Sensitivity, Accuracy, and Reproducibility of Biosensing (mHealth) Devices in Monitoring of Physical Activity and Respiratory Function in Smokers with and Without Respiratory Symptoms or Chronic Obstructive Pulmonary Disease (Preprint)

Mapping Intimacies ◽

10.2196/preprints.20347 ◽

2020 ◽

Author(s):

Almaz Sharman ◽

Baurzhan Zhussupov ◽

Saule Nurakysh

Keyword(s):

Physical Activity ◽

Chronic Obstructive Pulmonary Disease ◽

Heart Rate ◽

Pulmonary Disease ◽

Respiratory Function ◽

Respiratory Symptoms ◽

Chronic Obstructive ◽

Grey Zone ◽

Obstructive Pulmonary Disease ◽

Home Setting

BACKGROUND Chronic obstructive pulmonary disease (COPD) is a global public health problem, and continuous monitoring is essential for both its management as well as the management of other chronic diseases. Telemonitoring using mobile health (mHealth) devices has the potential to promote self-management, improve control, increase quality of life, and prevent hospital admissions. OBJECTIVE This feasibility and proof-of-concept study aims to assess utility (sensitivity, accuracy, and reproducibility) of biosensing (mHealth) devices in monitoring of physical activity and respiratory function in smokers with and without respiratory symptoms/COPD. METHODS A total of 3 cohorts, with 9 participants in each, used mHealth devices for 90 days while undergoing the current standard of care. These groups were: 9 “non-COPD,” otherwise healthy, smokers; 9 “grey zone” smokers (forced expiratory volume in 1 second/ forced vital capacity ≥0.70 after bronchodilator treatment; COPD Assessment Test ≥10); and 9 smokers diagnosed with Stage 1-3 COPD. Rates of recruitment, retention, and adherence will be measured. Overall, two mHealth devices were utilized in the study: (1) the AnaMed Original Equipment Manufacturer device (OEM) that measures distance, energy expenditure, heart rate, and heart rate variability by using photoplethysmographic method and displays the results on a watchface, smartphone or a tablet, and (2) the Air Next mobile spirometry device portable device that performs spirometric measurements (FEV1, FVC and FEV1/FVC) ratio by a turbine mechanism and displays the results on a smartphone or a tablet. The mHealth devices were compared against industry standards. Additionally, a questionnaire will be administered to assess the participants’ perceptions of the mHealth technologies used. RESULTS The AnaMed device was demonstrated as precise in measuring heart rate, and less so when measuring number of steps and meters. It is unreliable in measuring SpO2. It is easy to use, requires no significant technical support. The Air-Next Spirometer is a simple and very precise instrument for detecting obstructive airway diseases which was confirmed when compared with the industry standard. It is easy to use, which could make it especially useful non-specialized care and in-home setting and other areas. CONCLUSIONS We demonstrated that both devices, AnaMed and AirNext can provide precise measurements or heart rate and spirometric data, and it is feasible to incorporate them into a large-scale study. However, such task would require serious efforts to hire technical staff and to provide additional training for the clinical investigators to take care of technical and logistical issues, i.e. sending reminders, synching devices with smartphones, communication efforts. CLINICALTRIAL ClinicalTrials.gov NCT04081961; https://clinicaltrials.gov/ct2/show/NCT04081961

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Altered skeletal muscle mitochondrial phenotype in COPD: disease vs. disuse

Journal of Applied Physiology ◽

10.1152/japplphysiol.00788.2017 ◽

2018 ◽

Vol 124 (4) ◽

pp. 1045-1053 ◽

Cited By ~ 9

Author(s):

Jayson R. Gifford ◽

Joel D. Trinity ◽

Oh-Sung Kwon ◽

Gwenael Layec ◽

Ryan S. Garten ◽

...

Keyword(s):

Oxidative Stress ◽

Physical Activity ◽

Chronic Obstructive Pulmonary Disease ◽

Skeletal Muscle ◽

Pulmonary Disease ◽

Respiratory Function ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Mitochondrial Density ◽

Control Subjects

Patients with chronic obstructive pulmonary disease (COPD) exhibit an altered skeletal muscle mitochondrial phenotype, which often includes reduced mitochondrial density, altered respiratory function, and elevated oxidative stress. As this phenotype may be explained by the sedentary lifestyle that commonly accompanies this disease, the aim of this study was to determine whether such alterations are still evident when patients with COPD are compared to control subjects matched for objectively measured physical activity (PA; accelerometry). Indexes of mitochondrial density [citrate synthase (CS) activity], respiratory function (respirometry in permeabilized fibers), and muscle oxidative stress [4-hydroxynonenal (4-HNE) content] were assessed in muscle fibers biopsied from the vastus lateralis of nine patients with COPD and nine PA-matched control subjects (CON). Despite performing similar levels of PA (CON: 18 ± 3, COPD: 20 ± 7 daily minutes moderate-to-vigorous PA; CON: 4,596 ± 683, COPD: 4,219 ± 763 steps per day, P > 0.70), patients with COPD still exhibited several alterations in their mitochondrial phenotype, including attenuated skeletal muscle mitochondrial density (CS activity; CON 70.6 ± 3.8, COPD 52.7 ± 6.5 U/mg, P < 0.05), altered mitochondrial respiration [e.g., ratio of complex I-driven state 3 to complex II-driven state 3 (CI/CII); CON: 1.20 ± 0.11, COPD: 0.90 ± 0.05, P < 0.05), and oxidative stress (4-HNE; CON: 1.35 ± 0.19, COPD: 2.26 ± 0.25 relative to β-actin, P < 0.05). Furthermore, CS activity ( r = 0.55), CI/CII ( r = 0.60), and 4-HNE ( r = 0.49) were all correlated with pulmonary function, assessed as forced expiratory volume in 1 s ( P < 0.05), but not PA ( P > 0.05). In conclusion, the altered mitochondrial phenotype in COPD is present even in the absence of differing levels of PA and appears to be related to the disease itself. NEW & NOTEWORTHY Chronic obstructive pulmonary disease (COPD) is associated with debilitating alterations in the function of skeletal muscle mitochondria. By comparing the mitochondrial phenotype of patients with COPD to that of healthy control subjects who perform the same amount of physical activity each day, this study provides evidence that many aspects of the dysfunctional mitochondrial phenotype observed in COPD are not merely due to reduced physical activity but are likely related to the disease itself.

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Feasibility of Using a Smartwatch to Intensively Monitor Patients With Chronic Obstructive Pulmonary Disease: Prospective Cohort Study (Preprint)

10.2196/preprints.10046 ◽

2018 ◽

Author(s):

Robert Wu ◽

Daniyal Liaqat ◽

Eyal de Lara ◽

Tatiana Son ◽

Frank Rudzicz ◽

...

Keyword(s):

Physical Activity ◽

Chronic Obstructive Pulmonary Disease ◽

Heart Rate ◽

Pulmonary Disease ◽

Predictive Analytics ◽

Sensor Data ◽

Chronic Obstructive ◽

Activity Data ◽

Obstructive Pulmonary Disease ◽

Technical Issues

BACKGROUND Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with accelerated decline in lung function, diminished quality of life, and higher mortality. Proactively monitoring patients for early signs of an exacerbation and treating them early could prevent these outcomes. The emergence of affordable wearable technology allows for nearly continuous monitoring of heart rate and physical activity as well as recording of audio which can detect features such as coughing. These signals may be able to be used with predictive analytics to detect early exacerbations. Prior to full development, however, it is important to determine the feasibility of using wearable devices such as smartwatches to intensively monitor patients with COPD. OBJECTIVE We conducted a feasibility study to determine if patients with COPD would wear and maintain a smartwatch consistently and whether they would reliably collect and transmit sensor data. METHODS Patients with COPD were recruited from 3 hospitals and were provided with a smartwatch that recorded audio, heart rate, and accelerations. They were asked to wear and charge it daily for 90 days. They were also asked to complete a daily symptom diary. At the end of the study period, participants were asked what would motivate them to regularly use a wearable for monitoring of their COPD. RESULTS Of 28 patients enrolled, 16 participants completed the full 90 days. The average age of participants was 68.5 years, and 36% (10/28) were women. Survey, heart rate, and activity data were available for an average of 64.5, 65.1, and 60.2 days respectively. Technical issues caused heart rate and activity data to be unavailable for approximately 13 and 17 days, respectively. Feedback provided by participants indicated that they wanted to actively engage with the smartwatch and receive feedback about their activity, heart rate, and how to better manage their COPD. CONCLUSIONS Some patients with COPD will wear and maintain smartwatches that passively monitor audio, heart rate, and physical activity, and wearables were able to reliably capture near-continuous patient data. Further work is necessary to increase acceptability and improve the patient experience.

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