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1.
Int J Sports Med ; 40(12): 756-761, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31476782

RESUMO

We studied the effects of supramaximal interval exercise (SIE) with or without antihypertensive medication (AHM) on 21-hr blood pressure (BP) response. Twelve hypertensive patients chronically medicated with AHM, underwent three trials in a randomized order: a) control trial without exercise and substituting their AHM with a placebo (PLAC); b) placebo medicine and a morning bout of SIE (PLAC+SIE), and c) combining AHM and exercise (AHM+SIE). Acute and ambulatory blood pressure responses were measured for 21-hr after treatment. 20 min after treatment, systolic blood pressure (SBP) readings were reduced, similar to readings after PLAC+SIE (-9.7±6.0 mmHg, P<0.001) and AHM+SIE (-10.4±7.9 mmHg, P=0.001). 21 h after treatment, SBP remained reduced after PLAC+SIE (125±12 mmHg, P=0.022) and AHM+SIE (122±12 mmHg, P=0.013) compared to PLAC (132±16 mmHg). The BP reduction in PLAC+SIE faded out at 4 a.m., while in AHM+SIE it continued overnight. At night, BP reduction was larger in AHM+SIE than PLAC+SIE (-5.6±4.0 mmHg, P=0.006). Our data shows that a bout of supramaximal aerobic interval exercise in combination with ARB medication in the morning elicits a sustained blood pressure reduction lasting at least 21-h. Thus, the combination of exercise and angiotensin receptor blocker medication seems superior to exercise alone for acutely decreasing blood pressure.


Assuntos
Anti-Hipertensivos/uso terapêutico , Treinamento Intervalado de Alta Intensidade , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Hipotensão Pós-Exercício/fisiopatologia , Actigrafia/métodos , Idoso , Pressão Sanguínea/fisiologia , Estudos Cross-Over , Método Duplo-Cego , Feminino , Monitores de Aptidão Física , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Postura/fisiologia , Estudos de Tempo e Movimento
2.
Eur Arch Otorhinolaryngol ; 276(11): 3057-3065, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31444561

RESUMO

BACKGROUND: Classical posturography techniques have been recently enhanced by the use of different motion tracking devices, but for technical reasons they are not used to track directly the body spatial position of a subject. OBJECTIVE: To describe and clinically evaluate a wireless inertial measurement unit-based mobile system to track body position changes. METHODS: The developed system used a calculus transformation method using the acceleration data corrected by Kalman and Butterworth filters to output position data. A prospective non-randomized clinical study involving 15 healthy subjects was performed to evaluate the agreement between the confidence ellipse areas synchronously measured by the new developed system and a classical posturography system while performing a modified clinical test of sensory interaction in balance. RESULTS: The overall intra-class correlation index was 0.93 (CI 0.89, 0.96). Grouped by conditions, under conditions 1-4, Pearson's correlation was 0.604, 0.78, 0.882, and 0.81, respectively. CONCLUSION: The developed wireless inertial measurement unit-based posturography system was valid for tracking the sway variances in normal subjects under habitual clinical testing conditions. Further studies are needed to validate this system on patients and also under other posture conditions.


Assuntos
Actigrafia , Movimento , Equilíbrio Postural , Postura , Aceleração , Acelerometria/instrumentação , Acelerometria/métodos , Actigrafia/instrumentação , Actigrafia/métodos , Adulto , Feminino , Humanos , Masculino , Teste de Materiais , Estudos Prospectivos , Tecnologia sem Fio
3.
Handb Clin Neurol ; 160: 371-379, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31277861

RESUMO

Actigraphy involves acquisition of data using a movement sensor worn continuously on the nondominant wrist, typically for a week or more. Computer-based algorithms estimate sleep episodes by analysis of continuous minutes of no to low movement, or spans of time when movement is relatively low compared with movements during presumed ambulatory wakefulness. Inherent advantages of actigraphy over polysomnography include its noninvasive nature, cost-effectiveness, lesser burden on patients/research participants, and ability to collect data over multiple days/nights, thereby allowing examination of sleep-wake patterning. Therefore, actigraphy is emerging as a common method to objectively assess sleep parameters providing estimates of sleep duration and continuity. Modes of actigraphy data collection, scoring algorithms, sleep quality/disturbance measures, validation studies, and clinical and research applications are discussed.


Assuntos
Actigrafia/métodos , Polissonografia/métodos , Fases do Sono/fisiologia , Transtornos do Sono-Vigília/fisiopatologia , Actigrafia/tendências , Humanos , Polissonografia/tendências , Transtornos do Sono-Vigília/diagnóstico
4.
BMC Public Health ; 19(Suppl 2): 542, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31159752

RESUMO

BACKGROUND: Exercise interventions are typically delivered to people with cancer and survivors via supervised clinical rehabilitation. However, motivating and maintaining activity changes outside of the clinic setting remains challenging. This study investigated the feasibility, acceptability and efficacy of an individually-tailored, text message-enhanced intervention that focused on increasing whole-of-day activity both during and beyond a 4-week, supervised clinical exercise rehabilitation program for people with cancer and survivors. METHODS: Participants (n = 36; mean ± SD age 64.8 ± 9.6 years; 44.1 ± 30.8 months since treatment) were randomized 1:1 to receive the text message-enhanced clinical exercise rehabilitation program, or the standard clinical exercise rehabilitation program alone. Activity was assessed at baseline, 4-weeks (end of the standard program) and 12-weeks (end of enhanced program) using both device (activPAL accelerometer; sitting, standing, light-stepping, moderate-stepping) and self-report [Multimedia Activity Recall for Children and Adults (MARCA); sedentary, light, moderate-to-vigorous physical activity (MVPA)] methods. The MARCA also assessed time use domains to provide context to activity changes. Changes and intervention effects were evaluated using linear mixed models, adjusting for baseline values and potential confounders. RESULTS: The study had high retention (86%) and participants reported high levels of satisfaction [4.3/5 (±0.8)] with the intervention. Over the first 4 weeks, MARCA-assessed MVPA increased [+ 53.2 (95%CI: 2.9, 103.5) min/d] between groups, favoring the text message-enhanced program, but there were no significant intervention effects on sedentary behavior. By 12 weeks, relative to the standard group, participants in the text message-enhanced group sat less [activPAL overall sitting: - 48.2 (- 89.9, - 5.6) min/16 h awake; MARCA: -80.1 (- 156.5, - 3.8) min/d] and were participating in more physical activity [activPAL light stepping: + 7.0 (0.4, 13.6: min/16 h awake; MARCA MVPA: + 67.3 (24.0, 110.6) min/d]. The time-use domains of Quiet Time [- 63.3 (- 110.5, - 16.0) min/d] and Screen Time [- 62.0 (- 109.7, - 14.2) min/d] differed significantly between groups. CONCLUSIONS: Results demonstrate feasibility, acceptability and efficacy of a novel, text message-enhanced clinical exercise rehabilitation program to support changes in whole-of-day activity, including both physical activity and sedentary behavior. Changes were largely seen at 12-week follow-up, indicating potential for the intervention to result in continued improvement and maintenance of behavior change following a supervised exercise intervention. TRIAL REGISTRATION: This trial is registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12616000641493 ; date registered 17/5/16).


Assuntos
Actigrafia/métodos , Terapia por Exercício/estatística & dados numéricos , Neoplasias/reabilitação , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Mensagem de Texto/estatística & dados numéricos , Adulto , Austrália , Sobreviventes de Câncer , Criança , Exercício , Estudos de Viabilidade , Feminino , Humanos , Masculino , Motivação , Neoplasias/psicologia , Comportamento Sedentário , Autorrelato
5.
BMC Public Health ; 19(Suppl 2): 451, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31159764

RESUMO

This Supplement aims to raise awareness and knowledge of how time use surveys may be applied to studying health behaviours such as physical activity, sedentary behaviour, and eating. This commentary provides an overview and discussion of the papers in this Supplement about time use and health research, and considers possible future directions for the field.


Assuntos
Actigrafia/métodos , Atividades Cotidianas , Inquéritos Epidemiológicos/métodos , Saúde Pública/métodos , Fatores de Tempo , Exercício , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Comportamento Sedentário
6.
JMIR Mhealth Uhealth ; 7(6): e12190, 2019 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-31237237

RESUMO

BACKGROUND: Consumer wearables can provide a practical and accessible method of data collection in actigraphy research. However, as this area continues to grow, it is becoming increasingly important for researchers to be aware of the many challenges facing the capture of quality data using consumer wearables. OBJECTIVE: This study aimed to (1) present the challenges encountered by a research team in actigraphy data collection using a consumer wearable and (2) present considerations for researchers to apply in the pursuit of robust data using this approach. METHODS: The Nokia Go was deployed to 33 elite Gaelic footballers from a single team for a planned period of 14 weeks. A bring-your-own-device model was employed for this study where the Health Mate app was downloaded on participants' personal mobile phones and connected to the Nokia Go via Bluetooth. Retrospective evaluation of the researcher and participant experience was conducted through transactional data such as study logs and email correspondence. The participant experience of the data collection process was further explored through the design of a 34-question survey utilizing aspects of the Technology Acceptance Model. RESULTS: Researcher challenges included device disconnection, logistics and monitoring, and rectifying of technical issues. Participant challenges included device syncing, loss of the device, and wear issues, particularly during contact sport. Following disconnection issues, the data collection period was defined as 87 days for which there were 18 remaining participants. Average wear time was 79 out of 87 days (90%) and 20.8 hours per day. The participant survey found mainly positive results regarding device comfort, perceived ease of use, and perceived usefulness. CONCLUSIONS: Although this study did not encounter some of the common published barriers to wearable data collection, our experience was impacted by technical issues such as disconnection and syncing challenges, practical considerations such as loss of the device, issues with personal mobile phones in the bring-your-own-device model, and the logistics and resources required to ensure a smooth data collection with an active cohort. Recommendations for achieving high-quality data are made for readers to consider in the deployment of consumer wearables in research.


Assuntos
Comportamento do Consumidor/estatística & dados numéricos , Dispositivos Eletrônicos Vestíveis/estatística & dados numéricos , Actigrafia/instrumentação , Actigrafia/métodos , Actigrafia/estatística & dados numéricos , Estudos de Coortes , Monitores de Aptidão Física , Humanos , Estudos Retrospectivos , Inquéritos e Questionários
7.
Int Marit Health ; 70(2): 95-99, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31237668

RESUMO

In order to determine the health status of seafarers, questionnaires are frequently applied or medical/ /psychological examinations conducted ashore, for example, in the form of medical fitness examinations or simulator training. In such a survey design, the occupational influences and the individual reaction cannot be ascertained. However, these aspects are especially important in the maritime context as employees on board are often exposed to the typical shipping-related stressors in the workplace for many months, both during working hours and during leisure time. In particular, it is assumed that working on board requires a high level of physical effort. Therefore, an exploration of occupational stress and strain, particularly the assessment of the seafarers' physical activity, should preferably be carried out in a comprehensive and realistic way in a maritime field study, i.e. an on-the-job survey directly on board.


Assuntos
Exercício , Medicina Naval , Estresse Ocupacional , Inquéritos e Questionários/normas , Actigrafia/métodos , Metabolismo Energético , Frequência Cardíaca , Humanos , Autorrelato , Navios , Sono
8.
PLoS Med ; 16(6): e1002836, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31237875

RESUMO

BACKGROUND: Data are lacking from physical activity (PA) trials with long-term follow-up of both objectively measured PA levels and robust health outcomes. Two primary care 12-week pedometer-based walking interventions in adults and older adults (PACE-UP and PACE-Lift) found sustained objectively measured PA increases at 3 and 4 years, respectively. We aimed to evaluate trial intervention effects on long-term health outcomes relevant to walking interventions, using routine primary care data. METHODS AND FINDINGS: Randomisation was from October 2012 to November 2013 for PACE-UP participants from seven general (family) practices and October 2011 to October 2012 for PACE-Lift participants from three practices. We downloaded primary care data, masked to intervention or control status, for 1,001 PACE-UP participants aged 45-75 years, 36% (361) male, and 296 PACE-Lift participants, aged 60-75 years, 46% (138) male, who gave written informed consent, for 4-year periods following randomisation. The following new events were counted for all participants, including those with preexisting diseases (apart from diabetes, for which existing cases were excluded): nonfatal cardiovascular, total cardiovascular (including fatal), incident diabetes, depression, fractures, and falls. Intervention effects on time to first event post-randomisation were modelled using Cox regression for all outcomes, except for falls, which used negative binomial regression to allow for multiple events, adjusting for age, sex, and study. Absolute risk reductions (ARRs) and numbers needed to treat (NNTs) were estimated. Data were downloaded for 1,297 (98%) of 1,321 trial participants. Event rates were low (<20 per group) for outcomes, apart from fractures and falls. Cox hazard ratios for time to first event post-randomisation for interventions versus controls were nonfatal cardiovascular 0.24 (95% confidence interval [CI] 0.07-0.77, p = 0.02), total cardiovascular 0.34 (95% CI 0.12-0.91, p = 0.03), diabetes 0.75 (95% CI 0.42-1.36, p = 0.34), depression 0.98 (95% CI 0.46-2.07, p = 0.96), and fractures 0.56 (95% CI 0.35-0.90, p = 0.02). Negative binomial incident rate ratio for falls was 1.07 (95% CI 0.78-1.46, p = 0.67). ARR and NNT for cardiovascular events were nonfatal 1.7% (95% CI 0.5%-2.1%), NNT = 59 (95% CI 48-194); total 1.6% (95% CI 0.2%-2.2%), NNT = 61 (95% CI 46-472); and for fractures 3.6% (95% CI 0.8%-5.4%), NNT = 28 (95% CI 19-125). Main limitations were that event rates were low and only events recorded in primary care records were counted; however, any underrecording would not have differed by intervention status and so should not have led to bias. CONCLUSIONS: Routine primary care data used to assess long-term trial outcomes demonstrated significantly fewer new cardiovascular events and fractures in intervention participants at 4 years. No statistically significant differences between intervention and control groups were demonstrated for other events. Short-term primary care pedometer-based walking interventions can produce long-term health benefits and should be more widely used to help address the public health inactivity challenge. TRIAL REGISTRATIONS: PACE-UP isrctn.com ISRCTN98538934; PACE-Lift isrctn.com ISRCTN42122561.


Assuntos
Actigrafia/tendências , Análise de Dados , Exercício/fisiologia , Atenção Primária à Saúde/tendências , Caminhada/fisiologia , Actigrafia/métodos , Idoso , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Feminino , Seguimentos , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Atenção Primária à Saúde/métodos , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
9.
JMIR Mhealth Uhealth ; 7(6): e12013, 2019 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-31199304

RESUMO

BACKGROUND: Mobile and wearable technology presents exciting opportunities for monitoring behavior using widely available sensor data. This could support clinical research and practice aimed at improving quality of life among the growing number of people with dementia. However, it requires suitable tools for measuring behavior in a natural real-life setting that can be easily implemented by others. OBJECTIVE: The objectives of this study were to develop and test a set of algorithms for measuring mobility and activity and to describe a technical setup for collecting the sensor data that these algorithms require using off-the-shelf devices. METHODS: A mobility measurement module was developed to extract travel trajectories and home location from raw GPS (global positioning system) data and to use this information to calculate a set of spatial, temporal, and count-based mobility metrics. Activity measurement comprises activity bout extraction from recognized activity data and daily step counts. Location, activity, and step count data were collected using smartwatches and mobile phones, relying on open-source resources as far as possible for accessing data from device sensors. The behavioral monitoring solution was evaluated among 5 healthy subjects who simultaneously logged their movements for 1 week. RESULTS: The evaluation showed that the behavioral monitoring solution successfully measures travel trajectories and mobility metrics from location data and extracts multimodal activity bouts during travel between locations. While step count could be used to indicate overall daily activity level, a concern was raised regarding device validity for step count measurement, which was substantially higher from the smartwatches than the mobile phones. CONCLUSIONS: This study contributes to clinical research and practice by providing a comprehensive behavioral monitoring solution for use in a real-life setting that can be replicated for a range of applications where knowledge about individual mobility and activity is relevant.


Assuntos
Técnicas de Observação do Comportamento/instrumentação , Demência/diagnóstico , Sistemas de Informação Geográfica/instrumentação , Dispositivos Eletrônicos Vestíveis/normas , Actigrafia/instrumentação , Actigrafia/métodos , Idoso , Idoso de 80 Anos ou mais , Técnicas de Observação do Comportamento/métodos , Técnicas de Observação do Comportamento/normas , Demência/fisiopatologia , Demência/psicologia , Feminino , Sistemas de Informação Geográfica/normas , Sistemas de Informação Geográfica/estatística & dados numéricos , Humanos , Masculino , Qualidade de Vida/psicologia , Dispositivos Eletrônicos Vestíveis/estatística & dados numéricos
10.
Yale J Biol Med ; 92(2): 179-186, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31249478

RESUMO

Chronotype (i.e., disposition for activity early or late in the day) has traditionally been measured with questionnaires. A few studies with small sample sizes have also been conducted using actigraphy devices. In the present study, analysis was conducted of the daily pattern of activity of 1887 United States residents who wore actigraphy devices for a whole week. The devices also recorded the participants' exposure to light. As determined by cosinor analysis, the mean pattern of ambulatory activity exhibited robust 24-hour oscillation with a peak at 14:48. On average, participants went to sleep 2 minutes before midnight and woke up at 07:43. The distribution of chronotypes (defined as the midpoint of sleep) had a mean of 03:50, and 95% of all chronotypes were between 01:00 and 07:00. The mean duration of exposure to bright daylight was 3.57 hours per day. Duration of daily exposure to bright light was moderately but significantly correlated with chronotype (r = -0.18). The acrophase of the rhythm of exposure to bright light was significantly correlated with chronotype (r = 0.27) and with the acrophase of the activity rhythm (r = 0.36). Chronotype did not vary with the seasons, but exposure to bright light was longer in summer and spring than in winter and fall. These results confirmed chronotype findings from actigraphic studies with smaller sample sizes, endorsed their equivalence to the results of questionnaire studies, and confirmed and extended previous observations that urban dwellers have limited daily exposure to sunlight.


Assuntos
Actigrafia/métodos , Ritmo Circadiano/fisiologia , Luz , Sono/efeitos da radiação , Adulto , Idoso , Estudos de Coortes , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Sono/fisiologia , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
11.
Yale J Biol Med ; 92(2): 205-212, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31249481

RESUMO

The correct expression of circadian rhythmicity, together with a good sleep behavior, are key factors for the body homeostasis. Rest-activity circadian rhythms (RARs) are involved in the control of the sleep-wake cycle and altered RARs could lead to a compromised health status. Therefore, we aimed to investigate the existence of RAR and to study actigraphy-based sleep behavior in a 14-year-old male patient affected by severe idiopathic scoliosis and treated with a rigid brace 23 hours per day. RAR and sleep parameters were studied through actigraphy for seven consecutive days in July 2018. The mean cosinor analysis revealed the presence of a significant RAR (p < 0.001), specifically: the percentage of rhythm was 23.4%, the mean MESOR was 84.6 Activity Count (AC), the amplitude registered a mean value of 74.4 AC's, and the acrophase occurred at 17:56 h. The subject reached a good sleep quantity: 507.9 ± 30.2 minutes of Time in Bed with a mean Total Sleep Time of 450.7 ± 20.1 minutes; Similarly, Sleep Efficiency was equal to 83.3 ± 7.2% and the Fragmentation Index was 27.3 ± 12.8%. We observed that both RAR and sleep behavior had normal trends in a 14-year-old patient treated with a rigid brace for a severe adolescent idiopathic scoliosis (AIS). Improved assessment of sleep in routine clinical practice can help to identify and manage health-related problems that could potentially affect some clinical outcomes, such as pain, mood state, and recovery process.


Assuntos
Actigrafia/métodos , Braquetes , Ritmo Circadiano/fisiologia , Descanso/fisiologia , Escoliose/terapia , Sono/fisiologia , Adolescente , Humanos , Masculino , Escoliose/fisiopatologia , Vigília/fisiologia
12.
Technol Health Care ; 27(3): 243-256, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30932906

RESUMO

BACKGROUND: Although actigraphy is widely used to measure sleep quality, few studies directly compared actigraphy data with polysomnography data, especially electromyography data. OBJECTIVE: We developed an algorithm which transforms actigraphy and electromyography signals to verify the interchangeability between them and tested the utility of this algorithm in sleep healthcare. METHODS: Thirty-eight subjects underwent polysomnography and actigraphy. We transformed electromyography signals extracted from polysomnography as integrated electromyography (IEMG) and actigraphy signals as integrated acceleration (IACC) using their physical properties. We compared receiver operating characteristic (ROC) curves obtained from transformed datasets with those of raw datasets in distinguishing REM and non-REM sleep. RESULTS: There was no significant correlation between raw electromyography and raw actigraphy data (r= 0.001, p= 0.124). After applying our transformation algorithm, significant correlation between IEMG and IACC was shown (r= 0.392, p< 0.001). In order to overcome small adjusted R2 from simple regression model (adjusted R=2 0.153, p< 0.001), we used panel data regression model to correct individual variances (adjusted R=2 0.542, p< 0.001). In ROC curve for distinguishing REM and non-REM sleep, AUCs were 0.536, 0.735 and 0.729 in raw data, IEMG and IACC respectively. CONCLUSIONS: The transformation algorithm revealed the relationship between electromyography and actigraphy data, and also yielded improved sleep staging ability.


Assuntos
Actigrafia/métodos , Algoritmos , Eletromiografia/métodos , Polissonografia/métodos , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/fisiopatologia , Adolescente , Adulto , Eletricidade , Feminino , Humanos , Cinética , Masculino , Fases do Sono , Adulto Jovem
13.
Med Sci Sports Exerc ; 51(9): 1852-1859, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30933002

RESUMO

PURPOSE: We tried to clarify the trends in step-determined physical activity (PA) among Japanese adults from 1995 to 2016. METHODS: Raw data from the National Health and Nutrition Surveys Japan (NHNS-J) performed between 1995 and 2016 were used, in compliance with the Statistics Act of Japan. NHNS-J was conducted annually by the Japanese government (the Ministry of Health, Labour, and Welfare) using a representative Japanese sample, with the same sampling method every year except in 2012 and 2016. A 1-d pedometer survey was conducted each year as a part of the NHNS-J, on a weekday in November specified by each individual. Because of the difference in age distribution of the samples, age-adjusted mean steps per day were calculated from 1995 to 2016 by sex. The time trends of step-determined PA levels among Japanese adults were described and examined using Joinpoint regression. RESULTS: The highest age-adjusted mean number of steps for men was 8235 steps per day in 2000, whereas it was 7667 steps per day in 2015. The highest age-adjusted mean numbers of steps for women were 7474 steps per day in 1998 and 6691 steps per day in 2015. The age-adjusted step-determined PA trend showed significantly decreasing trend from 1997 to 2008 in men (annual percentage change, -0.74; P < 0.001) and from 1998 to 2008 (annual percentage change, -1.30; P < 0.001) in women, by Joinpoint regression. CONCLUSION: The age-adjusted step-determined PA among Japanese adults between 1995 and 2016 decreased from around 1997 to 1998 until around 2008, but since then, the decreasing trend became unclear both in men and in women. Continuous monitoring of PA trends is essential to assess the effectiveness of policies.


Assuntos
Actigrafia/métodos , Exercício/fisiologia , Monitores de Aptidão Física , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Inquéritos Epidemiológicos , Estilo de Vida Saudável , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
J Sports Sci ; 37(15): 1708-1716, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30843462

RESUMO

Sedentary behaviour (SB) is an independent health risk-factor and interrupting SB seems to be beneficial. SB is both defined by posture and intensity, thus objective measurement of postures remains a priority. The ActivPAL inclinometer (AP) has been used as a reference for postural estimation, but information on the validity of the Actigraph inclinometer (AGincl) is scarce. We compared postural estimation from waist-worn AGincl against thigh-worn AP, under free-living. Data from 10 participants (50.4 ± 11.4 years) were used and each 15s-block from 60-valid days was matched for the devices' comparison. At group level, no differences were found for SB and standing-time between inclinometers (p ≥ 0.05). AGincl underestimated stepping-time by 26.3 min and overestimated SB-to-upright transitions by 200.7 occasions (p < 0.05). Inter-individual variability was higher for SB and standing-time, and AGincl was in better agreement with AP for the stepping-time (area under the ROC curve = 0.98, with 100% sensitivity and 94% specificity; CCC = 0.44). These results highlight potential error in estimating individual postures using AGincl in overweight/obese adults and provide insights on the differences of using specific criteria on data-analysis. Our findings suggest that at the group level, AGincl provides similar estimates compared to AP for SB and standing-time, but not for SB-to-upright transitions or stepping-time. (ClinicalTrials.govID:NCT02007681).


Assuntos
Actigrafia/métodos , Atividades Cotidianas , Exercício/fisiologia , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Postura/fisiologia , Comportamento Sedentário , Actigrafia/instrumentação , Adulto , Idoso , Estudos Cross-Over , Feminino , Monitores de Aptidão Física , Humanos , Masculino , Pessoa de Meia-Idade , Movimento/fisiologia , Posição Ortostática , Caminhada/fisiologia
15.
Sensors (Basel) ; 19(5)2019 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-30832392

RESUMO

Prolonged monitoring of infant sleep is paramount for parents and healthcare professionals for interpreting and evaluating infants' sleep quality. Wake-sleep patterns are often studied to assess this. Video cameras have received a lot of attention in infant sleep monitoring because they are unobtrusive and easy to use at home. In this paper, we propose a method using motion data detected from infrared video frames (video-based actigraphy) to identify wake and sleep states. The motion, mostly caused by infant body movement, is known to be substantially associated with infant wake and sleep states. Two features were calculated from the video-based actigraphy, and a Bayesian-based linear discriminant classification model was employed to classify the two states. Leave-one-subject-out cross validation was performed to validate our proposed wake and sleep classification model. From a total of 11.6 h of infrared video recordings of 10 healthy term infants in a laboratory pilot study, we achieved a reliable classification performance with a Cohen's kappa coefficient of 0.733 ± 0.204 (mean ± standard deviation) and an overall accuracy of 92.0% ± 4.6%.


Assuntos
Actigrafia/métodos , Teorema de Bayes , Sono/fisiologia , Vigília/fisiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Projetos Piloto
16.
Sensors (Basel) ; 19(3)2019 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-30744003

RESUMO

Movement disorders, such as Parkinson's disease, dystonia, tic disorder, and attention-deficit/hyperactivity disorder (ADHD) are clinical syndromes with either an excess of movement or a paucity of voluntary and involuntary movements. As the assessment of most movement disorders depends on subjective rating scales and clinical observations, the objective quantification of activity remains a challenging area. The purpose of our study was to verify whether an impulse radio ultra-wideband (IR-UWB) radar sensor technique is useful for an objective measurement of activity. Thus, we proposed an activity measurement algorithm and quantitative activity indicators for clinical assistance, based on IR-UWB radar sensors. The received signals of the sensor are sufficiently sensitive to measure heart rate, and multiple sensors can be used together to track the positions of people. To measure activity using these two features, we divided movement into two categories. For verification, we divided these into several scenarios, depending on the amount of activity, and compared with an actigraphy sensor to confirm the clinical feasibility of the proposed indicators. The experimental environment is similar to the environment of the comprehensive attention test (CAT), but with the inclusion of the IR-UWB radar. The experiment was carried out, according to a predefined scenario. Experiments demonstrate that the proposed indicators can measure movement quantitatively, and can be used as a quantified index to clinically record and compare patient activity. Therefore, this study suggests the possibility of clinical application of radar sensors for standardized diagnosis.


Assuntos
Actigrafia/métodos , Transtornos dos Movimentos/diagnóstico , Radar , Processamento de Sinais Assistido por Computador , Algoritmos , Humanos , Movimento/fisiologia , Transtornos dos Movimentos/fisiopatologia
17.
BMC Musculoskelet Disord ; 20(1): 71, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30744606

RESUMO

BACKGROUND: Low back pain is one of the most prevalent musculoskeletal conditions and the highest contributor to disability in the world. It is characterized by frequent relapses leading to additional care-seeking. Engagement in leisure physical activity is associated with lower recurrences and better prognosis and potentially reduced care-seeking. Our aim was to investigate the feasibility and preliminary efficacy of a patient-centred physical activity intervention, supported by health coaching and mobile health, to reduce care-seeking, pain and disability in patients with chronic low back pain after treatment discharge. METHODS: We conducted a pilot randomised controlled trial with blinded outcome assessment. Sixty-eight participants were recruited from four public outpatient physiotherapy departments and the general community in Sydney. The intervention group received a physical activity information booklet, plus one face-to-face and 12 telephone-based health coaching sessions. The intervention was supported by an internet-based application and an activity tracker (Fitbit). Control group (standard care) received the physical activity information booklet and advice to stay active. Feasibility measures included recruitment rate, intervention compliance, data completeness, and participant satisfaction. Primary outcomes were care-seeking, pain levels and activity limitation. Outcomes were assessed at baseline, 6-month follow-up and weekly for 6 months. RESULTS: Ninety potential participants were invited over 15 months, with 68 agreeing to take part (75%). Overall, 903 weekly questionnaires were answered by participants from a total of 1107 sent (89%). Participants were largely satisfied with the intervention (mean = 8.7 out of 10 on satisfaction scale). Intervention group participants had a 38% reduced rate of care-seeking (Incidence Rate Ratio (IRR): 0.62, 95% CI: 0.32 to 1.18, p = 0.14, using multilevel mixed-effects Poisson regression analysis) compared to standard care, although none of the estimates was statistically significant. No between groups differences were found for pain levels or activity limitation. CONCLUSION: The health coaching physical activity approach trialed here is feasible and well accepted by participants and may reduce care-seeking in patients with low back pain after treatment discharge, although further evaluation with an adequately powered trial is needed. TRIAL REGISTRATION: Australian and New Zealand Trial Registry ACTRN12615000189527 . Registered prospectively on 26-02-2015.


Assuntos
Actigrafia/métodos , Dor Crônica/terapia , Exercício , Conhecimentos, Atitudes e Prática em Saúde , Dor Lombar/terapia , Educação de Pacientes como Assunto/métodos , Telemedicina/métodos , Actigrafia/instrumentação , Adulto , Idoso , Telefone Celular , Dor Crônica/diagnóstico , Dor Crônica/fisiopatologia , Dor Crônica/psicologia , Avaliação da Deficiência , Estudos de Viabilidade , Feminino , Monitores de Aptidão Física , Comportamentos Relacionados com a Saúde , Estilo de Vida Saudável , Humanos , Dor Lombar/diagnóstico , Dor Lombar/fisiopatologia , Dor Lombar/psicologia , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis , New South Wales , Medição da Dor , Folhetos , Cooperação do Paciente , Satisfação do Paciente , Projetos Piloto , Telemedicina/instrumentação , Fatores de Tempo , Resultado do Tratamento
18.
J Vis Exp ; (143)2019 01 26.
Artigo em Inglês | MEDLINE | ID: mdl-30741255

RESUMO

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and research participants. Home sleep testing has gained momentum in the field of sleep medicine due to its convenience and lower cost, as well as being more naturalistic. The accuracy and quality of home sleep testing, however, may be variable because studies are not monitored by sleep technologists. There has been some success in improving the accuracy of home sleep studies by having trained sleep technicians assist participants inside their homes with putting on the devices, but this can be intrusive and time-consuming for those involved. In this protocol, participants undergo at-home sleep monitoring with multiple devices: 1) a single-channel EEG device; 2) a home sleep test for sleep-disordered breathing and periodic limb movements; 3) actigraphy; and 4) sleep logs. A major challenge of this study is obtaining high-quality sleep monitoring data on the first attempt in order to minimize participant burden. This protocol describes the implementation of educational manuals with step-by-step instructions and photos. The goal is to improve the quality of home sleep testing.


Assuntos
Actigrafia/métodos , Eletroencefalografia/métodos , Monitorização Ambulatorial/métodos , Polissonografia/métodos , Transtornos do Sono-Vigília/diagnóstico , Sono/fisiologia , Adulto , Idoso , Humanos , Pessoa de Meia-Idade
19.
Support Care Cancer ; 27(10): 3793-3798, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30721369

RESUMO

PURPOSE: Performance status is an important factor in determining quality of life, the choice of treatment, and prognostic tool in patients. All scoring systems currently in use measure the patient's performance subjectively. A new method of objective assessment of performance ECOG/WHO grades 2 and 3 was constructed and tested. METHODS: A performance meter-an adapted USB data logger with a mercury tilt switch-was constructed. The device was tested in a feasibility study on 33 residents of a retirement home. Parallel to the objective assessment, each resident gave their own estimate of their performance, and each resident was in turn assessed by the nursing staff. RESULTS: With the performance meter, 4 residents (12%) were assessed as PS ≥ 3 in comparison with 8 (24%) and 7 (21%) residents with an ECOG score ≥ 3 estimated by patients themselves and nursing staff respectively. CONCLUSION: Subjective scoring-estimated by patients themselves and by nursing staff-showed underestimation of patients' performance. In 12% of patients, a better performance score was observed with objective measurement in comparison with subjective assessment. Performance meter could be a useful tool for health care professionals for type of care decisions.


Assuntos
Actigrafia/instrumentação , Actigrafia/métodos , Monitorização Fisiológica/instrumentação , Desempenho Físico Funcional , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , Prognóstico
20.
J Neurol ; 266(3): 651-658, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30659356

RESUMO

OBJECTIVE: Dosing schedules for oral levodopa in advanced stages of Parkinson's disease (PD) require careful tailoring to fit the needs of each patient. This study proposes a dosing algorithm for oral administration of levodopa and evaluates its integration into a sensor-based dosing system (SBDS). MATERIALS AND METHODS: In collaboration with two movement disorder experts a knowledge-driven, simulation based algorithm was designed and integrated into a SBDS. The SBDS uses data from wearable sensors to fit individual patient models, which are then used as input to the dosing algorithm. To access the feasibility of using the SBDS in clinical practice its performance was evaluated during a clinical experiment where dosing optimization of oral levodopa was explored. The supervising neurologist made dosing adjustments based on data from the Parkinson's KinetiGraph™ (PKG) that the patients wore for a week in a free living setting. The dosing suggestions of the SBDS were compared with the PKG-guided adjustments. RESULTS: The SBDS maintenance and morning dosing suggestions had a Pearson's correlation of 0.80 and 0.95 (with mean relative errors of 21% and 12.5%), to the PKG-guided dosing adjustments. Paired t test indicated no statistical differences between the algorithmic suggestions and the clinician's adjustments. CONCLUSION: This study shows that it is possible to use algorithmic sensor-based dosing adjustments to optimize treatment with oral medication for PD patients.


Assuntos
Actigrafia/métodos , Algoritmos , Antiparkinsonianos/administração & dosagem , Carbidopa/administração & dosagem , Levodopa/administração & dosagem , Doença de Parkinson/diagnóstico , Doença de Parkinson/tratamento farmacológico , Dispositivos Eletrônicos Vestíveis , Administração Oral , Idoso , Idoso de 80 Anos ou mais , Combinação de Medicamentos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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