Dataset Information

Reliability of Wearable-Sensor-Derived Measures of Physical Activity in Wheelchair-Dependent Spinal Cord Injured Patients.

ABSTRACT: Physical activity (PA) has been shown to have a positive influence on functional recovery in patients after a spinal cord injury (SCI). Hence, it can act as a confounder in clinical intervention studies. Wearable sensors are used to quantify PA in various neurological conditions. However, there is a lack of knowledge about the inter-day reliability of PA measures. The objective of this study was to investigate the single-day reliability of various PA measures in patients with a SCI and to propose recommendations on how many days of PA measurements are required to obtain reliable results. For this, PA of 63 wheelchair-dependent patients with a SCI were measured using wearable sensors. Patients of all age ranges (49.3 ± 16.6 years) and levels of injury (from C1 to L2, ASIA A-D) were included for this study and assessed at three to four different time periods during inpatient rehabilitation (2 weeks, 1 month, 3 months, and if applicable 6 months after injury) and after in-patient rehabilitation in their home-environment (at least 6 months after injury). The metrics of interest were total activity counts, PA intensity levels, metrics of wheeling quantity and metrics of movement quality. Activity counts showed consistently high single-day reliabilities, while measures of PA intensity levels considerably varied depending on the rehabilitation progress. Single-day reliabilities of metrics of movement quantity decreased with rehabilitation progress, while metrics of movement quality increased. To achieve a mean reliability of 0.8, we found that three continuous recording days are required for out-patients, and 2 days for in-patients. Furthermore, the results show similar weekday and weekend wheeling activity for in- and out-patients. To our knowledge, this is the first study to investigate the reliability of an extended set of sensor-based measures of PA in both acute and chronic wheelchair-dependent SCI patients. The results provide recommendations for sensor-based assessments of PA in clinical SCI studies.

SUBMITTER: Schneider S

PROVIDER: S-EPMC6295582 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Reliability of Wearable-Sensor-Derived Measures of Physical Activity in Wheelchair-Dependent Spinal Cord Injured Patients.

Schneider Sophie S Popp Werner L WL Brogioli Michael M Albisser Urs U Demkó László L Debecker Isabelle I Velstra Inge-Marie IM Gassert Roger R Curt Armin A

Frontiers in neurology 20181210

Physical activity (PA) has been shown to have a positive influence on functional recovery in patients after a spinal cord injury (SCI). Hence, it can act as a confounder in clinical intervention studies. Wearable sensors are used to quantify PA in various neurological conditions. However, there is a lack of knowledge about the inter-day reliability of PA measures. The objective of this study was to investigate the single-day reliability of various PA measures in patients with a SCI and to propos ...[more]

PMID: 30619026

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Project description:IntroductionCardiovascular and metabolic diseases are a growing concern for individuals with spinal cord injury (SCI). Physical inactivity contributes to cardiometabolic morbidity and mortality in the SCI population. However, previous studies have shown mixed results regarding the effects of exercise on cardiometabolic risk factors in individuals with SCI. This discrepancy could be influenced by insufficient exercise stimuli. Recent guidelines recommend 30 min of moderate-to-vigorous intensity aerobic exercise, three times per week, for improvement in cardiometabolic health in individuals with SCI. However, to date, no studies have implemented an exercise intervention matching the new recommendations to examine the effects on cardiometabolic risk factors. Therefore, the primary objective of this study is to determine the effects of 12 weeks of wheelchair user-modified upper-body rowing exercise on both traditional (constituents of the metabolic syndrome) and novel (eg, vascular structure and function) cardiometabolic risk factors in manual wheelchair users with SCI.Methods and analysisA randomised controlled trial will compare 12 weeks of upper-body rowing exercise, 30 min three times per week, with a control group continuing their normal lifestyle. Outcome measurements will be performed immediately before (baseline), after 6 weeks (halfway), 12 weeks of training (post) and 6 months after the termination of the intervention period (follow-up). Outcomes will include inflammatory (eg, C reactive protein) and metabolic biomarkers determined from venous blood (with serum fasting insulin as primary outcome), body composition, arterial blood pressure, cardiorespiratory fitness level, brachial artery vascular structure and function and autonomic nervous system function.Ethics and disseminationThis trial is reported to the Danish Data Protection Agency (J.nr. 2019-899/10-0406) and approved by the Committees on Health Research Ethics in The North Denmark Region on 12 December 2019 (J.nr. N-20190053). The principal investigator will collect written informed consent from all participants prior to inclusion. Irrespective of study outcomes, the results will be submitted to peer-reviewed scientific journals for publication.Trial registration numberNCT04390087.

Project description:Promoting the combination of robust regeneration of damaged axons and synaptic reconnection of these growing axon populations with appropriate neuronal targets represents a major therapeutic goal following spinal cord injury (SCI). A key impediment to achieving this important aim includes an intrinsic inability of neurons to extend axons in adult CNS, particularly in the context of the chronically-injured spinal cord. We tested whether an inhibitory peptide directed against phosphatase and tensin homolog (PTEN: a central inhibitor of neuron-intrinsic axon growth potential) could restore inspiratory diaphragm function by reconnecting critical respiratory neural circuitry in a rat model of chronic cervical level 2 (C2) hemisection SCI. We found that systemic delivery of PTEN antagonist peptide 4 (PAP4) starting at 8 weeks after C2 hemisection promoted substantial, long-distance regeneration of injured bulbospinal rostral Ventral Respiratory Group (rVRG) axons into and through the lesion and back toward phrenic motor neurons (PhMNs) located in intact caudal C3-C5 spinal cord. Despite this robust rVRG axon regeneration, PAP4 stimulated only minimal recovery of diaphragm function. Furthermore, re-lesion through the hemisection site completely removed PAP4-induced functional improvement, demonstrating that axon regeneration through the lesion was responsible for this partial functional recovery. Interestingly, there was minimal formation of putative excitatory monosynaptic connections between regrowing rVRG axons and PhMN targets, suggesting that (1) limited rVRG-PhMN synaptic reconnectivity was responsible at least in part for the lack of a significant functional effect, (2) chronically-injured spinal cord presents an obstacle to achieving synaptogenesis between regenerating axons and post-synaptic targets, and (3) addressing this challenge is a potentially-powerful strategy to enhance therapeutic efficacy in the chronic SCI setting. In conclusion, our study demonstrates a non-invasive and transient pharmacological approach in chronic SCI to repair the critically-important neural circuitry controlling diaphragmatic respiratory function, but also sheds light on obstacles to circuit plasticity presented by the chronically-injured spinal cord.

Dataset Information

Reliability of Wearable-Sensor-Derived Measures of Physical Activity in Wheelchair-Dependent Spinal Cord Injured Patients.

Publications

Reliability of Wearable-Sensor-Derived Measures of Physical Activity in Wheelchair-Dependent Spinal Cord Injured Patients.

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