Effects of daily intake of yoghurt enriched with bioactive components on chronic stress responses: a double-blinded randomized controlled trial.

Chronic stress has a negative influence on health. The aim was to determine stress reducing effects of yoghurt enriched with bioactive components as compared to normal yoghurt. High-trait anxiety individuals (n = 67) aged 18-63 years participated in a randomized, placebo-controlled, double-blinded intervention with parallel groups. They received either yoghurt enriched with alpha-lactalbumin, casein tripeptides and B vitamins (active) or isoenergetic standard yoghurt (control). To detect changes in psychological and physiological stress, State-Trait Anxiety Inventory, Profile of Mood States, salivary cortisol, inflammatory markers, blood pressure, heart rate variability (HRV) and actigraphy were monitored. We observed higher ratings of vigor (p = 0.047) and reduced feeling of inefficiency (p = 0.048) in the active group. HRV (baseline adjusted mean 49.1 ± 2.3 ms) and recovery index (106.6 ± 33.4) were higher in the active group than in controls (42.5 ± 2.2 ms and 80.0 ± 29.3) (p = 0.046 and p = 0.02, respectively). In conclusion, daily intake of yoghurt enriched with bioactive components may aid in stress coping.

Wearable Monitoring of Physical Functioning and Disability Changes, Circadian Rhythms and Sleep Patterns in Nursing Home Residents.

Sleep problems and disrupted circadian rhythms are common among older adults and may be associated with several health issues and physical functioning status. Wearable continuous monitoring of physical activity enables unobtrusive monitoring of circadian activity and sleep patterns. The objective of this retrospective study was to analyze whether physical functioning status (Activities of Daily Living assessment of Resident Assessment Instrument) is associated with diurnal activity rhythm and sleep patterns measured with wearable activity sensor in nursing home residents during their normal daily life. Continuous activity data were collected by the wearable sensor from 16 nursing home residents (average age of 90.7 years, seven demented subjects, one female) in their daily life over several months (12-18 months). The subjects' physical activity and sleep were quantified by several parameters from the activity data. In the cross-sectional analysis, physical functioning status was associated with the strength (RHO = 0.78, ) and the stability (RHO = 0.72, ) of the activity rhythm when the level of dementia was not controlled. In the longitudinal analysis (12-18 months), at an individual level the activity rhythm indices and activity level had the strongest correlations with changes in physical functioning but the associations were to some extent individual. In these long-term case recordings, decrease in the physical functioning was most strongly associated with decreasing levels of activity, stability, and strength of the activity rhythm, and with increasing fragmentation of rhythm and daytime passivity. Daily wearable monitoring of physical activity may hence reveal information about functioning state and health of older adults. However, since the changes in activity patterns implying changes in physical functioning status may not be consistent between the individuals, a multivariate approach is recommended for monitoring of these changes by continuous physical activity measurement.

Gait analysis and estimation of changes in fall risk factors.

Falls are a major problem for older adults. A continuous gait monitoring that provides fall risk assessment would allow timely interventions aiming for preventing falls. The objective of this work was to find out whether gait variables calculated from the acceleration signal measured during walk task in the baseline assessment can predict changes in commonly used fall risk assessment scales after 12 months follow-up. Forty two subjects were measured during walk test with a triaxial acceleration sensor worn on a waist belt at the lower back near the centre of mass. The fall risk was assessed using a test protocol, which included several assessment methods. Gait analysis was able to predict a decline in ABC, BBS and GDS total scores and slower time in STS-5 after twelve-months follow-up. A subsequent study is needed to confirm the model's suitability for data recorded in everyday lives.

Accelerometry-based berg balance scale score estimation.

The objective of the study was to investigate the validity of 3-D-accelerometry-based Berg balance scale (BBS) score estimation. In particular, acceleration patterns of BBS tasks and gait were the targets of analysis. Accelerations of the lower back were measured during execution of the BBS test and corridor walking for 54 subjects, consisting of neurological patients, older adults, and healthy young persons. The BBS score was estimated from one to three BBS tasks and from gait-related data, separately, through assessment of the similarity of acceleration patterns between subjects. The work also validated both approaches' ability to classify subjects into high- and low-fall-risk groups. The gait-based method yielded the best BBS score estimates and the most accurate BBS-task-based estimates were produced with the stand to sit, reaching, and picking object tasks. The proposed gait-based method can identify subjects with high or low risk of falling with an accuracy of 77.8% and 96.6%, respectively, and the BBS-task based method with corresponding accuracy of 89.5% and 62.1%.

3D accelerometer features' differences between young and older people, and between lower back and neck band sensor placements.

In the earlier studies we have developed activity recognition algorithms which are based on features calculated from data of 3D accelerometer sensor placed on the hip, close to the centre of mass. In the development subjects have been young adults. Now we study if the input features of the algorithm are generalized for different set-ups; for older adults and when the sensor is worn as a necklace. From the 3D accelerometer resultant magnitude the following features were calculated for each second: spectral entropy, peak frequency, power and range. The frequency domain features behaved in a relatively stable manner in the set-ups but the time domain features differed significantly from statistical and algorithm perspective between the set-ups. By developing time domain features to be more inter-individual independent would be beneficial for activity recognition algorithms.

Wireless, multipurpose in-home health monitoring platform: two case trials.

We propose a general purpose home area sensor network and monitoring platform that is intended for e-Health applications, ranging from elderly monitoring to early homecoming after a hospitalization period. Our monitoring platform is multipurpose, meaning that the system is easily configurable for various user needs and is easy to set up. The system could be temporarily rented from a service company by, for example, hospitals, elderly service providers, specialized physiological rehabilitation centers, or individuals. Our system consists of a chosen set of sensors, a wireless sensor network, a home client, and a distant server. We evaluated our concept in two initial trials: one with an elderly woman living in sheltered housing, and the other with a hip surgery patient during his rehabilitation phase. The results prove the functionality of the platform. However, efficient utilization of such platforms requires further work on the actual e-Health service concepts.

Compliance and technical feasibility of long-term health monitoring with wearable and ambient technologies.

We developed a system consisting of both wearable and ambient technologies designed to monitor personal wellbeing for several months during daily life. The variables monitored included bodyweight, blood pressure, heart-rate variability and air temperature. Two different user groups were studied: there were 17 working-age subjects participating in a vocational rehabilitation programme and 19 elderly people living in an assisted living facility. The working-age subjects collected data for a total of 1406 days; the average participation period was 83 days (range 43-99). The elderly subjects collected data for a total of 1593 days; the average participation period was 84 days (range 19-107). Usage, technical feasibility and usability of the system were also studied. Some technical and practical problems appeared which we had not expected such as thunder storm damage to equipment in homes and scheduling differences between staff and the subjects. The users gave positive feedback in almost all their responses in a questionnaire. The study suggests that the data-collection rate is likely be 70-90% for typical health monitoring data.

Relationship of psychological and physiological variables in long-term self-monitored data during work ability rehabilitation program.

Individual wellness comprises both psychological and physiological wellbeing, which are interrelated. In long-term monitoring of wellness, both components should be included. Work-related stress and burnout are persistent problems in industrial countries. Early identification of work-related stress symptoms and early intervention could reduce individual suffering and improve the working productivity and creativity. The goal of this study was to explore the relationship between physiological and psychological variables measured at home by the users themselves or automatically. In all, 17 (3 males and 14 females, age 40-62) people participating in a work ability rehabilitation program (due to work overload) were monitored for three months. Physiological and behavioral variables (activity, bed occupancy, heart rate (HR) and respiration during night, HR during day, blood pressure, steps, weight, room illumination, and temperature) were measured with different unobtrusive wireless sensors. Daily self-assessment of stress, mood, and behaviors (exercise, sleep) were collected using a mobile phone diary. The daily self-assessment of stress and the Derogatis stress profile questionnaire were used as reference for stress status. Results show modest, but significant pooled overall correlations between self-assessed stress level, and physiological and behavioral variables (e.g., sleep length measured with wrist-worn activity monitor: rho = -0.22, p < 0.001, and variance of nightly bedroom illumination: rho = 0.13, p < 0.001). Strong, but sometimes conflicting correlations can be found at individual level, suggesting individual reactions to stress in daily life.

Mobile diary for wellness management--results on usage and usability in two user studies.

The prevalence of lifestyle-related health problems is increasing rapidly. Many of the diseases and health risks could be prevented or alleviated by making changes toward healthier lifestyles. We have developed the Wellness Diary (WD), a concept for personal and mobile wellness management based on Cognitive-Behavioral Therapy (CBT). Two implementations of the concept were made for the Symbian Series 60 (S60) mobile phone platform, and their usability, usage, and acceptance were studied in two 3-month user studies. Study I was related to weight management and study II to general wellness management. In both the studies, the concept and its implementations were well accepted and considered as easy to use and useful in wellness management. The usage rate of the WD was high and sustained at a high level throughout the study. The average number of entries made per day was 5.32 (SD = 2.59, range = 0-14) in study I, and 5.48 (SD = 2.60, range = 0-17) in study II. The results indicate that the WD is well suited for supporting CBT-based wellness management.

Long-term subjective and objective sleep analysis of total sleep time and sleep quality in real life settings.

Sleep quality is one of the key elements of the human health status. By observing sleep patterns we can gain information about personal wellbeing. Consumer electronic sleep analysis solutions are now available for use in long-term conditions. In this study we compare different measures for total sleep time and sleep quality. We analyzed visually long- term sleep data collected with actigraphy, sleep logs and ambient sensors to gain more reliable results and compared these results to each single method's output. Correlations of visually analyzed total sleep time between actigraphy total sleep time (correlation coefficient (r) = 0.662, p <0.01) and sleep log total sleep time (r = 0.787, p <0.01) were high. Also comparison between subjective and objective sleep quality was analyzed and small, but significant correlation was found (r = 0.270, p < 0.01).

Evaluation of technology-based service scenarios for supporting independent living.

To develop technology -based service solutions for supporting the independent living of elderly citizens, we conducted a user assessment study. Six different service scenarios were created and analyzed in six focus groups by young adults, elderly, and health-care professionals (n=29). Results show that safety was viewed as the most significant aspect. The study also showed that independent of age, most individuals take interest in health related issues only when a clear threat is posed, even though health in general is considered an important issue in life.