Dataset Information

Wearable Sensors in Ambulatory Individuals With a Spinal Cord Injury: From Energy Expenditure Estimation to Activity Recommendations.

ABSTRACT: Inappropriate physical inactivity is a global health problem increasing the risk of cardiometabolic diseases. Wearable sensors show great potential to promote physical activity and thus a healthier lifestyle. While commercial activity trackers are available to estimate energy expenditure (EE) in non-disabled individuals, they are not designed for reliable assessments in individuals with an incomplete spinal cord injury (iSCI). Furthermore, activity recommendations for this population are currently rather vague and not tailored to their individual needs, and activity guidelines provided for the non-disabled population may not be easily translated for this population. However, especially in iSCI individuals with impaired abilities to stand and walk, the assessment of physical activities and appropriate recommendations for a healthy lifestyle are challenging. Therefore, the study aimed at developing an EE estimation model for iSCI individuals able to walk based on wearable sensor data. Additionally, the data collected within this study was used to translate common activity recommendations for the non-disabled population to easily understandable activity goals for ambulatory individuals with an iSCI. In total, 30 ambulatory individuals with an iSCI were equipped with wearable sensors while performing 12 different physical activities. EE was measured continuously and demographic and anthropometric variables, clinical assessment scores as well as wearable-sensor-derived features were used to develop different EE estimation models. The best EE estimation model comprised the estimation of resting EE using the updated Harris-Benedict equation, classifying activities using a k-nearest neighbor algorithm, and applying a multiple linear regression-based EE estimation model for each activity class. The mean absolute estimation error of this model was 15.2 ± 6.3% and the corresponding mean signed error was -3.4 ± 8.9%. Translating activity recommendations of global health institutions, we suggest a minimum of 2,000-3,000 steps per day for ambulatory individuals with an iSCI. If ambulatory individuals with an iSCI targeted the popular 10,000 steps a day recommendation for the non-disabled population, their equivalent would be around 8,000 steps a day. The combination of the presented dedicated EE estimation model for ambulatory individuals with an iSCI and the translated activity recommendations is an important step toward promoting an active lifestyle in this population.

SUBMITTER: Popp WL

PROVIDER: S-EPMC6838774 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Wearable Sensors in Ambulatory Individuals With a Spinal Cord Injury: From Energy Expenditure Estimation to Activity Recommendations.

Popp Werner L WL Schneider Sophie S Bär Jessica J Bösch Philipp P Spengler Christina M CM Gassert Roger R Curt Armin A

Frontiers in neurology 20191101

Inappropriate physical inactivity is a global health problem increasing the risk of cardiometabolic diseases. Wearable sensors show great potential to promote physical activity and thus a healthier lifestyle. While commercial activity trackers are available to estimate energy expenditure (EE) in non-disabled individuals, they are not designed for reliable assessments in individuals with an incomplete spinal cord injury (iSCI). Furthermore, activity recommendations for this population are current ...[more]

PMID: 31736845

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Project description:BACKGROUND:Monitoring physical activity and leveraging wearable sensor technologies to facilitate active living in individuals with neurological impairment has been shown to yield benefits in terms of health and quality of living. In this context, accurate measurement of physical activity estimates from these sensors are vital. However, wearable sensor manufacturers generally only provide standard proprietary algorithms based off of healthy individuals to estimate physical activity metrics which may lead to inaccurate estimates in population with neurological impairment like stroke and incomplete spinal cord injury (iSCI). The main objective of this cross-sectional investigation was to evaluate the validity of physical activity estimates provided by standard proprietary algorithms for individuals with stroke and iSCI. Two research grade wearable sensors used in clinical settings were chosen and the outcome metrics estimated using standard proprietary algorithms were validated against designated golden standard measures (Cosmed K4B2 for energy expenditure and metabolic equivalent and manual tallying for step counts). The influence of sensor location, sensor type and activity characteristics were also studied. METHODS:28 participants (Healthy (n = 10); incomplete SCI (n = 8); stroke (n = 10)) performed a spectrum of activities in a laboratory setting using two wearable sensors (ActiGraph and Metria-IH1) at different body locations. Manufacturer provided standard proprietary algorithms estimated the step count, energy expenditure (EE) and metabolic equivalent (MET). These estimates were compared with the estimates from gold standard measures. For verifying validity, a series of Kruskal Wallis ANOVA tests (Games-Howell multiple comparison for post-hoc analyses) were conducted to compare the mean rank and absolute agreement of outcome metrics estimated by each of the devices in comparison with the designated gold standard measurements. RESULTS:The sensor type, sensor location, activity characteristics and the population specific condition influences the validity of estimation of physical activity metrics using standard proprietary algorithms. CONCLUSIONS:Implementing population specific customized algorithms accounting for the influences of sensor location, type and activity characteristics for estimating physical activity metrics in individuals with stroke and iSCI could be beneficial.

Project description:BackgroundSpinal cord injury (SCI) is a serious clinical condition that impacts a patient's physical, psychological, and socio-economic status. The aim of this pilot study was to evaluate the effects of training with a newly developed powered wearable exoskeleton (Hyundai Medical Exoskeleton [H-MEX]) on functional mobility, physiological health, and quality of life in non-ambulatory SCI patients.MethodsParticipants received 60 minutes of walking training with a powered exoskeleton 3 times per week for 10 weeks (total 30 sessions). The 6-minute walking test (6MWT) and timed-up-and-go test (TUGT) were performed to assess ambulatory function. The physiological outcomes of interest after exoskeleton-assisted walking training were spasticity, pulmonary function, bone mineral density, colon transit time, and serum inflammatory markers. Effects of walking training on subjective outcomes were estimated by the Korean version of the Falls Efficacy Scale-International and the 36-Item Short-Form Health Survey version 2.ResultsTen participants finished 30 sessions of training and could ambulate independently. No severe adverse events were reported during the study. After training, the mean distance walked in the 6MWT (49.13 m) was significantly enhanced compared with baseline (20.65 m). The results of the TUGT also indicated a statistically significant improvement in the times required to stand up, walk 3 m and sit down. Although not statistically significant, clinically meaningful changes in some secondary physiological outcomes and/or quality of life were reported in some participants.ConclusionIn conclusion, this study demonstrated that the newly developed wearable exoskeleton, H-MEX is safe and feasible for non-ambulatory SCI patients, and may have potential to improve quality of life of patients by assisting bipedal ambulation. These results suggest that the H-MEX can be considered a beneficial device for chronic non-ambulatory SCI patients.Trial registrationClinicalTrials.gov Identifier: NCT04055610.

Project description:PURPOSE:To assess the validity of a derived algorithm, combining tri-axial accelerometry and heart rate (HR) data, compared to a research-grade multi-sensor physical activity device, for the estimation of ambulatory physical activity energy expenditure (PAEE) in individuals with traumatic lower-limb amputation. METHODS:Twenty-eight participants [unilateral (n = 9), bilateral (n = 10) with lower-limb amputations, and non-injured controls (n = 9)] completed eight activities; rest, ambulating at 5 progressive treadmill velocities (0.48, 0.67, 0.89, 1.12, 1.34m.s-1) and 2 gradients (3 and 5%) at 0.89m.s-1. During each task, expired gases were collected for the determination of [Formula: see text] and subsequent calculation of PAEE. An Actigraph GT3X+ accelerometer was worn on the hip of the shortest residual limb and, a HR monitor and an Actiheart (AHR) device were worn on the chest. Multiple linear regressions were employed to derive population-specific PAEE estimated algorithms using Actigraph GT3X+ outputs and HR signals (GT3X+HR). Mean bias±95% Limits of Agreement (LoA) and error statistics were calculated between criterion PAEE (indirect calorimetry) and PAEE predicted using GT3X+HR and AHR. RESULTS:Both measurement approaches used to predict PAEE were significantly related (P<0.01) with criterion PAEE. GT3X+HR revealed the strongest association, smallest LoA and least error. Predicted PAEE (GT3X+HR; unilateral; r = 0.92, bilateral; r = 0.93, and control; r = 0.91, and AHR; unilateral; r = 0.86, bilateral; r = 0.81, and control; r = 0.67). Mean±SD percent error across all activities were 18±14%, 15±12% and 15±14% for the GT3X+HR and 45±20%, 39±23% and 34±28% in the AHR model, for unilateral, bilateral and control groups, respectively. CONCLUSIONS:Statistically derived algorithms (GT3X+HR) provide a more valid estimate of PAEE in individuals with traumatic lower-limb amputation, compared to a proprietary group calibration algorithm (AHR). Outputs from AHR displayed considerable random error when tested in a laboratory setting in individuals with lower-limb amputation.

Project description:Gait speed is a powerful clinical marker for mobility impairment in patients suffering from neurological disorders. However, assessment of gait speed in coordination with delivery of comprehensive care is usually constrained to clinical environments and is often limited due to mounting demands on the availability of trained clinical staff. These limitations in assessment design could give rise to poor ecological validity and limited ability to tailor interventions to individual patients. Recent advances in wearable sensor technologies have fostered the development of new methods for monitoring parameters that characterize mobility impairment, such as gait speed, outside the clinic, and therefore address many of the limitations associated with clinical assessments. However, these methods are often validated using normal gait patterns; and extending their utility to subjects with gait impairments continues to be a challenge. In this paper, we present a machine learning method for estimating gait speed using a configurable array of skin-mounted, conformal accelerometers. We establish the accuracy of this technique on treadmill walking data from subjects with normal gait patterns and subjects with multiple sclerosis-induced gait impairments. For subjects with normal gait, the best performing model systematically overestimates speed by only 0.01 m/s, detects changes in speed to within less than 1%, and achieves a root-mean-square-error of 0.12 m/s. Extending these models trained on normal gait to subjects with gait impairments yields only minor changes in model performance. For example, for subjects with gait impairments, the best performing model systematically overestimates speed by 0.01 m/s, quantifies changes in speed to within 1%, and achieves a root-mean-square-error of 0.14 m/s. Additional analyses demonstrate that there is no correlation between gait speed estimation error and impairment severity, and that the estimated speeds maintain the clinical significance of ground truth speed in this population. These results support the use of wearable accelerometer arrays for estimating walking speed in normal subjects and their extension to MS patient cohorts with gait impairment.

Dataset Information

Wearable Sensors in Ambulatory Individuals With a Spinal Cord Injury: From Energy Expenditure Estimation to Activity Recommendations.

Publications

Wearable Sensors in Ambulatory Individuals With a Spinal Cord Injury: From Energy Expenditure Estimation to Activity Recommendations.

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