1
|
Zanoletti M, Bufano P, Bossi F, Di Rienzo F, Marinai C, Rho G, Vallati C, Carbonaro N, Greco A, Laurino M, Tognetti A. Combining Different Wearable Devices to Assess Gait Speed in Real-World Settings. SENSORS (BASEL, SWITZERLAND) 2024; 24:3205. [PMID: 38794059 PMCID: PMC11124953 DOI: 10.3390/s24103205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 04/30/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Assessing mobility in daily life can provide significant insights into several clinical conditions, such as Chronic Obstructive Pulmonary Disease (COPD). In this paper, we present a comprehensive analysis of wearable devices' performance in gait speed estimation and explore optimal device combinations for everyday use. Using data collected from smartphones, smartwatches, and smart shoes, we evaluated the individual capabilities of each device and explored their synergistic effects when combined, thereby accommodating the preferences and possibilities of individuals for wearing different types of devices. Our study involved 20 healthy subjects performing a modified Six-Minute Walking Test (6MWT) under various conditions. The results revealed only little performance differences among devices, with the combination of smartwatches and smart shoes exhibiting superior estimation accuracy. Particularly, smartwatches captured additional health-related information and demonstrated enhanced accuracy when paired with other devices. Surprisingly, wearing all devices concurrently did not yield optimal results, suggesting a potential redundancy in feature extraction. Feature importance analysis highlighted key variables contributing to gait speed estimation, providing valuable insights for model refinement.
Collapse
Affiliation(s)
- Michele Zanoletti
- National Research Council, Institute of Clinical Physiology, 56124 Pisa, Italy; (P.B.); (M.L.)
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Pasquale Bufano
- National Research Council, Institute of Clinical Physiology, 56124 Pisa, Italy; (P.B.); (M.L.)
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - Francesco Bossi
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Francesco Di Rienzo
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Carlotta Marinai
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Gianluca Rho
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Carlo Vallati
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Nicola Carbonaro
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Alberto Greco
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Marco Laurino
- National Research Council, Institute of Clinical Physiology, 56124 Pisa, Italy; (P.B.); (M.L.)
| | - Alessandro Tognetti
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| |
Collapse
|
2
|
Ibrahim AA, Gabr Ali AMM, Fadulelmulla IA, Ragab MMM, Aldemery AA, Mohamed AR, Dewir IM, Hakami HA, Hussein HM. Using Inspiratory Muscle Training to Improve Respiratory Strength, Functional Capacity, Fatigue, and Stress in Breast Cancer Patients Undergoing Surgery. J Multidiscip Healthc 2024; 17:1931-1941. [PMID: 38706507 PMCID: PMC11070168 DOI: 10.2147/jmdh.s463961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose The main aim of the trial was to assess the effectiveness of inspiratory muscle training on respiratory muscle strength, functional capacity, fatigue, and stress in post-surgical breast cancer survivors. Methods Forty-seven females who had undergone unilateral post-mastectomy were randomly assigned to an intervention group (IG; n = 24) and a control group (CG; n = 23). Both groups received aerobic exercise training. In addition, the intervention group received inspiratory muscle training 3 days a week for 8 weeks. Maximum inspiratory and expiratory pressure (Pimax) (Pemex), 6-minute walk test, Handgrip strength by hand-held dynamometer, Fatigue Assessment Scale (FAS), and Perceived Stress Scale pss 10 values were measured before the training and then at the eighth week for both groups. Results No differences were detected between the groups in terms of sample and clinical characteristics 8 weeks post-intervention. In favor of the intervention group, a significant difference with medium to high effect size was found in terms of Pimax, Pemax, FAS, PS, and 6MWT (p < 0.05). However, there was no difference in terms of handgrip strength (p-value: 0.072), with a medium effect size (0.070). Regarding within-group comparisons, IG exhibited substantial differences in all outcome measures (p < 0.05) compared to CG, with the exception of PImax and 6MWT. Conclusion In post-operative breast cancer survivors, respiratory muscle training combined with aerobic training increases respiratory muscle strength and functional ability while lowering stress and tiredness.
Collapse
Affiliation(s)
- Ahmed Abdelmoniem Ibrahim
- Department of Physical Therapy, College of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
| | | | | | | | | | - Amany Raafat Mohamed
- Department of Physical Therapy for Internal Medicine & Geriatrics, Faculty of Physical Therapy, Suez University, Suez, Egypt
| | - Ibrahim Metwally Dewir
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Hamad Ali Hakami
- Department of Physical Therapy, Jazan General Hospital, Jazan, Saudi Arabia
| | - Hisham Mohamed Hussein
- Department of Physical Therapy, College of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
- Department of Basic Sciences for Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| |
Collapse
|
3
|
王 星, 李 茜, 马 彩, 张 铄, 林 钰, 李 建, 刘 澄. [Artificial intelligence in wearable electrocardiogram monitoring]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2023; 40:1084-1092. [PMID: 38151930 PMCID: PMC10753313 DOI: 10.7507/1001-5515.202301032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 10/31/2023] [Indexed: 12/29/2023]
Abstract
Electrocardiogram (ECG) monitoring owns important clinical value in diagnosis, prevention and rehabilitation of cardiovascular disease (CVD). With the rapid development of Internet of Things (IoT), big data, cloud computing, artificial intelligence (AI) and other advanced technologies, wearable ECG is playing an increasingly important role. With the aging process of the population, it is more and more urgent to upgrade the diagnostic mode of CVD. Using AI technology to assist the clinical analysis of long-term ECGs, and thus to improve the ability of early detection and prediction of CVD has become an important direction. Intelligent wearable ECG monitoring needs the collaboration between edge and cloud computing. Meanwhile, the clarity of medical scene is conducive for the precise implementation of wearable ECG monitoring. This paper first summarized the progress of AI-related ECG studies and the current technical orientation. Then three cases were depicted to illustrate how the AI in wearable ECG cooperate with the clinic. Finally, we demonstrated the two core issues-the reliability and worth of AI-related ECG technology and prospected the future opportunities and challenges.
Collapse
Affiliation(s)
- 星尧 王
- 东南大学 仪器科学与工程学院(南京 210096)School of Instrument Science and Engineering, Southeast University, Nanjing 210096, P. R. China
- 东南大学 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, Southeast University, Nanjing 210096, P. R. China
| | - 茜 李
- 东南大学 仪器科学与工程学院(南京 210096)School of Instrument Science and Engineering, Southeast University, Nanjing 210096, P. R. China
- 东南大学 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, Southeast University, Nanjing 210096, P. R. China
| | - 彩云 马
- 东南大学 仪器科学与工程学院(南京 210096)School of Instrument Science and Engineering, Southeast University, Nanjing 210096, P. R. China
- 东南大学 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, Southeast University, Nanjing 210096, P. R. China
| | - 铄 张
- 东南大学 仪器科学与工程学院(南京 210096)School of Instrument Science and Engineering, Southeast University, Nanjing 210096, P. R. China
- 东南大学 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, Southeast University, Nanjing 210096, P. R. China
| | - 钰洁 林
- 东南大学 仪器科学与工程学院(南京 210096)School of Instrument Science and Engineering, Southeast University, Nanjing 210096, P. R. China
- 东南大学 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, Southeast University, Nanjing 210096, P. R. China
| | - 建清 李
- 东南大学 仪器科学与工程学院(南京 210096)School of Instrument Science and Engineering, Southeast University, Nanjing 210096, P. R. China
- 东南大学 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, Southeast University, Nanjing 210096, P. R. China
| | - 澄玉 刘
- 东南大学 仪器科学与工程学院(南京 210096)School of Instrument Science and Engineering, Southeast University, Nanjing 210096, P. R. China
- 东南大学 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, Southeast University, Nanjing 210096, P. R. China
| |
Collapse
|
4
|
Seneviratne MG, Connolly SB, Martin SS, Parakh K. Grains of Sand to Clinical Pearls: Realizing the Potential of Wearable Data. Am J Med 2023; 136:136-142. [PMID: 36351523 DOI: 10.1016/j.amjmed.2022.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022]
Abstract
Despite the rapid growth of wearables as a consumer technology sector and a growing evidence base supporting their use, they have been slow to be adopted by the health system into clinical care. As regulatory, reimbursement, and technical barriers recede, a persistent challenge remains how to make wearable data actionable for clinicians-transforming disconnected grains of wearable data into meaningful clinical "pearls". In order to bridge this adoption gap, wearable data must become visible, interpretable, and actionable for the clinician. We showcase emerging trends and best practices that illustrate these 3 pillars, and offer some recommendations on how the ecosystem can move forward.
Collapse
Affiliation(s)
| | | | - Seth S Martin
- Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Johns Hopkins, Baltimore, MD
| | - Kapil Parakh
- Google Research, Washington, DC; Georgetown School of Medicine, Washington, DC
| |
Collapse
|
5
|
Sun S, Folarin AA, Zhang Y, Cummins N, Liu S, Stewart C, Ranjan Y, Rashid Z, Conde P, Laiou P, Sankesara H, Dalla Costa G, Leocani L, Sørensen PS, Magyari M, Guerrero AI, Zabalza A, Vairavan S, Bailon R, Simblett S, Myin-Germeys I, Rintala A, Wykes T, Narayan VA, Hotopf M, Comi G, Dobson RJ. The utility of wearable devices in assessing ambulatory impairments of people with multiple sclerosis in free-living conditions. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 227:107204. [PMID: 36371974 DOI: 10.1016/j.cmpb.2022.107204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 07/27/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Multiple sclerosis (MS) is a progressive inflammatory and neurodegenerative disease of the central nervous system affecting over 2.5 million people globally. In-clinic six-minute walk test (6MWT) is a widely used objective measure to evaluate the progression of MS. Yet, it has limitations such as the need for a clinical visit and a proper walkway. The widespread use of wearable devices capable of depicting patients' activity profiles has the potential to assess the level of MS-induced disability in free-living conditions. METHODS In this work, we extracted 96 features in different temporal granularities (from minute-level to day-level) from wearable data and explored their utility in estimating 6MWT scores in a European (Italy, Spain, and Denmark) MS cohort of 337 participants over an average of 10 months' duration. We combined these features with participants' demographics using three regression models including elastic net, gradient boosted trees and random forest. In addition, we quantified the individual feature's contribution using feature importance in these regression models, linear mixed-effects models, generalized estimating equations, and correlation-based feature selection (CFS). RESULTS The results showed promising estimation performance with R2 of 0.30, which was derived using random forest after CFS. This model was able to distinguish the participants with low disability from those with high disability. Furthermore, we observed that the minute-level (≤ 8 minutes) step count, particularly those capturing the upper end of the step count distribution, had a stronger association with 6MWT. The use of a walking aid was indicative of ambulatory function measured through 6MWT. CONCLUSIONS This study demonstrates the utility of wearables devices in assessing ambulatory impairments in people with MS in free-living conditions and provides a basis for future investigation into the clinical relevance.
Collapse
Affiliation(s)
- Shaoxiong Sun
- The Department of Biostatistics and Health informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Amos A Folarin
- The Department of Biostatistics and Health informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Institute of Health Informatics, University College London, London, UK
| | - Yuezhou Zhang
- The Department of Biostatistics and Health informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nicholas Cummins
- The Department of Biostatistics and Health informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Shuo Liu
- Chair of Embedded Intelligence for Health Care & Wellbeing, University of Augsburg, Germany
| | - Callum Stewart
- The Department of Biostatistics and Health informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yatharth Ranjan
- The Department of Biostatistics and Health informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Zulqarnain Rashid
- The Department of Biostatistics and Health informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pauline Conde
- The Department of Biostatistics and Health informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Petroula Laiou
- The Department of Biostatistics and Health informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Heet Sankesara
- The Department of Biostatistics and Health informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Letizia Leocani
- Vita-Salute University and Experimental Neurophysiology Unit, Institute of Experimental Neurology-INSPE, Scientific Institute San Raffaele, Milan, Italy
| | - Per Soelberg Sørensen
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Melinda Magyari
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ana Isabel Guerrero
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Zabalza
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Raquel Bailon
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragon Institute of Engineering Research (I3A), IIS Aragon, University of Zaragoza, Zaragoza, Spain; Centro de Investigacion Biomedica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Sara Simblett
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Inez Myin-Germeys
- Department of Neurosciences, Centre for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Aki Rintala
- Department of Neurosciences, Centre for Contextual Psychiatry, KU Leuven, Leuven, Belgium; Faculty of Social Services and Health Care, LAB University of Applied Sciences, Lahti, Finland
| | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Giancarlo Comi
- Vita Salute San Raffaele University, Milan, Italy; Casa di Cura Privata del Policlinico, Milan, Italy
| | - Richard Jb Dobson
- The Department of Biostatistics and Health informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Institute of Health Informatics, University College London, London, UK.
| |
Collapse
|
6
|
Bingel A, Messroghli D, Weimar A, Runte K, Salcher-Konrad M, Kelle S, Pieske B, Berger F, Kuehne T, Goubergrits L, Fuerstenau D, Kelm M. Hemodynamic Changes During Physiological and Pharmacological Stress Testing in Patients With Heart Failure: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2022; 9:718114. [PMID: 35514442 PMCID: PMC9062977 DOI: 10.3389/fcvm.2022.718114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Although disease etiologies differ, heart failure patients with preserved and reduced ejection fraction (HFpEF and HFrEF, respectively) both present with clinical symptoms when under stress and impaired exercise capacity. The extent to which the adaptation of heart rate (HR), stroke volume (SV), and cardiac output (CO) under stress conditions is altered can be quantified by stress testing in conjunction with imaging methods and may help to detect the diminishment in a patient’s condition early. The aim of this meta-analysis was to quantify hemodynamic changes during physiological and pharmacological stress testing in patients with HF. A systematic literature search (PROSPERO 2020:CRD42020161212) in MEDLINE was conducted to assess hemodynamic changes under dynamic and pharmacological stress testing at different stress intensities in HFpEF and HFrEF patients. Pooled mean changes were estimated using a random effects model. Altogether, 140 study arms with 7,248 exercise tests were analyzed. High-intensity dynamic stress testing represented 73% of these data (70 study arms with 5,318 exercise tests), where: HR increased by 45.69 bpm (95% CI 44.51–46.88; I2 = 98.4%), SV by 13.49 ml (95% CI 6.87–20.10; I2 = 68.5%), and CO by 3.41 L/min (95% CI 2.86–3.95; I2 = 86.3%). No significant differences between HFrEF and HFpEF groups were found. Despite the limited availability of comparative studies, these reference values can help to estimate the expected hemodynamic responses in patients with HF. No differences in chronotropic reactions, changes in SV, or CO were found between HFrEF and HFpEF. When compared to healthy individuals, exercise tolerance, as well as associated HR and CO changes under moderate-high dynamic stress, was substantially impaired in both HF groups. This may contribute to a better disease understanding, future study planning, and patient-specific predictive models.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42020161212].
Collapse
Affiliation(s)
- Anne Bingel
- Department of Internal Medicine and Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Daniel Messroghli
- Department of Internal Medicine and Cardiology, German Heart Center Berlin, Berlin, Germany
- Department of Internal Medicine/Cardiology, Charité—Universitätsmedizin Berlin, Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Andreas Weimar
- Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Informatics, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Kilian Runte
- Department of Congenital Heart Disease, German Heart Center Berlin, Berlin, Germany
| | - Maximilian Salcher-Konrad
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Sebastian Kelle
- Department of Internal Medicine and Cardiology, German Heart Center Berlin, Berlin, Germany
- Department of Internal Medicine/Cardiology, Charité—Universitätsmedizin Berlin, Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Burkert Pieske
- Department of Internal Medicine and Cardiology, German Heart Center Berlin, Berlin, Germany
- Department of Internal Medicine/Cardiology, Charité—Universitätsmedizin Berlin, Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Felix Berger
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Department of Congenital Heart Disease, German Heart Center Berlin, Berlin, Germany
| | - Titus Kuehne
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Department of Congenital Heart Disease, German Heart Center Berlin, Berlin, Germany
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Leonid Goubergrits
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center Digital Future (ECDF), Berlin, Germany
| | - Daniel Fuerstenau
- Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Informatics, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Department of Digitalization, Copenhagen Business School, Frederiksberg, Denmark
| | - Marcus Kelm
- Department of Congenital Heart Disease, German Heart Center Berlin, Berlin, Germany
- Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- *Correspondence: Marcus Kelm,
| |
Collapse
|
7
|
Wicks JR, Turner GT, Leslie SL, Jayasinghe R. Changes Observed in the 6-minute Walk Test in Response to Exercise-based Cardiac Rehabilitation. EXERCISE MEDICINE 2022. [DOI: 10.26644/em.2022.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: The six-minute walk test (6MWT) is widely used in exercise based cardiac rehabilitation (EBCR) for assessment of functional capacity. The purpose of this study was to assess the effect of structured exercise in an EBCR program on 6MWT change and to determine the significance of age, gender, body mass index (BMI), pathology and exercise attendance on influencing this outcome.Methods: Data from a single centre 6-week (twice weekly exercise and education of one-hour duration) exercise-based cardiac rehabilitation program were analysed. Between 2006 and 2019, 2524 patients (males 1923, females 601, mean age 63.5 ± 11.2 years) with cardiovascular disease completed a pre and post 6MWT. Analysis included the effect of age, gender, pathology, BMI and exercise attendance on 6MWT outcome.Results: The group mean improvement in the 6MWT was 21.8% (pre 6MWT 432 ± 83, post 6MWT 527 ± 102 metres). The age-related improvement showed that both males and females achieved a post 6MWT results equivalent to the pre 6MWT result of patients two decades younger with improvement in the 6MWT unrelated to exercise attendance.Conclusions: The 6MWT provides simple safe method for assessment of functional capacity in an out-of-hospital environment being suitable for all ages. The post EBCR 6MWT results showed a group mean improvement in excess of 20% for both sexes. The decline per decade in 6MWT distance is less than 20 metres up to the sixth decade with a more marked decline from the sixth to the eighth decade, the decline being approximately 40-metres for both sexes in the eighth decade.
Collapse
|
8
|
Shah VV, Curtze C, Sowalsky K, Arpan I, Mancini M, Carlson-Kuhta P, El-Gohary M, Horak FB, McNames J. Inertial Sensor Algorithm to Estimate Walk Distance. SENSORS 2022; 22:s22031077. [PMID: 35161822 PMCID: PMC8838103 DOI: 10.3390/s22031077] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/16/2022]
Abstract
The “total distance walked” obtained during a standardized walking test is an integral component of physical fitness and health status tracking in a range of consumer and clinical applications. Wearable inertial sensors offer the advantages of providing accurate, objective, and reliable measures of gait while streamlining walk test administration. The aim of this study was to develop an inertial sensor-based algorithm to estimate the total distance walked using older subjects with impaired fasting glucose (Study I), and to test the generalizability of the proposed algorithm in patients with Multiple Sclerosis (Study II). All subjects wore two inertial sensors (Opals by Clario-APDM Wearable Technologies) on their feet. The walking distance algorithm was developed based on 108 older adults in Study I performing a 400 m walk test along a 20 m straight walkway. The validity of the algorithm was tested using a 6-minute walk test (6MWT) in two sub-studies of Study II with different lengths of a walkway, 15 m (Study II-A, n = 24) and 20 m (Study II-B, n = 22), respectively. The start and turn around points were marked with lines on the floor while smaller horizontal lines placed every 1 m served to calculate the manual distance walked (ground truth). The proposed algorithm calculates the forward distance traveled during each step as the change in the horizontal position from each foot-flat period to the subsequent foot-flat period. The total distance walked is then computed as the sum of walk distances for each stride, including turns. The proposed algorithm achieved an average absolute error rate of 1.92% with respect to a fixed 400 m distance for Study I. The same algorithm achieved an absolute error rate of 4.17% and 3.21% with respect to an averaged manual distance for 6MWT in Study II-A and Study II-B, respectively. These results demonstrate the potential of an inertial sensor-based algorithm to estimate a total distance walked with good accuracy with respect to the manual, clinical standard. Further work is needed to test the generalizability of the proposed algorithm with different administrators and populations, as well as larger diverse cohorts.
Collapse
Affiliation(s)
- Vrutangkumar V. Shah
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; (I.A.); (M.M.); (P.C.-K.); (F.B.H.)
- Correspondence:
| | - Carolin Curtze
- Department of Biomechanics, University of Nebraska at Omaha, 6001 Dodge St., Omaha, NE 68182, USA;
| | - Kristen Sowalsky
- APDM Wearable Technologie—A Clario Company, 2828 S Corbett Ave, Ste 135, Portland, OR 97201, USA; (K.S.); (M.E.-G.); (J.M.)
| | - Ishu Arpan
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; (I.A.); (M.M.); (P.C.-K.); (F.B.H.)
| | - Martina Mancini
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; (I.A.); (M.M.); (P.C.-K.); (F.B.H.)
| | - Patricia Carlson-Kuhta
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; (I.A.); (M.M.); (P.C.-K.); (F.B.H.)
| | - Mahmoud El-Gohary
- APDM Wearable Technologie—A Clario Company, 2828 S Corbett Ave, Ste 135, Portland, OR 97201, USA; (K.S.); (M.E.-G.); (J.M.)
| | - Fay B. Horak
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; (I.A.); (M.M.); (P.C.-K.); (F.B.H.)
- APDM Wearable Technologie—A Clario Company, 2828 S Corbett Ave, Ste 135, Portland, OR 97201, USA; (K.S.); (M.E.-G.); (J.M.)
| | - James McNames
- APDM Wearable Technologie—A Clario Company, 2828 S Corbett Ave, Ste 135, Portland, OR 97201, USA; (K.S.); (M.E.-G.); (J.M.)
- Department of Electrical and Computer Engineering, Portland State University, 1825 SW Broadway, Portland, OR 97201, USA
| |
Collapse
|
9
|
Pires IM, Denysyuk HV, Villasana MV, Sá J, Marques DL, Morgado JF, Albuquerque C, Zdravevski E. Development Technologies for the Monitoring of Six-Minute Walk Test: A Systematic Review. SENSORS 2022; 22:s22020581. [PMID: 35062542 PMCID: PMC8782011 DOI: 10.3390/s22020581] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/03/2022] [Accepted: 01/11/2022] [Indexed: 12/12/2022]
Abstract
In the pandemic time, the monitoring of the progression of some diseases is affected and rehabilitation is more complicated. Remote monitoring may help solve this problem using mobile devices that embed low-cost sensors, which can help measure different physical parameters. Many tests can be applied remotely, one of which is the six-minute walk test (6MWT). The 6MWT is a sub-maximal exercise test that assesses aerobic capacity and endurance, allowing early detection of emerging medical conditions with changes. This paper presents a systematic review of the use of sensors to measure the different physical parameters during the performance of 6MWT, focusing on various diseases, sensors, and implemented methodologies. It was performed with the PRISMA methodology, where the search was conducted in different databases, including IEEE Xplore, ACM Digital Library, ScienceDirect, and PubMed Central. After filtering the papers related to 6MWT and sensors, we selected 31 papers that were analyzed in more detail. Our analysis discovered that the measurements of 6MWT are primarily performed with inertial and magnetic sensors. Likewise, most research studies related to this test focus on multiple sclerosis and pulmonary diseases.
Collapse
Affiliation(s)
- Ivan Miguel Pires
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal;
- Escola de Ciências e Tecnologia, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
- Correspondence: ; Tel.: +351-966-379-785
| | | | - María Vanessa Villasana
- Centro Hospitalar Universitário da Cova da Beira, 6200-251 Covilhã, Portugal;
- Health Sciences Research Unit: Nursing (UICISA: E), School of Health, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal; (J.S.); (C.A.)
| | - Juliana Sá
- Health Sciences Research Unit: Nursing (UICISA: E), School of Health, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal; (J.S.); (C.A.)
- Faculty of Health Sciences, Universidade da Beira Interior, 6200-506 Covilhã, Portugal
- Centro Hospitalar Universitário do Porto, 4099-001 Oporto, Portugal
| | - Diogo Luís Marques
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal;
| | | | - Carlos Albuquerque
- Health Sciences Research Unit: Nursing (UICISA: E), School of Health, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal; (J.S.); (C.A.)
| | - Eftim Zdravevski
- Faculty of Computer Science and Engineering, University Ss Cyril and Methodius, 1000 Skopje, North Macedonia;
| |
Collapse
|
10
|
Sokas D, Paliakaitė B, Rapalis A, Marozas V, Bailón R, Petrėnas A. Detection of Walk Tests in Free-Living Activities Using a Wrist-Worn Device. Front Physiol 2021; 12:706545. [PMID: 34456748 PMCID: PMC8397518 DOI: 10.3389/fphys.2021.706545] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
Exercise testing to assess the response to physical rehabilitation or lifestyle interventions is administered in clinics thus at best can be repeated only few times a year. This study explores a novel approach to collecting information on functional performance through walk tests, e.g., a 6-min walk test (6MWT), unintentionally performed in free-living activities. Walk tests are detected in step data provided by a wrist-worn device. Only those events of minute-to-minute variation in walking cadence, which is equal or lower than the empirically determined maximal SD (e.g., 5-steps), are considered as walk test candidates. Out of detected walk tests within the non-overlapping sliding time interval (e.g., 1-week), the one with the largest number of steps is chosen as the most representative. This approach is studied on a cohort of 99 subjects, assigned to the groups of patients with cardiovascular disease (CVD) and healthy subjects below and over 40-years-old, who were asked to wear the device while maintaining their usual physical activity regimen. The total wear time was 8,864 subject-days after excluding the intervals of occasionally discontinued monitoring. About 82% (23/28) of patients with CVD and 88% (21/24) of healthy subjects over 40-years-old had at least a single 6MWT over the 1st month of monitoring. About 52% of patients with CVD (12/23) and 91% (19/21) of healthy subjects over 40-years-old exceeded 500 m. Patients with CVD, on average, walked 46 m shorter 6MWT distance (p = 0.04) compared to healthy subjects. Unintentional walk testing is feasible and could be valuable for repeated assessment of functional performance outside the clinical setting.
Collapse
Affiliation(s)
- Daivaras Sokas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Birutė Paliakaitė
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Andrius Rapalis
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania.,Faculty of Electrical and Electronics Engineering, Kaunas University of Technology, Kaunas, Lithuania
| | - Vaidotas Marozas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania.,Faculty of Electrical and Electronics Engineering, Kaunas University of Technology, Kaunas, Lithuania
| | - Raquel Bailón
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain
| | - Andrius Petrėnas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania.,Faculty of Electrical and Electronics Engineering, Kaunas University of Technology, Kaunas, Lithuania
| |
Collapse
|
11
|
Hegazy FA, Mohamed Kamel SM, Abdelhamid AS, Aboelnasr EA, Elshazly M, Hassan AM. Effect of postoperative high load long duration inspiratory muscle training on pulmonary function and functional capacity after mitral valve replacement surgery: A randomized controlled trial with follow-up. PLoS One 2021; 16:e0256609. [PMID: 34449776 PMCID: PMC8396720 DOI: 10.1371/journal.pone.0256609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 08/08/2021] [Indexed: 11/27/2022] Open
Abstract
Objectives Although, pre-operative inspiratory muscle training has been investigated and reported to be an effective strategy to reduce postoperative pulmonary complications, the efficacy of postoperative inspiratory muscle training as well as the proper load, frequency, and duration necessary to reduce the postoperative pulmonary complications has not been fully investigated. This study was designed to investigate the effect of postoperative high-load long-duration inspiratory muscle training on pulmonary function, inspiratory muscle strength, and functional capacity after mitral valve replacement surgeries. Design Prospective randomized controlled trial. Methods A total of one hundred patients (mean age 38.3±3.29years) underwent mitral valve replacement surgery were randomized into experimental (n = 50) and control (n = 50) groups. The control group received conventional physiotherapy care, while experimental group received conventional care in addition to inspiratory muscle training, with 40% of the baseline maximal inspiratory pressure targeting a load of 80% by the end of the 8 weeks intervention protocol. Inspiratory muscle training started on the patient’s first day in the inpatient ward. Lung functions, inspiratory muscle strength, and functional capacity were evaluated using a computer-based spirometry system, maximal inspiratory pressure measurement and 6MWT respectively at 5 time points and a follow-up assessment was performed 6 months after surgery. Repeated measure ANOVA and post-hoc analyses were used (p <0.05). Results Group-time interactions were detected for all the studied variables (p<0.001). Between-group analysis revealed statistically significant postoperative improvements in all studied variables in the experimental group compared to the control group (p <0.001) with large effect size of η2 ˃0.14. Within-group analysis indicated substantial improvements in lung function, inspiratory pressure and functional capacity in the experimental group (p <0.05) over time, and these improvements were maintained at follow-up. Conclusion High intensity, long-duration postoperative inspiratory muscle training is highly effective in improving lung function, inspiratory muscle strength, and functional capacity after mitral valve replacement surgeries.
Collapse
Affiliation(s)
- Fatma A. Hegazy
- Department of Physiotherapy, Collage of Health Sciences, University of Sharjah, Sharjah, UAE
- Faculty of Physical Therapy, Cairo University, Giza, Egypt
- * E-mail:
| | | | - Ahmed S. Abdelhamid
- Department of Physical Therapy for Musculoskeletal Disorders and Its Surgeries, Faculty of Physical Therapy, South Valley University, Qena, Egypt
| | | | - Mahmoud Elshazly
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, South Valley University, Qena, Egypt
| | - Ali M. Hassan
- Department of Physical Therapy for Internal Medicine and Geriatrics, Faculty of Physical Therapy, South Valley University, Qena, Egypt
| |
Collapse
|
12
|
Mieda R, Matsui Y, Tobe M, Kanamoto M, Suto T, Saito S. Education program for prevention of outdoor accidents in middle-high aged trekkers: Monitoring of change in blood pressure and heart rate during exercise. Prev Med Rep 2021; 23:101396. [PMID: 34094816 PMCID: PMC8164081 DOI: 10.1016/j.pmedr.2021.101396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/07/2021] [Accepted: 05/07/2021] [Indexed: 11/30/2022] Open
Abstract
Senior trekkers' accidents has increased markedly over the past 5 years. Educational program is effective to prevent extreme hemodynamics during exercise. Green exercise education promotes a healthy life-style in seniors.
This is an observational study to evaluate cardiovascular parameters during an educational trekking program. The number of alpine accidents involving elderly trekkers has been increasing in developed countries in recent years. Many middle-high aged trekkers have potential cardiovascular risks of which they are unaware. More than 77% of trekkers involved in alpine accidents in Japan were aged >40 years. The most common cardiovascular conditions were stroke or heart attack while trekking at altitude. An alpine club conducted an 8-month education program with participants aged >40 years in the setting of a mountain-side town. Blood pressure and heart rate during outdoor exercise were monitored, and any other adverse effects were recorded. As a result, the cardiovascular parameters evaluated during the first and final trek presented a physiological and similar behavior, however, lower heart rate values were registered at the highest point of the route in the final trek (p < 0.05). The trend of these parameters was similar in males and females, and there was little correlation between the cardiovascular parameters and age. In conclusion, the lower heart rate values may indicate the higher risk awareness of trekkers while self-pacing the physical activity outdoors, which may indicate the positive effect of the education program in increasing the safety of such unsupervised activities.
Collapse
|