The use of wearable technology to monitor physical activity in patients with COPD: a literature review

Background: Physical activity is an important predictor for survival in patients with COPD. Wearable technology, such as pedometer or accelerometer, may offer an opportunity to quantify physical activity and evaluate related health benefits in these patients.

Objectives: To assess the performance of wearable technology in monitoring and improving physical activity in COPD patients from published studies.

Methods: Literature search of Medline, Cochrane, Dare, Embase and PubMed databases was made to find relevant articles that used wearable technology to monitor physical activity in COPD patients.

Results: We identified 13 studies that used wearable technology, a pedometer or an accelerator, to monitor physical activity in COPD patients. Of these, six studies were randomized controlled trials (RCTs) which used the monitors as part of the intervention. Two studies reported the same outcomes and comparable units. They had measured the difference that the intervention makes on the number of steps taken daily by the patients. The results were highly heterogeneous with I²=92%. The random-effects model gave an effect outcome on the number of steps taken daily of 1,821.01 [−282.71; 3,924.74] in favor of the wearable technology. Four of the 13 studies have reported technical issues with the use of the wearable technology, including high signal-to-noise ratio, memory storage problems and inaccuracy of counts. While other studies did not mention any technical issues, it is not clear whether these did not experience them or chose not to report them.

Conclusions: Our literature search has shown that data on the use of wearable technology to monitor physical activity in COPD patients are limited by the small number of studies and their heterogeneous study design. Further research and better-designed RCTs are needed to provide reliable results before physical activity monitors can be implemented routinely for COPD patients.

Pragmatic trials: ignoring a mediator and adjusting for confounding

OBJECTIVES

In pragmatic trials, the new treatment is compared with usual care (heterogeneous control arm) that makes the comparison of the new treatment with each treatment within the control arm more difficult. The usual assumption is that we can fully capture the relations between different quantities. In this paper we use simulation to assess the performance of statistical methods that adjust for confounding when the assumed relations are not true. The true relations contain a mediator and heterogeneity with or without confounding, but the assumption is that there is no mediator and that confounding and heterogeneity are fully captured. The statistical methods that are compared include multivariable logistic regression, propensity score, disease risk score, inverse probability weighting, doubly robust inverse probability weighting and standardisation.

RESULTS

The misconception that there is no mediator can cause to misleading comparative effectiveness of individual treatments when a method that estimates the conditional causal effect is used. Using a method that estimates the marginal causal effect is a better approach, but not for all scenarios.

Can resistance training improve the symptoms of polycystic ovary syndrome?

Objectives

It has been suggested that the symptoms of Polycystic Ovary Syndrome (PCOS) could be improved by resistance training.

Design

This review focuses on identifying studies that use resistance training to examine how it can affect the symptoms of polycystic ovary syndrome (PCOS).

Methods

Medline, Cochrane, Dare and PubMed databases were searched to find relevant articles. All studies were assessed in terms of their design and methods.

Results

We found 10 studies that used resistance training to examine how it affects the symptoms of PCOS.

Conclusions

There is a need for further investigation. Most studies that examine the effects of resistance training on the symptoms of PCOS needed to consider the diet (macronutrient) of the participants along with the resistance training to have a better picture of how resistance training can affect the PCOS symptoms. Many questions are still unanswered.