Physical Activity Measurement Accuracy in Individuals With Chronic Lung Disease: A Systematic Review With Meta-Analysis of Method Comparison Studies

Dhillon, Satvir S.; Sima, Carmen A.; Kirkham, Ashley; Syed, Nafeez; Camp, Pat G.

doi:10.1016/j.apmr.2015.05.015

Cited by 20 publications

(13 citation statements)

References 38 publications

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“…Although acceptance of the monitors was high, the total data recording times were insufficient in many patients to obtain meaningful results. The reasons for this require further exploration; although this may be a useful secondary outcome, 168,[184][185][186] it is difficult to recommend this marker as a primary outcome.…”

Section: Discussionmentioning

confidence: 99%

The feasibility of early pulmonary rehabilitation and activity after COPD exacerbations: external pilot randomised controlled trial, qualitative case study and exploratory economic evaluation

Cox

O’Connor

Biggs

et al. 2018

Health Technol Assess

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BackgroundChronic obstructive pulmonary disease (COPD) affects > 3 million people in the UK. Acute exacerbations of COPD (AECOPD) are the second most common reason for emergency hospital admission in the UK. Pulmonary rehabilitation is usual care for stable COPD but there is little evidence for early pulmonary rehabilitation (EPR) following AECOPD, either in hospital or immediately post discharge.ObjectiveTo assess the feasibility of recruiting patients, collecting data and delivering EPR to patients with AECOPD to evaluate EPR compared with usual care.DesignParallel-group, pilot 2 × 2 factorial randomised trial with nested qualitative research and an economic analysis.SettingTwo acute hospital NHS trusts. Recruitment was carried out from September 2015 to April 2016 and follow-up was completed in July 2016.ParticipantsEligible patients were those aged ≥ 35 years who were admitted with AECOPD, who were non-acidotic and who maintained their blood oxygen saturation level (SpO2) within a prescribed range. Exclusions included the presence of comorbidities that affected the ability to undertake the interventions.Interventions(1) Hospital EPR: muscle training delivered at the patient’s hospital bed using a cycle ergometer and (2) home EPR: a pulmonary rehabilitation programme delivered in the patient’s home. Both interventions were delivered by trained physiotherapists. Participants were allocated on a 1 : 1 : 1 : 1 ratio to (1) hospital EPR (n = 14), (2) home EPR (n = 15), (3) hospital EPR and home EPR (n = 14) and (4) control (n = 15). Outcome assessors were blind to treatment allocation; it was not possible to blind patients.Main outcome measuresFeasibility of recruiting 76 participants in 7 months at two centres; intervention delivery; views on intervention/research acceptability; clinical outcomes including the 6-minute walk distance (6WMD); and costs. Semistructured interviews with participants (n = 27) and research health professionals (n = 11), optimisation assessments and an economic analysis were also undertaken.ResultsOver 7 months 449 patients were screened, of whom most were not eligible for the trial or felt too ill/declined entry. In total, 58 participants (76%) of the target 76 participants were recruited to the trial. The primary clinical outcome (6MWD) was difficult to collect (hospital EPR,n = 5; home EPR,n = 6; hospital EPR and home EPR,n = 5; control,n = 5). Hospital EPR was difficult to deliver over 5 days because of patient discharge/staff availability, with 34.1% of the scheduled sessions delivered compared with 78.3% of the home EPR sessions. Serious adverse events were experienced by 26 participants (45%), none of which was related to the interventions. Interviewed participants generally found both interventions to be acceptable. Home EPR had a higher rate of acceptability, mainly because patients felt too unwell when in hospital to undergo hospital EPR. Physiotherapists generally found the interventions to be acceptable and valued them but found delivery difficult because of staffing issues. The health economic analysis results suggest that there would be value in conducting a larger trial to assess the cost-effectiveness of the hospital EPR and hospital EPR plus home EPR trial arms and collect more information to inform the hospital cost and quality-adjusted life-year parameters, which were shown to be key drivers of the model.ConclusionsA full-scale randomised controlled trial using this protocol would not be feasible. Recruitment and delivery of the hospital EPR intervention was difficult. The data obtained can be used to design a full-scale trial of home EPR. Because of the small sample and large confidence intervals, this study should not be used to inform clinical practice.Trial registrationCurrent Controlled Trials ISRCTN18634494.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 22, No. 11. See the NIHR Journals Library website for further project information.

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Section: Discussionmentioning

confidence: 99%

The feasibility of early pulmonary rehabilitation and activity after COPD exacerbations: external pilot randomised controlled trial, qualitative case study and exploratory economic evaluation

Cox

O’Connor

Biggs

et al. 2018

Health Technol Assess

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“…Lifestyle trackers that document and provide an around-the-clock record of activity and sleep habits may hold some promise for the future [48][49][50][51][52][53][54]. However, we have yet to effectively capture and document those daily lifestyle effects and changes that are more significant for patients with Morquio A.…”

Section: Expert Commentarymentioning

confidence: 99%

Elosulfase alfa (BMN 110) for the treatment of mucopolysaccharidosis IVA (Morquio A Syndrome)

Hendriksz

2016

Expert Review of Clinical Pharmacology

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“…The methodological quality of the validation studies included in this review was assessed using an adapted version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) framework [18,31]. Due to the heterogeneity of the included studies, a metaanalysis was not possible.…”

Section: Data Extractionmentioning

confidence: 99%

“…A number of reviews have been published which have examined the validity and reliability of using wearable sensors to measure physical activity in chronic lung disease and in stroke patients [14,18,19]. The studies included in these reviews were highly heterogeneous in terms of the type of activity monitor used, the activity monitor outcome reported, and the methods used for data collection and analysis.…”

Section: Introductionmentioning

confidence: 99%

“…The studies included in these reviews were highly heterogeneous in terms of the type of activity monitor used, the activity monitor outcome reported, and the methods used for data collection and analysis. Nonetheless, the evidence presented suggests that multiaxial accelerometer or multisensor devices appear to produce the most valid and reliable data about physical activity in chronic disease populations [14,18,19]. A recent systematic review concluded that remote physical activity monitoring is feasible in individuals with neurological diseases, including those with moderate-to-severe disability [20].…”

Section: Introductionmentioning

confidence: 99%

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Physical Activity Monitoring in Patients with Neurological Disorders: A Review of Novel Body-Worn Devices

2017

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Aim:The aim was to conduct a systematic review to examine the literature reporting the validity and reliability of wearable physical activity monitoring in individuals with neurological disorders. Method: A systematic search of the literature was performed using a specific search strategy in PubMed and CINAHL. A search constraint of articles published in English, including human participants, published between January 2008 and March 2017 was applied. Peerreviewed studies which enrolled adult participants with any neurological disorder were included. For the studies which sought to explore the validity of activity monitors, the outcomes measured using the monitor were compared to a criterion measure of physical activity. The studies' methodological quality was assessed using an adapted version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) framework. Data extracted from each study included the following: characteristics of the study participants, study setting, devices used, study protocol/methods, outcomes measured, and the validity/reliability of measurement produced. Results: Twenty-three studies examining the validity and reliability of 16 different monitors were included. The identified studies comprised participants with a range of different disorders of neurological origin. The available evidence suggests that biaxial or triaxial accelerometer devices positioned around the ankle produce the most accurate step count measurements in patients with neurological disorders. The findings regarding the reliability and validity of activity counts and energy expenditure are largely inconclusive in this population. Discussion: Ankle-worn biaxial or triaxial accelerometer-type devices provide the most accurate measurement of physical activity. However, further work is required in this field be-

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Physical Activity Measurement Accuracy in Individuals With Chronic Lung Disease: A Systematic Review With Meta-Analysis of Method Comparison Studies

Cited by 20 publications

References 38 publications

The feasibility of early pulmonary rehabilitation and activity after COPD exacerbations: external pilot randomised controlled trial, qualitative case study and exploratory economic evaluation

The feasibility of early pulmonary rehabilitation and activity after COPD exacerbations: external pilot randomised controlled trial, qualitative case study and exploratory economic evaluation

Elosulfase alfa (BMN 110) for the treatment of mucopolysaccharidosis IVA (Morquio A Syndrome)

Physical Activity Monitoring in Patients with Neurological Disorders: A Review of Novel Body-Worn Devices

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