scholarly journals Middle-Aged Men With HIV Have Diminished Accelerometry-Based Activity Profiles Despite Similar Lab-Measured Gait Speed: Pilot Study (Preprint)

2018 ◽  
Author(s):  
Timothy M Hale ◽  
Viola Guardigni ◽  
Eva Roitmann ◽  
Matthieu Vegreville ◽  
Brooke Brawley ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pilot Study ◽  
T Cell Activation ◽  
Gait Speed ◽  
Functional Decline ◽  
Activity Level ◽  
Accelerometer Data ◽  
Middle Aged ◽  
Free Living ◽  
Increased Risk

BACKGROUND People aging with HIV are living with increased risk for functional decline compared with uninfected adults of the same age. Early preclinical changes in biomarkers in middle-aged individuals at risk for mobility and functional decline are needed. OBJECTIVE This pilot study aims to compare measures of free-living activity with lab-based measures. In addition, we aim to examine differences in the activity level and patterns by HIV status. METHODS Forty-six men (23 HIV+, 23 HIV−) currently in the MATCH (Muscle and Aging Treated Chronic HIV) cohort study wore a consumer-grade wristband accelerometer continuously for 3 weeks. We used free-living activity to calculate the gait speed and time spent at different activity intensities. Accelerometer data were compared with lab-based gait speed using the 6-minute walk test (6-MWT). Plasma biomarkers were measured and biobehavioral questionnaires were administered. RESULTS HIV+ men more often lived alone (P=.02), reported more pain (P=.02), and fatigue (P=.048). In addition, HIV+ men had lower blood CD4/CD8 ratios (P<.001) and higher Veterans Aging Cohort Study Index scores (P=.04) and T-cell activation (P<.001) but did not differ in levels of inflammation (P=.30) or testosterone (P=.83). For all participants, accelerometer-based gait speed was significantly lower than the lab-based 6-MWT gait speed (P<.001). Moreover, accelerometer-based gait speed was significantly lower in HIV+ participants (P=.04) despite the absence of differences in the lab-based 6-MWT (P=.39). HIV+ participants spent more time in the lowest quartile of activity compared with uninfected (P=.01), who spent more time in the middle quartiles of activity (P=.02). CONCLUSIONS Accelerometer-based assessment of gait speed and activity patterns are lower for asymptomatic men living with HIV compared with uninfected controls and may be useful as preclinical digital biomarkers that precede differences captured in lab-based measures.

Very Low Levels of Physical Activity in Older Patients During Hospitalization at an Acute Geriatric Ward: A Prospective Cohort Study

2015 ◽  
Vol 23 (4) ◽  
pp. 542-549 ◽  
Author(s):  
Morten Villumsen ◽  
Martin Gronbech Jorgensen ◽  
Jane Andreasen ◽  
Michael Skovdal Rathleff ◽  
Carsten Møller Mølgaard
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Older Patients ◽  
Geriatric Patients ◽  
Functional Decline ◽  
Activity Level ◽  
Accelerometer Data ◽  
Geriatric Ward ◽  
Acute Geriatric Ward ◽  
Low Levels

Lack of activity during hospitalization may contribute to functional decline. The purpose of this study was to investigate (1) the time spent walking during hospitalization by geriatric patients referred to physical and/or occupational therapy and (2) the development in time spent walking during hospitalization. In this observational study, 24-hr accelerometer data (ActivPal) were collected from inclusion to discharge in 124 patients at an acute geriatric ward. The median time spent walking was 7 min per day. During the first quartile of hospitalization, the patients spent 4 (IQR:1;11) min per day walking, increasing to 10 (IQR:1;29) min during the last quartile. Improvement in time spent walking was primarily observed in the group able to perform the Timed Up & Go task at admission. When walking only 7 min per day, patients could be classified as inactive and at risk for functional decline; nonetheless, the physical activity level increased significantly during hospitalization.

Evaluating upper limb function after stroke using the free-living accelerometer data

2020 ◽  
Vol 29 (11) ◽  
pp. 3249-3264 ◽  
Author(s):  
Lin Tang ◽  
Shane Halloran ◽  
Jian Qing Shi ◽  
Yu Guan ◽  
Chunzheng Cao ◽  
...  
Keyword(s):  
Upper Limb ◽  
Daily Living ◽  
Gaussian Mixture ◽  
Activity Level ◽  
Accelerometer Data ◽  
Free Living ◽  
Limb Function ◽  
Nonlinear Mixed Effects Model ◽  
Analysis Techniques ◽  
Upper Limb Function

Accelerometer devices are becoming efficient tools in clinical studies for automatically measuring the activities of daily living. Such data provides a time series describing activity level at every second and displays a subject’s activity pattern throughout a day. However, the analysis of such data is very challenging due to the large number of observations produced each second and the variability among subjects. The purpose of this study is to develop efficient statistical analysis techniques for predicting the recovery level of the upper limb function after stroke based on the free-living accelerometer data. We propose to use a Gaussian Mixture Model (GMM)-based method for clustering and extracting new features to capture the information contained in the raw data. A nonlinear mixed effects model with Gaussian Process prior for the random effects is developed as the predictive model for evaluating the recovery level of the upper limb function. Results of applying to the accelerometer data for patients after stroke are presented.

scholarly journals Effect of metformin on the size of the HIV reservoir in non-diabetic ART-treated individuals: single-arm non-randomised Lilac pilot study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e028444 ◽  
Author(s):  
Jean-Pierre Routy ◽  
Stéphane Isnard ◽  
Vikram Mehraj ◽  
Mario Ostrowski ◽  
Nicolas Chomont ◽  
...  
Keyword(s):  
Pilot Study ◽  
T Cell Activation ◽  
Cell Activation ◽  
Health Centre ◽  
Mammalian Target Of Rapamycin ◽  
Viral Reservoir ◽  
People Living With Hiv ◽  
Hiv Reservoir ◽  
Increased Risk ◽  
Hiv Eradication

IntroductionPeople living with HIV (PLWH) on antiretroviral therapy (ART) do not progress to AIDS. However, they still suffer from an increased risk of inflammation-associated complications. HIV persists in long-lived CD4+ T cells, which form the major viral reservoir. The persistence of this reservoir despite long-term ART is the major hurdle to curing HIV. Importantly, the size of the HIV reservoir is larger in individuals who start ART late in the course of infection and have a low CD4+/CD8+ ratio. HIV reservoir size is also linked to the levels of persistent inflammation on ART. Thus, novel strategies to reduce immune inflammation and improve the host response to control the HIV reservoir would be a valuable addition to current ART. Among the different strategies under investigation is metformin, a widely used antidiabetic drug that was recently shown to modulate T-cell activation and inflammation. Treatment of non-diabetic individuals with metformin controls inflammation by improving glucose metabolism and by regulating intracellular immunometabolic checkpoints such as the adenosin 5 monophosphate activated protein kinase and mammalian target of rapamycin, in association with microbiota modification.Methods and analysis22 PLWH on ART for more than 3 years, at high risk of inflammation or the development of non-AIDS events (low CD4+/CD8+ ratio) will be recruited in a clinical single-arm pilot study. We will test whether supplementing ART with metformin in non-diabetic HIV-infected individuals can reduce the size of the HIV reservoir as determined by various virological assays. The expected outcome of this study is a reduction in both the size of the HIV reservoir and inflammation following the addition of metformin to ART, thus paving the way towards HIV eradication.Ethics and disseminationEthical approval: McGill university Health Centre committee number MP-37-2016-2456. Canadian Canadian Institutes of Health Research/Canadian HIV Trials Network (CTN) protocol CTNPT027. Results will be made available through publication in peer-reviewed journals and through the CTN website.Trial registration numberNCT02659306

scholarly journals Predictors of difficulty in bedside percutaneous dilatational tracheostomy: pilot study

2020 ◽  
Vol 47 ◽  
Author(s):  
LUCAS RIBEIRO TENÓRIO ◽  
MARIANNE YUMI NAKAI ◽  
JÚLIO PATROCÍNIO MORAES ◽  
MARCELO BENEDITO MENEZES ◽  
LETÍCIA DE MELO SILVA ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Pilot Study ◽  
Prospective Cohort ◽  
Percutaneous Dilatational Tracheostomy ◽  
Technical Difficulty ◽  
Single Center ◽  
Dilatational Tracheostomy ◽  
Increased Risk

ABSTRACT Introduction: percutaneous dilatational tracheostomy is currently one of the main procedures performed in an intensive care unit (ICU). However, there are no well-defined indicators of technical difficulty in performing the procedure. Objectives: to define predictors of difficulty in performing bedside percutaneous dilatational tracheostomy. Methodology: prospective cohort study encompassing 21 patients who underwent bedside percutaneous dilatational tracheostomy in the ICU at a single center. Results: Sternohyoid (SH) distance shorter than 7 cm is associated with a 50% increase in the risk of technical difficulty (OR 0.44 and p <0.03). Conclusion: the reduction in (SH) distance is related to an increased risk of difficulty in performing percutaneous dilatational tracheostomy in the ICU bed.

scholarly journals The descriptive epidemiology of standing activity during free-living in 5412 middle-aged adults: the 1970 British Cohort Study

2020 ◽  
pp. jech-2020-213783 ◽  
Author(s):  
Mark Hamer ◽  
Emmanuel Stamatakis
Keyword(s):  
Cohort Study ◽  
Public Health Intervention ◽  
Population Level ◽  
Middle Aged ◽  
Free Living ◽  
Potential Health ◽  
Aged People ◽  
National Cohort ◽  
British Cohort Study ◽  
Professional Occupation

BackgroundStanding is often classified as light-intensity physical activity, with potential health benefits compared with sitting. Standing is, however, rarely captured as an independent activity. To better understand free-living standing behaviour at a population level, we incorporated a gold standard postural allocation technique into a national cohort study.MethodsParticipants (n=5412, aged 46.8±0.7 years) from the 1970 British Cohort Study were fitted with a water-proofed thigh-mounted accelerometer device (activPAL3 micro) worn 24 hours continuously over 7 days (90.7% provided at least 3 full days). We examined the correlates of free-living standing during waking hours.ResultsTotal daily standing time averaged 4.6±1.5 h/d, accounting for 29% of waking hours, which was largely (98.7%) accumulated in bouts lasting less than 30 min. In mutually adjusted models, male sex, obesity, diabetes, professional occupation, poor self-rated health and disability were associated with lower device-measured standing times.ConclusionMiddle-aged people in Britain spent a surprisingly large proportion of the day in activities involving standing. Standing merits attention as a health-related posture and may represent a potential target for public health intervention.

Effects of mental practice strategies associated to physiotherapy on gait and risk of falls in Parkinson’s disease: a pilot study of a randomized clinical trial

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
T Silva ◽  
L Silva ◽  
K Silva ◽  
S Silva ◽  
D Silva ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pilot Study ◽  
Gait Speed ◽  
Mental Practice ◽  
Control Group ◽  
Timed Up And Go ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Degenerative Disorder

Abstract Introduction Parkinson’s Disease (PD) is a degenerative disorder that interferes with the voluntary movements due to dysfunction of the basal ganglia and presenting with motor signals, such as the reduction of gait speed. This contributes to an increased risk of falls. In rehabilitation, mental practice (MP) has been shown to promote plastic modulation of neural circuits and improve motor learning, but the results of research with MP in PD are still ambiguous due to the diversity of intervention strategies. Objectives To compare the effects of MP strategies associated to physiotherapy in gait and risk of falls in PD patients. Methodology We performed a pilot study of a clinical randomized, single blind, trial, conducted in accordance with the consort checklist. Patients with idiopathic PD were included and allocated to four groups: Control group (CG); Group with mental practice guided by images (MPI); Group with mental practice guided by audio (MPA); group with mental practice without a guide (MPWG). The subjects of the experimental groups were submitted to 15 sessions of physiotherapy and mental practice, while the CG received only physiotherapy. The sessions were held 2 times per week, 40 minutes for physiotherapy and approximately 5-10 minutes for the corresponding mental practice protocol. Spatial-temporal parameters of gait were assessed with the 10 meters Walking Test (TC10m), and the risk of falls was evaluated with the Timed Up and Go (TUG) test. Results The MPI group showed significant results for the parameters time (p = 0.027) and speed (p = 0.025) when compared with the results of the CG. No main effects for the group were observed concerning cadence and risk of falls had. Groups MPWG and MPA showed no significant results for the TC10m and TUG when compared with the CG. Conclusion The results of this pilot study suggest that MP guided by images associated to physical therapy was more effective to increase the gait speed than the alternative strategies.

scholarly journals Objectively Measured Physical Activity in Asymptomatic Middle-Aged Men Is Associated With Routine Blood-Based Biomarkers

2019 ◽  
Vol 74 (Supplement_1) ◽  
pp. S32-S37 ◽  
Author(s):  
Karol M Pencina ◽  
Zhuoying Li ◽  
Monty Montano
Keyword(s):  
Physical Activity ◽  
T Cell ◽  
Gait Speed ◽  
Sex Hormone Binding Globulin ◽  
Walk Test ◽  
Middle Aged ◽  
Cross Sectional ◽  
Increased Risk ◽  
6 Minute Walk Test ◽  
Minute Walk

Abstract Background The use of circulating clinically routine biomarkers and volitional physical activity using wristband accelerometry in preclinical middle-aged adults may provide sensitive measures of physical function and predict sooner the onset of age- and HIV-related physical decline. Methods Nested cross-sectional cohort study of adult men 50–65 years old with HIV infection on potent antiretroviral therapy and uninfected control participants within the Boston metropolitan area. Gait speed derived from wristband accelerometry, gait speed derived from a standardized 6-minute walk test, cellular immune biomarker levels (CD4 T cell, CD8 T cell), and serum anabolic biomarker levels (total and free testosterone, and sex-hormone-binding globulin) were measured. Results Of the five measured biomarkers, four were significantly associated with volitional gait speed based on accelerometry, whereas only one was associated with gait speed based on the 6-minute walk test collected in a laboratory environment. Conclusion Levels of selected immune and anabolic biomarkers were associated with volitional physical activity in middle-aged individuals. Digital and circulating biomarkers may be useful in future studies designed to identify presymptomatic individuals at increased risk for age- and HIV-associated functional decline.

scholarly journals “Susceptibility and risk of suffering SARS-COV-2 infection by demographic characteristics and pre-existing medical conditions among middle-aged and older adults in Tarragona, Spain: results from the COVID19 TARRACO Cohort Study, March-June 2020”

2021 ◽  
Author(s):  
EM. Satué-Gracia ◽  
A. Vila-Córcoles ◽  
C. de Diego-Cabanes ◽  
A. Vila-Rovira ◽  
C. Torrente-Fraga ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Nursing Home ◽  
Influenza Vaccination ◽  
Angiotensin Receptor Blockers ◽  
Medical Conditions ◽  
Middle Aged ◽  
Increased Risk ◽  
Receptor Blockers ◽  
Reduced Risk

SUMMARYObjectiveTo analyse susceptibility/risk of suffering COVID19 among adults with distinct underlying medical conditions.MethodsCohort study (population-based) including 79,083 people ≥50 years-old in Tarragona (Southern Catalonia, Spain). At study start (01/03/2020) baseline cohort characteristics (demographic, previous comorbidities, chronic medications and vaccinations’ history) were recorded. Primary outcome was laboratory-confirmed COVID19 incurred in cohort members throughout 01/03/2020-30/06/2020. Risk of suffering COVID19 was evaluated by Cox regression, estimating multivariable hazard ratios (HRs) adjusted for age/sex and previous comorbidities.ResultsAcross study period, 536 laboratory-confirmed COVID19 cases were observed (mean incidence: 39.5 cases per 100,000 persons-week). In multivariable-analysis, age/years (HR: 1.01; 95% CI: 1.00-1.02; p=0.050), nursing-home (HR: 20.19; 95% CI: 15.98-25.51; p<0.001), neurological disease (HR: 1.35; 95% CI: 1.03-1.77; p=0.029), taking diuretics (HR: 1.39; 95% CI: 1.10-1.75; p=0.006), antiplatelet (HR: 1.36; 95% CI: 1.05-1.76; p=0.021) and benzodiazepines (HR: 1.24; 95% CI:1.00-1.53; p=0.047) significantly increased risk; while smoking (HR: 0.57; 95%CI: 0.41-0.80; p=0.001), angiotensin converting enzyme inhibitors (HR: 0.78; 95% CI: 0.61-1.00; p=0.048), angiotensin II receptor blockers (HR: 0.70; 95%CI: 0.51-0.96; p=0.027) and statins (HR: 0.75; 95% CI: 0.58-0.96; p=0.025) were associated with reduced risk. Among non-institutionalised persons, cancer, renal and cardiac disease appeared also related to increased risk, whereas influenza vaccination was associated with reduced risk.ConclusionIn a setting with relatively low incidence of COVID19 across the first wave of pandemic period, age, nursing-home residence and multiple comorbidities appear predisposing for COVID19 among middle-aged/older adults. Conversely, statins, angiotensin-receptor blockers/inhibitors and influenza vaccination were related with decreased risk.

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