Dataset Information

Monitoring Walking Activity with Wearable Technology in Rural-dwelling Older Adults in Tanzania: A Feasibility Study Nested within a Frailty Prevalence Study.

ABSTRACT: BACKGROUND:Older adults with lower levels of activity can be at risk of poor health outcomes. Wearable technology has improved the acceptability and objectivity of measuring activity for older adults in high-income countries. Nevertheless, the technology is under-utilized in low-to-middle income countries. The aim was to explore feasibility, acceptability and utility of wearable technology to measure walking activity in rural-dwelling, older Tanzanians. METHODS:A total of 65 participants (73.9 ± 11.2 years), 36 non-frail and 29 frail, were assessed. Free-living data were recorded for 7 days with an accelerometer on the lower back. Data were analyzed via an automatic cloud-based pipeline: volume, pattern and variability of walking were extracted. Acceptability questionnaires were completed. T-tests were used for comparison between the groups. RESULTS:59/65 datasets were analyzed. Questionnaires indicated that 15/65 (23.0%) experienced some therapeutic benefit from the accelerometer, 15/65 (23.0%) expected diagnostic benefit; 16/65 (24.6%) experienced symptoms while wearing the accelerometer (e.g. itching). Frail adults walked significantly less, had less variable walking patterns, and had a greater proportion of shorter walking bouts compared to the non-frail. CONCLUSION:This study suggests that important contextual and practical limitations withstanding wearable technology may be feasible for measuring walking activity in older rural-dwelling adults in low-income settings, identifying those with frailty.

SUBMITTER: Del Din S

PROVIDER: S-EPMC7497586 | biostudies-literature | 2020 Oct-Dec

REPOSITORIES: biostudies-literature

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Monitoring Walking Activity with Wearable Technology in Rural-dwelling Older Adults in Tanzania: A Feasibility Study Nested within a Frailty Prevalence Study.

Del Din Silvia S Lewis Emma Grace EG Gray William K WK Collin Harry H Kissima John J Rochester Lynn L Dotchin Catherine C Urasa Sarah S Walker Richard R

Experimental aging research 20200708 5

<h4>Background</h4>Older adults with lower levels of activity can be at risk of poor health outcomes. Wearable technology has improved the acceptability and objectivity of measuring activity for older adults in high-income countries. Nevertheless, the technology is under-utilized in low-to-middle income countries. The aim was to explore feasibility, acceptability and utility of wearable technology to measure walking activity in rural-dwelling, older Tanzanians.<h4>Methods</h4>A total of 65 parti ...[more]

PMID: 32643558

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Project description:Humans routinely modify their walking speed to adapt to functional goals and physical demands. However, damage to the central nervous system (CNS) often results in abnormal modulation of walking speed and increased risk of falls. There is considerable interest in treatment modalities that can provide safe and salient training opportunities, feedback about walking performance, and that may augment less reliable sensory feedback within the CNS after injury or disease. Fully immersive virtual reality technologies show benefits in boosting training-related gains in walking performance; however, they lack views of the real world that may limit functional carryover. Augmented reality and mixed reality head-mount displays (MR-HMD) provide partially immersive environments to extend the virtual reality benefits of interacting with virtual objects but within an unobstructed view of the real world. Despite this potential advantage, the feasibility of using MR-HMD visual feedback to promote goal-directed changes in overground walking speed remains unclear. Thus, we developed and evaluated a novel mixed reality application using the Microsoft HoloLens MR-HMD that provided real-time walking speed targets and augmented visual feedback during overground walking. We tested the application in a group of adults not living with disability and examined if they could use the targets and visual feedback to walk at 85%, 100%, and 115% of each individual's self-selected speed. We examined whether individuals were able to meet each target gait speed and explored differences in accuracy across repeated trials and at the different speeds. Additionally, given the importance of task-specificity to therapeutic interventions, we examined if walking speed adjustment strategies were consistent with those observed during usual overground walking, and if walking with the MR-HMD resulted in increased variability in gait parameters. Overall, participants matched their overground walking speed to the target speed of the MR-HMD visual feedback conditions (all p-values > 0.05). The percent inaccuracy was approximately 5% across all speed matching conditions and remained consistent across walking trials after the first overall walking trial. Walking with the MR-HMD did not result in more variability in walking speed, however, we observed more variability in stride length and time when walking with feedback from the MR-HMD compared to walking without feedback. The findings offer support for mixed reality-based visual feedback as a method to provoke goal-specific changes in overground walking behavior. Further studies are necessary to determine the clinical safety and efficacy of this MR-HMD technology to provide extrinsic sensory feedback in combination with traditional treatments in rehabilitation.

Project description:Few studies of the association between prospective falls and sensor-based measures of motor performance and physical activity (PA) have evaluated subgroups of frailty status separately.To evaluate wearable sensor-based measures of gait, balance, and PA that are predictive of future falls in community-dwelling older adults.The Arizona Frailty Cohort Study in Tucson, Arizona, followed community-dwelling adults aged 65 years and over (without baseline cognitive deficit, severe movement disorders, or recent stroke) for falls over 6 months. Baseline measures included Fried frailty criteria: in-home and sensor-based gait (normal and fast walk), balance (bipedal eyes open and eyes closed), and spontaneous daily PA over 48 h, measured using validated wearable technologies.Of the 119 participants (36% non-frail, 48% pre-frail, and 16% frail), 48 reported one or more fall (47% of non-frail, 33% of pre-frail, and 47% of frail). Although balance deficit and PA were independent fall predictors in pre-frail and frail groups, they were not sensitive to predict prospective falls in the non-frail group. Even though gait performance deteriorated as frailty increased, gait was not a predictor of prospective falls when participants were stratified based on frailty status. In pre-frail and frail participants combined, center of mass sway [odds ratio (OR) = 5.9, 95% confidence interval (CI) 2.6-13.7], PA mean walking bout duration (OR = 1.1, 95% CI 1.0-1.2), PA mean standing bout duration (OR = 0.94, 95% CI 0.91-0.99), and a fall in previous 6 months (OR = 7.3, 95% CI 1.5-36.4) were independent predictors of prospective falls (area under the curve: 0.882).This study suggests that independent predictors of falls are dependent on frailty status. Among sensor-derived parameters, balance deficit, longer typical walking episodes, and shorter typical standing episodes were the most sensitive predictors of prospective falls in the combined pre-frail and frail sample. Gait deficit was not a sensitive fall predictor in the context of frailty status.

Project description:IntroductionBreast cancer (BC) survivors often suffer from disease- and therapy-related long-term side-effects. The study aim was to explore the feasibility, adherence, and individual experiences as well as possible effects of 2 different walking interventions in BC patients.MethodsThis randomized controlled, pragmatic pilot trial included a qualitative study component. BC patients were randomized to either mindful walking (MFW) with mindfulness exercises and walking or moderate walking (MW) alone in weekly group sessions over 8 weeks. After 8 and 16 weeks, satisfaction, and self-perceived effectiveness as well as different health-related outcomes including health-related (WHOQOL-BREF) and disease-specific quality of life (FACT-G), perceived stress (PSQ) and cancer-related fatigue (CFS-D) were assessed. ANCOVA was used to evaluate differences in study outcomes. Qualitative data included 4 focus group interviews including 20 patients and were analyzed using a directed qualitative content analysis approach.ResultsAltogether, 51 women (mean age 55.8 years (SD 10.9)) were randomized (n = 24 MFW; n = 27 MW). Both groups would recommend the course to other BC patients (MFW 88.9%; MW 95.2%) and showed possible improvements from baseline to week 8, without statistically significant difference between groups: WHOQOL-BREF (MFW: adjusted mean 65.4 (95% confidence interval (CI), 57.1-73.7); MW: 61.6 (53.6-69.6)); FACT-G (MFW: 76.0 (71.5-80.5); MW: 73.0 (68.5-77.4)); PSQ (MFW: 45.3 (40.5-50.1); MW: 45.4 (40.8-50.0)); CFS-D (MFW: 24.3 (20.8-27.8); MW: 25.5 (22.1-28.8)). Improvements lasted until the 16-weeks follow-up. The qualitative analysis suggested that MFW primarily promoted mindfulness, self-care, and acceptability in BC patients, whereas MW activated and empowered the patients as a result of the physical exercise.ConclusionBoth study interventions were positively evaluated by patients and showed possible pre-post effects in disease-specific health-related outcomes without differences between groups. The qualitative analysis results indicate that different resources and coping strategies were addressed by the 2 study interventions.Trial registrationDKRS00011521; prospectively registered 21.12.2016; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011521.

Project description:An increasing number of mobile app interventions have been developed for problem drinking among college students; however, few studies have examined the integration of a mobile app with continuous physiological monitoring and alerting of affective states related to drinking behaviors.The aim of this paper was to evaluate the acceptability and feasibility of Mind the Moment (MtM), a theoretically based intervention for female college students with problem drinking that combines brief, in-person counseling with ecological momentary intervention (EMI) on a mobile app integrated with a wearable sensorband.We recruited 10 non-treatment seeking, female undergraduates from a university health clinic who scored a 3 or higher on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) to participate in this pilot study. Study activities involved an in-person baseline intake and 1 follow-up assessment, 2 in-person alcohol brief intervention counseling sessions, and use of MtM technology components (sensorband and EMI on a mobile app) for approximately 3-4 weeks. The intervention used motivational interviewing (MI) and cognitive behavioral therapy (CBT) strategies for reducing risks associated with drinking. We used both qualitative and quantitative assessments to measure acceptability of the intervention and feasibility of delivery. Use patterns of the sensorband and mobile app were also collected.Quantitative and qualitative data indicated high levels of acceptability for the MtM intervention. Altogether, participants made reports on the app on 26.7% (78/292) the days the technology was available to them and completed a total of 325 reports with wide variation between participants. Qualitative findings indicated that sensorband-elicited alerts promoted an increase in awareness of thoughts, feelings, and behaviors related to current environmental stressors and drinking behaviors in theoretically meaningful ways. Specific challenges related to functionality and form of the sensorband were identified.Delivering intervention material "just-in-time," at the moment participants need to use behavioral strategies has great potential to individualize behavioral interventions for reducing problem drinking and other health behaviors. These findings provide initial evidence for the promise of wearable sensors for increasing potency of theoretically grounded mobile health interventions and point to directions for future research and uptake of these technologies.

Dataset Information

Monitoring Walking Activity with Wearable Technology in Rural-dwelling Older Adults in Tanzania: A Feasibility Study Nested within a Frailty Prevalence Study.

Publications

Monitoring Walking Activity with Wearable Technology in Rural-dwelling Older Adults in Tanzania: A Feasibility Study Nested within a Frailty Prevalence Study.

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