Consumer-based activity trackers in evaluation of physical activity in myositis patients

Rheumatology ◽  
2021 ◽  
Author(s):  
Didem Saygin ◽  
Bonny Rockette-Wagner ◽  
Chester Oddis ◽  
Nicole Neiman ◽  
Diane Koontz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Disease Activity ◽  
Manual Muscle Testing ◽  
Functional Tests ◽  
Daily Step ◽  
Timed Up And Go ◽  
Step Counts ◽  
Muscle Testing ◽  
Sf 36 ◽  
Global Disease Activity

Abstract Objectives Inflammatory myopathies are characterized by muscle weakness that limits the activities of daily living. Daily step count is an accepted metric of physical activity. Wearable technologies such as Fitbit® enable tracking of daily step counts. We assessed the psychometric properties of Fitbit® and compared the accuracy of Fitbit® step counts to ActiGraph®. Methods This was a pilot, proof of concept, prospective observational study with four visits at 0, 1, 3 and 6 months in PM, DM, necrotizing myopathy (NM) or anti-synthetase syndrome (AS) subjects. Six core set measures (manual muscle testing, physician global disease activity, patient global disease activity, and extra-muscular disease activity, HAQ-Disability Index and creatine kinase), three functional tests (six-min walk, timed up-and-go, sit-to-stand tests) and SF-36 physical function-10 (PF10) were collected at each visit. Patients wore waist-worn Fitbit® One and ActiGraph® T3X-BT concurrently for 7 days/month for 6 months. Results Twenty-four (10 DM, 8 PM/NM, 6 AS) patients (17 females/7 males; 91% Caucasian) were enrolled. Test-retest reliability of daily steps was strong in 1-month follow-up (ICC 0.89). Daily steps and peak 1-min cadence showed moderate-strong correlations with physician global disease activity, patient global disease activity, HAQ-Disability Index, SF-36 PF10 and all three functional tests. Fitbit® and ActiGraph® step counts demonstrated good agreement and strong correlation (ICC 0.96). Conclusion Fitbit® daily steps and peak 1-min cadence are reliable and valid measures of physical activity in a cohort of myositis patients. This pilot data suggests that Fitbit® has a potential for use in clinical practice and trials to monitor physical activity in myositis patients, but larger studies are needed for further validation.

Reliability, Validity and Responsiveness of Physical Activity Monitors in Patients with Inflammatory Myopathy

Rheumatology ◽  
2021 ◽  
Author(s):  
Bonny Rockette-Wagner ◽  
Didem Saygin ◽  
Siamak Moghadam-Kia ◽  
Chester Oddis ◽  
Océane Landon-Cardinal ◽  
...  
Keyword(s):  
Physical Activity ◽  
Construct Validity ◽  
Disease Activity ◽  
Retest Reliability ◽  
Activity Monitors ◽  
Muscle Testing ◽  
Patient Reported ◽  
Physical Activity Monitors ◽  
Global Disease Activity ◽  
Test Retest Reliability

Abstract Objective Idiopathic inflammatory myopathies (IIM) cause proximal muscle weakness, which affect activities of daily living. Wearable physical activity monitors (PAMs) objectively assess continuous activity with potential clinical usefulness in IIM assessment. We examined the psychometric characteristics for PAM outcomes in IIM. Methods Adult IIM patients were prospectively evaluated (baseline, 3 and 6-months) in an observational study. A waist-worn PAM (ActiGraph GT3X-BT) assessed average step counts/min, peak 1-min cadence, and vector magnitude/min. Validated myositis core set measures (CSM) including manual muscle testing (MMT), physician global disease activity (MD global), patient global disease activity (Pt global), extra-muscular disease activity (Ex-muscular global), HAQ-DI, muscle enzymes, and patient-reported physical function were evaluated. Test-retest reliability, construct validity, and responsiveness were determined for PAM measures and CSM using Pearson correlations and other appropriate analyses. Results 50 adult IIM patients enrolled [mean (SD) age, 53.6 (±14.6); 60% female, 94% Caucasian]. PAM measures showed strong test-retest reliability, moderate-to-strong correlations at baseline with MD global (r=-0.37- -0.48), Pt-global (r=-0.43- -0.61), HAQ-DI (r=-0.47- -0.59) and MMT (r = 0.37–0.52), and strong discriminant validity for categorical MMT and HAQ-DI. Longitudinal association with MD global (r=-0.38- -0.44), MMT (r = 0.50–0.57), HAQ-DI (r=-0.45- -0.55), and functional tests (r = 0.30–0.65) were moderate-to-strong. PAM measures were responsive to MMT improvement (≥10%) and moderate-to-major improvement on ACR/EULAR myositis response criteria. Peak 1-min cadence had the largest effect size and Standardized Response Means (SRMs). Conclusion PAM measures showed promising construct validity, reliability, and longitudinal responsiveness; especially peak 1-min cadence. PAMs provide valid outcome measures for future use in IIM clinical trials.

scholarly journals How COVID-19 lockdown and reopening affected daily steps: evidence based on 164,630 person-days of prospectively collected data from Shanghai, China

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ding Ding ◽  
Minna Cheng ◽  
Borja del Pozo Cruz ◽  
Tao Lin ◽  
Shuangyuan Sun ◽  
...  
Keyword(s):  
Physical Activity ◽  
At Risk ◽  
Body Composition ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
University Education ◽  
Control Group ◽  
Daily Step ◽  
Step Counts ◽  
Reduced Physical Activity

Abstract Background COVID-19 lockdowns may lead to physical inactivity, a major risk factor for non-communicable diseases. This study aims to determine: 1) the trajectory in daily step counts before, during and after the lockdown in China, and 2) the characteristics associated with the trajectories. Methods From December 2019 to July 2020, smartphone-based step counts were continuously collected in 815 Chinese adults residing in Shanghai over 202 days across three phases: before, during, and after the lockdown. Participant characteristics were reported, and height, weight and body composition measured before the lockdown. A ‘sharp’ regression discontinuity design with cluster robust standard errors was used to test the effect of the lockdown and reopening on daily steps and a linear mixed model was used to examine the characteristics associated with trajectories during the observed period. Results Based on 164,630 person-days of data, we found a sharp decline in daily step counts upon the lockdown (24/01/2020) by an average of 3796 (SE = 88) steps, followed by a significant trend of increase by 34 steps/day (SE = 2.5; p < .001) until the end of the lockdown (22/03/2020). This increasing trend continued into the reopening phase at a slower rate of 5 steps per day (SE = 2.3; p = 0.029). Those who were older, married, university educated, insufficiently active, had an ‘at risk’ body composition, and those in the control group, were slower at recovering step counts during the lockdown, and those who were older, married, without university education and with an ‘at risk’ body composition recovered step counts at a slower pace after the reopening. Conclusions Despite later increases in step counts, COVID-19 lockdown led to a sustained period of reduced physical activity, which may have adverse health implications. Governments and health professionals around the world should continue to encourage and facilitate physical activity during the pandemic.

Hand-held dynamometry for assessment of muscle strength in patients with inflammatory myopathies

Rheumatology ◽  
2020 ◽  
Author(s):  
Didem Saygin ◽  
Chester V Oddis ◽  
Siamak Moghadam-Kia ◽  
Bonny Rockette-Wagner ◽  
Nicole Neiman ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Disease Activity ◽  
Neuromuscular Disorders ◽  
Strong Association ◽  
External Validation ◽  
Manual Muscle Testing ◽  
Inflammatory Myopathies ◽  
University Of Pittsburgh ◽  
Muscle Testing ◽  
The University

Abstract Objectives Muscle weakness in idiopathic inflammatory myopathies (IIMs) is conventionally assessed using manual muscle testing (MMT). However, more objective tools must be developed to accurately and reliably quantify muscle strength in myositis patients. Hand-held dynamometry (HHD) is a quantitative, portable device with reported reliability in neuromuscular disorders. Our aim was to assess the reliability, validity and responsiveness of HHD in myositis. Methods Myositis patients [DM, necrotizing myopathy (NM), PM and anti-synthetase syndrome] evaluated at the University of Pittsburgh myositis centre were prospectively enrolled. Each patient was assessed at 0, 3 and 6 months for validated outcome measures of myositis disease activity and physical function. At each visit, muscle strength was assessed using both MMT and HHD (Micro FET2, Hoggan Health Industries, Draper, UT, USA). The reliability, validity and responsiveness of the HHD was assessed using standard statistical methods. Results Fifty IIM patients (60% female; mean age 51.6 years; 6 PM, 9 NM, 24 DM and 11 anti-synthetase syndrome) were enrolled. HHD showed strong test–retest intrarater reliability (r = 0.96) and interrater reliability (r = 0.98). HHD correlated significantly with the MMT score (r = 0.48, P = 0.0006) and myositis disease activity and functional measures. Longitudinal analysis showed a significant and strong association between the HHD and MMT as well as 2016 ACR/EULAR myositis response criteria (r = 0.8, P &lt; 0.0001) demonstrating responsiveness. The mean effect size and standardized response mean of HHD was large: 0.95 and 1.03, respectively. MMT had a high ceiling effect compared with HHD. Conclusion HHD demonstrated strong reliability, construct validity and responsiveness in myositis patients. External validation studies are required to confirm these findings.

Alterations in activin A–myostatin–follistatin system associate with disease activity in inflammatory myopathies

Rheumatology ◽  
2020 ◽  
Vol 59 (9) ◽  
pp. 2491-2501 ◽  
Author(s):  
Lucia Vernerová ◽  
Veronika Horváthová ◽  
Tereza Kropáčková ◽  
Martina Vokurková ◽  
Martin Klein ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Disease Activity ◽  
Muscle Tissue ◽  
Activin A ◽  
Muscle Disease ◽  
Manual Muscle Testing ◽  
Healthy Controls ◽  
Inflammatory Myopathies ◽  
Muscle Testing ◽  
Tgf Β1

Abstract Objectives The aim of this study was to investigate the systemic and skeletal muscle levels of atrophy-associated myokines in patients with idiopathic inflammatory myopathies (IIM) and their association with clinical characteristics of myositis. Methods A total of 94 IIM patients and 162 healthy controls were recruited. Of those, 20 IIM patients and 28 healthy controls underwent a muscle biopsy. Circulating concentrations of myostatin, follistatin, activin A and TGF-β1 were assessed by ELISA. The expression of myokines and associated genes involved in the myostatin signalling pathway in muscle tissue was determined by real-time PCR. Results We report decreased levels of circulating myostatin (median 1817 vs 2659 pg/ml; P = 0.003) and increased follistatin (1319 vs 1055 pg/ml; P = 0.028) in IIM compared with healthy controls. Activin A levels were also higher in IIM (414 vs 309 pg/ml; P = 0.0005) compared with controls. Myostatin was negatively correlated to muscle disease activity assessed by physician on visual analogue scale (MDA) (r = −0.289, P = 0.015) and positively to manual muscle testing of eight muscles (r = 0.366, P = 0.002). On the other hand, follistatin correlated positively with MDA (r = 0.235, P = 0.047). Gene expression analysis showed higher follistatin (P = 0.003) and myostatin inhibitor follistatin-like 3 protein (FSTL3) (P = 0.008) and lower expression of activin receptor type 1B (ALK4) (P = 0.034), signal transducer SMAD3 (P = 0.023) and atrophy marker atrogin-1 (P = 0.0009) in IIM muscle tissue compared with controls. Conclusion This study shows lower myostatin and higher follistatin levels in circulation and attenuated expression of myostatin pathway signalling components in skeletal muscle of patients with myositis, a newly emerging pattern of the activin A–myostatin–follistatin system in muscle wasting diseases.

scholarly journals Pedometer-determined physical activity among primary schoolchildren in Kuala Lumpur

2019 ◽  
Vol 28 (2) ◽  
pp. 115-123
Author(s):  
Bee Suan Wee ◽  
Awang Bulgiba ◽  
Abd. Talib Ruzita ◽  
Mohd. Noor Ismail ◽  
Bee Koon Poh
Keyword(s):  
Physical Activity ◽  
Primary School ◽  
Sociodemographic Factors ◽  
Activity Level ◽  
Activity Levels ◽  
Kuala Lumpur ◽  
Daily Step ◽  
Step Counts ◽  
Primary Schoolchildren ◽  
Physical Activity Levels

Objective: The aim of this study was to objectively measure physical activity and its association with sociodemographic factors among Malaysian primary school-age children. Methods: A total of 111 primary school children in Kuala Lumpur were selected through random sampling. Activity pattern was determined using pedometers and differences by sex, ethnicity and body mass index categories were analysed. The relationship between pedometer-determined physical activity and sociodemographic factors were also studied. Results: Overall, boys attained significantly higher daily step counts than girls (9573 ± 4145 vs 7313 ± 2697). Significant difference in daily step counts between boys and girls were observed during weekdays ( p<0.01), weekends ( p<0.05) and total mean step counts ( p<0.01). Malay ethnicity showed higher daily step counts during weekdays than weekends ( p<0.05). Compared with boys, girls had higher odds (OR=5.58; 95% CI 1.12, 27.77) of not meeting the recommended daily step counts. Those who had low physical activity levels had higher odds (OR=15.75; 95% CI 1.78, 139.33) of not meeting recommended daily step counts than children who had moderate physical activity level. Conclusion: Boys were significantly more active than girls and physical activity was greater during weekdays than on weekends. The primary schoolchildren in Kuala Lumpur were sedentary, with minimum physical activity being observed. Differences in sexes and physical activity levels influenced pedometer step counts in children.

scholarly journals Laboratory-Assessed Markers of Cardiometabolic Health and Associations with GIS-Based Measures of Active-Living Environments

2018 ◽  
Vol 15 (10) ◽  
pp. 2079 ◽  
Author(s):  
Samantha Hajna ◽  
Kaberi Dasgupta ◽  
Nancy Ross
Keyword(s):  
Physical Activity ◽  
Sociodemographic Factors ◽  
Living Environment ◽  
Cardiometabolic Health ◽  
Active Living ◽  
Daily Step ◽  
Step Counts ◽  
Mediating Role ◽  
Intensity Physical Activity ◽  
Living Environments

Active-living-friendly environments have been linked to physical activity, but their relationships with specific markers of cardiometabolic health remain unclear. We estimated the associations between active-living environments and markers of cardiometabolic health, and explored the potential mediating role of physical activity in these associations. We used data collected on 2809 middle-aged adults who participated in the Canadian Health Measures Survey (2007–2009; 41.5 years, SD = 15.1). Environments were assessed using an index that combined GIS-derived measures of street connectivity, land use mix, and population density. Body mass index (BMI), systolic blood pressure (SBP), hemoglobin A1c, and cholesterol were assessed in a laboratory setting. Daily step counts and moderate-to-vigorous intensity physical activity (MVPA) were assessed for seven days using accelerometers. Associations were estimated using robust multivariable linear regressions adjusted for sociodemographic factors that were assessed via questionnaire. BMI was 0.79 kg/m2 lower (95% confidence interval (CI) −1.31, −0.27) and SBP was 1.65 mmHg lower (95% CI −3.10, −0.20) in participants living in the most active-living-friendly environments compared to the least, independent of daily step counts or MVPA. A 35.4 min/week difference in MPVA (95% CI 24.2, 46.6) was observed between residents of neighborhoods in the highest compared to the lowest active-living-environment quartiles. Cycling to work rates were also the highest in participants living in the highest living-environment quartiles (e.g., Q4 vs. Q1: 10.4% vs. 4.9%). Although active-living environments are associated with lower BMI and SBP, and higher MVPA and cycling rates, neither daily step counts nor MVPA appear to account for environment–BMI/SBP relationships. This suggests that other factors not assessed in this study (e.g., food environment or unmeasured features of the social environment) may explain this relationship.

scholarly journals Objectively assessed physical activity patterns and physical function in community-dwelling older adults: a cross-sectional study in Taiwan

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034645
Author(s):  
Ming-Chun Hsueh ◽  
Ru Rutherford ◽  
Chien-Chih Chou ◽  
Jong-Hwan Park ◽  
Hyun-Tae Park ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Function ◽  
Older Women ◽  
Handgrip Strength ◽  
Older Men ◽  
Daily Step ◽  
Cross Sectional ◽  
Step Counts ◽  
Single Leg Stance

ObjectivesTo objectively assess light physical activity (PA), moderate-to-vigorous PA (MVPA), step counts and number of 10 min MVPA bouts and their association with physical function among older adults.DesignCross-sectional design.SettingUrban community setting in Taiwan.Participants127 Taiwanese older adults aged over 65 years (mean age=70.8±5.3 years; 72% women).Primary and secondary outcome measuresTriaxial accelerometers were used to measure PA variables for 10 hours/day for seven consecutive days. Then, five physical function components (handgrip strength, single-leg stance, 5-metre walk speed, timed up and go and sit-to-stand test) were measured. Multiple linear regressions were used to perform separate analyses for older men and women.ResultsFor older women, daily MVPA time (β: 0.39, 95% CI: 0.12, 0.64; p=0.004), daily step counts (β: 0.46, 95% CI: 0.12, 0.78; p=0.009) and number of 10 min MVPA bouts (β: 0.27, 95% CI: 0.001, 0.53; p=0.049) were positively associated with handgrip strength after adjusting for accelerometer wear time, sedentary time and other confounders. Furthermore, daily MVPA time was positively associated with a single-leg stance (β: 0.25, 95% CI: 0.02, 0.49; p=0.036) and higher daily step counts were associated with shorter walking speed performance (β: −0.31, 95% CI: −0.57, −0.001; p=0.049). None of the variables of the objectively assessed PA patterns was associated with physical function outcomes among older men due to their small sample size.ConclusionsDaily MVPA, MVPA bouts of at least 10 min and accumulated daily steps are important for improving physical function among older women. Future prospective research should establish causal associations between PA patterns and functional ability among older adults.

A Pilot Study Comparing Pedometer Counts with Reported Physical Activity in Elementary Schoolchildren

2004 ◽  
Vol 16 (4) ◽  
pp. 355-367 ◽  
Author(s):  
Greet Cardon ◽  
Ilse De Bourdeaudhuij
Keyword(s):  
Physical Activity ◽  
Pilot Study ◽  
Vigorous Physical Activity ◽  
Step Count ◽  
Regression Equations ◽  
Moderate Correlation ◽  
Daily Step ◽  
Step Counts ◽  
Daily Step Count

In this study pedometer counts were recorded for 6 consecutive days for 92 children (mean age = 9.6 years; range 6.5–12.7) and were compared with the number of minutes per day in which the participants engaged in moderate-to-vigorous physical activity (MVPA). Diaries filled out with the assistance of one of the children’s parents were used to determine minutes of MVPA. The average daily step count was significantly higher in boys than in girls, although the average daily MVPA engagement in minutes did not vary significantly between genders. Based on the regression equations, 60 min of MVPA was equivalent to 15,340 step counts in boys, 11,317 step counts in girls, and 13,130 step counts when results for both genders were combined. A moderate correlation (r = .39, p < .001) was found between pedometer step counts and reported minutes of MVPA. According to the present study findings, however, predictions and promotion of daily MVPA engagement in children based on pedometer counts per day should be made with caution.

Self-Selected and Prescribed Intensity Exercise to Improve Physical Activity Among Inactive Retirees

2018 ◽  
Vol 40 (9) ◽  
pp. 1301-1318 ◽  
Author(s):  
Zhinan Yang ◽  
Marcia A. Petrini
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Waist Circumference ◽  
Negative Affect ◽  
Controlled Study ◽  
Daily Step ◽  
Exercise Programs ◽  
Exercise Interventions ◽  
Step Counts

A randomized controlled study explored the effects of two intensity-oriented exercise interventions on affect to exercise and physical activity behavior. Inactive retirees finished the 12-week group-based exercise intervention and 3-month telephone follow-up with 27 in self-selected intensity group and 26 in prescribed intensity group. Repeated measures of daily step counts (measured by Yamax pedometers), positive and negative affect to exercise, weight, height, waist circumference, and blood pressure were done at baseline, postintervention, and 3-month follow-up. Increased daily step counts and positive affect, and reduced body mass index, waist circumference, blood pressure of both groups, and negative affect of self-selected intensity group were found at different measuring times. Although self-selected intensity group had no significantly different daily step counts from prescribed intensity group, the former had a more positive and less negative affect to exercise. Findings suggest that future exercise programs use self-selected intensity exercise programs to improve pleasure affect to exercise.

Step Counts From Satellites: Methods for Integrating Accelerometer and GPS Data for More Accurate Measures of Pedestrian Travel

2020 ◽  
Vol 3 (1) ◽  
pp. 58-66
Author(s):  
Brian M. Wood ◽  
Herman Pontzer ◽  
Jacob A. Harris ◽  
Audax Z.P. Mabulla ◽  
Marc T. Hamilton ◽  
...  
Keyword(s):  
Physical Activity ◽  
Step Length ◽  
Step Count ◽  
Movement Speed ◽  
Gps Data ◽  
Daily Step ◽  
Step Counts ◽  
Functional Relationships ◽  
Biomechanical Models ◽  
Pedestrian Travel

The rapid adoption of lightweight activity tracking sensors demonstrates that precise measures of physical activity hold great value for a wide variety of applications. The corresponding growth of physical activity data creates an urgent need for methods to integrate such data. In this paper, we demonstrate methods for 1) synchronizing accelerometer and Global Positioning System (GPS) data with optimal corrections for device-related time drift, and 2) producing principled estimates of step counts from GPS data. These methods improve the accuracy of time-resolved physical activity measures and permit pedestrian travel from either sensor to be expressed in terms of a common currency, step counts. We show that sensor-based estimates of step length correspond well with expectations based on independent measures, and functional relationships between step length, height, and movement speed expected from biomechanical models. Using 123 person-days of data in which Hadza hunter-gatherers wore both GPS devices and accelerometers, we find that GPS-based estimates of daily step counts have a good correspondence with accelerometer-recorded values. A multivariate linear model predicting daily step counts from distance walked, mean movement speed, and height has an R2 value of 0.96 and a mean absolute percent error of 16.8% (mean absolute error = 1,354 steps; mean steps per day = 15,800; n = 123). To best represent step count estimation error, we fit a Bayesian model and plot the distributions of step count estimates it generates. Our methods more accurately situate accelerometer-based measures of physical activity in space and time, and provide new avenues for comparative research in biomechanics and human movement ecology.

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