of Anaesthesiology, Centre for Anaesthesiological Research Zealand University Hospital Køge Køge Denmark
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9
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Anderson JL, Yoward LS, Green AJ. A study investigating the validity of an accelerometer in quantification of step count in adult hospital inpatients recovering from critical illness. Clin Rehabil 2019; 33:936-942. [PMID: 30764647 DOI: 10.1177/0269215519829893] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the validity of the ActiGraph GT3X accelerometer in step count quantification when compared to observed step count in hospitalised adults recovering from critical illness. SETTING Large National Health Service (NHS) Hospitals Trust. SUBJECTS In total, 20 hospital ward-based adults (age: mean 62.3, SD 11.5) who had required greater than 48 hours of mechanical ventilation in the intensive care unit. MAIN MEASURES Participants walked self-selected distances and speeds as part of a semi-structured movement protocol not exceeding 3 hours. Two ActiGraph GT3X accelerometers were worn, one on the thigh and one on the ankle of the non-dominant leg. Accelerometer-recorded step counts were compared against observed step counts. RESULTS In total, 31 separate walking episodes were analysed. A mean (SD) of 45.87 (±19.72) steps was calculated for observed step count (range 15-90). Mean differences (95% limits of agreement) of -0.84 steps (-3.88 to 2.2) for the ankle placement and -17.7 steps (-40.63 to 5.25) for the thigh were calculated. Intraclass correlation coefficients (95% confidence intervals) of 0.99 (0.99 to 1.0) and 0.46 (-0.1 to 0.78) were determined for the ankle and thigh, respectively. Placement sites were well tolerated by 95% of participants. CONCLUSION An ankle-mounted ActiGraph GT3X accelerometer demonstrates validity in quantification of step count in hospitalised adults recovering from critical illness. A thigh placement was not considered valid.
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Affiliation(s)
- Jayne Lesley Anderson
- 1 Physiotherapy Department, Therapies Centre, Hull Royal Infirmary, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.,2 School of Health Sciences, York St John University, York, UK
| | | | - Angela J Green
- 1 Physiotherapy Department, Therapies Centre, Hull Royal Infirmary, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
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10
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Baldwin CE, Johnston KN, Rowlands AV, Williams MT. Physical Activity of ICU Survivors during Acute Admission: Agreement of the activPAL with Observation. Physiother Can 2018; 70:57-63. [PMID: 29434419 DOI: 10.3138/ptc.2016-61] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: We estimated the agreement of a thigh-worn accelerometer, the activPAL, used to measure activity and sedentary parameters, with observed mobility assessments of intensive care unit (ICU) survivors. Method: We prospectively compared activPAL measurements with direct observation during assessments at discharge from the ICU or acute hospital in eight participants with a median age of 56 (1st-3rd quartile 48-65) years and an Acute Physiology and Chronic Health Evaluation II score of 23 (1st-3rd quartile 17-24). Frequency of sit-to-stand transitions; time spent standing, stepping, upright (standing and stepping), and sedentary (lying/sitting); and total steps were described; analysis was performed using Bland-Altman plots and calculating the absolute percent error. Results: All sit-to-stand transitions were accurately detected. The mean difference on the Bland-Altman plots suggested an overestimation of standing time with the activPAL of 31 (95% CI: -9, 71) seconds and underestimation of stepping time by 25 (95% CI: -47, -3) seconds. The largest median absolute percent errors were for standing time (21.9%) and stepping time (18.7%); time spent upright (1.7%) or sedentary (0.3%) was more accurately estimated. The activPAL underestimated total steps per session, achieving the largest percent error (70.8%). Conclusion: Because it underestimated step count, the activPAL likely incorrectly recorded stepping time as standing time, so that time spent upright was the measure of activity with the smallest error. Sedentary behaviour, including frequency of transitions, was validly assessed.
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Affiliation(s)
- Claire E Baldwin
- Sansom Institute for Health Research, University of South Australia, Adelaide.,Flinders Medical Centre, Southern Adelaide Health Service, Bedford Park, S.A., Australia
| | - Kylie N Johnston
- Sansom Institute for Health Research, University of South Australia, Adelaide
| | - Alex V Rowlands
- Sansom Institute for Health Research, University of South Australia, Adelaide.,Diabetes Research Centre, University of Leicester.,Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, National Institute for Health Research, Leicester, United Kingdom.,Alliance for Research in Exercise, Nutrition and Activity (ARENA)
| | - Marie T Williams
- Sansom Institute for Health Research, University of South Australia, Adelaide.,Alliance for Research in Exercise, Nutrition and Activity (ARENA)
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11
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Anderson JL, Green AJ, Yoward LS, Hall HK. Validity and reliability of accelerometry in identification of lying, sitting, standing or purposeful activity in adult hospital inpatients recovering from acute or critical illness: a systematic review. Clin Rehabil 2017; 32:233-242. [DOI: 10.1177/0269215517724850] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To investigate the validity and reliability of accelerometers to detect lying, sitting and standing postures or purposeful activity in hospitalized adults recovering from acute or critical illness. Data sources: CINAHL, MEDLINE, EMBASE, AMED, Cochrane Library, PEDro, PsycINFO and SPORTDiscuss were searched from inception to June 2017. Professional networks and reference lists of relevant articles were also searched. The main selection criteria were hospitalized adults with acute or critical illness and studies investigating the validity or reliability of accelerometers to identify body position or purposeful activity. Review methods: Two authors individually assessed study eligibility and independently undertook methodological quality assessment and data extraction from selected articles. A narrative synthesis of the data was undertaken. Results: Fifteen studies, collectively enrolling 385 hospitalized participants, were identified. Populations included stroke, the elderly, acute exacerbation of chronic respiratory disease, abdominal surgery and those recovering from critical illness. Correlations of r = 0.36 to 0.98 and levels of agreement of κ = 0.28 to 0.98 were reported for identification of lying, sitting or standing postures. Correlations of r = 0.4 to 0.8 with general activity were found, with r = 0.94 and 0.96 reported for step count. The reliability of accelerometry measurement was investigated in one study evaluating step count quantification (intraclass correlation coefficient (ICC) = 0.99, 95% confidence interval (CI) = 0.99–1.00). Conclusion: The validity of accelerometers to determine lying, sitting and standing postures or quantify purposeful activity within hospitalized acute or critically ill populations is variable. The reliability of accelerometry measurement within this setting remains largely unexplored.
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Affiliation(s)
- Jayne L Anderson
- Physiotherapy Department, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
- School of Health Sciences, York St John University, York, UK
| | - Angela J Green
- Physiotherapy Department, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
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12
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Punt M, van Alphen B, van de Port IG, van Dieën JH, Michael K, Outermans J, Wittink H. Clinimetric properties of a novel feedback device for assessing gait parameters in stroke survivors. J Neuroeng Rehabil 2014; 11:30. [PMID: 24597594 PMCID: PMC3974014 DOI: 10.1186/1743-0003-11-30] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 02/20/2014] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Community-dwelling stroke survivors tend to become less physically active over time. There is no 'gold standard' to measure walking activity in this population. Assessment of walking activity generally involves subjective or observer-rated instruments. Objective measuring with an activity monitor, however, gives more insight into actual walking activity. Although several activity monitors have been used in stroke patients, none of these include feedback about the actual walking activity. FESTA (FEedback to Stimulate Activity) determines number of steps, number of walking bouts, covered distance and ambulatory activity profiles over time and also provides feedback about the walking activity to the user and the therapist. AIM To examine the criterion validity and test-retest-reliability of the FESTA as a measure of walking activity in patients with chronic stroke. To target the properties of the measurement device itself and thus exclude effects of behavioral variability as much as possible evaluation was performed in standardized activities. METHODS Community-dwelling individuals with chronic stroke were tested twice with a test-retest interval varying from two days to two weeks. They performed a six-minute walk test and a standardized treadmill test at different speeds on both testing days. Walking activity was expressed in gait parameters: steps, mean-step-length and walking distance. Output data of the FESTA on the treadmill was compared with video analysis as the criterion measurement. Intraclass Correlations Coefficients (ICCs) and Mean Relative Root Squared Error (MRRSE) were calculated. RESULTS Thirty-three patients were tested to determine criterion validity, 27 patients of this group were tested twice for test-retest reliability. ICC values for validity and reliability were high, ranging from .841 to .972. CONCLUSION This study demonstrated good criterion validity and test-retest-reliability of FESTA for measuring specific gait parameters in chronic stroke patients. FESTA is a valid and reliable tool for capturing walking activity measurements in stroke, and has applicability to both clinical practice and research.
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Affiliation(s)
- Michiel Punt
- Research group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Belinda van Alphen
- Research group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Ingrid G van de Port
- Research group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
- Revant Rehabilitation CentreBreda, Breda, The Netherlands
| | - Jaap H van Dieën
- Move Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
- King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Jacqueline Outermans
- Research group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Harriet Wittink
- Research group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
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