Validation of five minimally obstructive methods to estimate physical activity energy expenditure in young adults in semi-standardized settings

We compared the accuracy of five objective methods, including two newly developed methods combining accelerometry and activity type recognition (Acti4), against indirect calorimetry, to estimate total energy expenditure (EE) of different activities in semi-standardized settings. Fourteen participants performed a standardized and semi-standardized protocol including seven daily life activity types, while having their EE measured by indirect calorimetry. Simultaneously, physical activity was quantified by an ActivPAL3, two ActiGraph GT3X+’s and an Actiheart. EE was estimated by the standard ActivPAL3 software (ActivPAL), ActiGraph GT3X+ (ActiGraph) and Actiheart (Actiheart), and by a combination of activity type recognition via Acti4 software and activity counts per minute (CPM) of either a hip- or thigh-worn ActiGraph GT3X+ (AGhip + Acti4 and AGthigh + Acti4). At group level, estimated physical activities EE by Actiheart (MSE = 2.05) and AGthigh + Acti4 (MSE = 0.25) were not significantly different from measured EE by indirect calorimetry, while significantly underestimated by ActiGraph, ActivPAL and AGhip + Acti4. AGthigh + Acti4 and Actiheart explained 77% and 45%, of the individual variations in measured physical activity EE by indirect calorimetry, respectively. This study concludes that combining accelerometer data from a thigh-worn ActiGraph GT3X+ with activity type recognition improved the accuracy of activity specific EE estimation against indirect calorimetry in semi-standardized settings compared to previously validated methods using CPM only

How well do activity monitors estimate energy expenditure? A systematic review and meta-analysis

Objective: To determine the accuracy of wrist and arm-worn activity monitors’ estimates of energy expenditure (EE). Data sources: SportDISCUS (EBSCOHost), PubMed, MEDLINE (Ovid), PsycINFO (EBSCOHost), Embase (Ovid) and CINAHL (EBSCOHost). Design: A random effects meta-analysis was performed to evaluate the difference in EE estimates between activity monitors and criterion measurements. Moderator analyses were conducted to determine the benefit of additional sensors and to compare the accuracy of devices used for research purposes with commercially available devices. Eligibility criteria: We included studies validating EE estimates from wrist-worn or arm-worn activity monitors against criterion measures (indirect calorimetry, room calorimeters and doubly labelled water) in healthy adult populations. Results: 60 studies (104 effect sizes) were included in the meta-analysis. Devices showed variable accuracy depending on activity type. Large and significant heterogeneity was observed for many devices (I2 >75%). Combining heart rate or heat sensing technology with accelerometry decreased the error in most activity types. Research-grade devices were statistically more accurate for comparisons of total EE but less accurate than commercial devices during ambulatory activity and sedentary tasks. Conclusions: EE estimates from wrist and arm-worn devices differ in accuracy depending on activity type. Addition of physiological sensors improves estimates of EE, and research-grade devices are superior for total EE. These data highlight the need to improve estimates of EE from wearable devices, and one way this can be achieved is with the addition of heart rate to accelerometry. PROSPEROregistration number: CRD42018085016

Gait monitoring: from the clinics to the daily life

Monitoring of gait in daily living allows a quantitative analysis of walking in unrestricted conditions, with many potential clinical applications. This thesis aims at addressing the limitations that still hinder the wider adoption of this approach in clinical practice, providing healthcare professionals and researchers new tools which may impact on current gait assessment procedures and improve the treatment of many diseases leading to – or generated by – mobility impairments. The thesis comprises four experimental sections: Accuracy of commercially-available devices. Step detection accuracy in currently available physical activity monitors was assessed in healthy individuals. The best performing device was then tested in multiple sclerosis patients, showing reliability but highly speed-dependent accuracy. These findings suggest that a short set of tests performed in controlled conditions could inform researchers before starting unsupervised monitoring of gait in patients. Differences between laboratory and free-living gait parameters. The study assessed the accuracy of two algorithms for gait event detection, and provided normative values of gait temporal parameters for healthy subjects in different environments and types of walking. A pilot study toward clinical application. This pilot study compared laboratory based tests with daily living assessment of gait features in multiple sclerosis patients. Results provided clear evidence that in this population clinical gait tests might not represent typical gait patterns of daily living. Analysis of free-living walking in patients with Diabetes. A systematic review is presented looking for evidence of the effectiveness of walking as physical activity to reduce inflammation. Then, cadence and step duration variability are examined during free-living walking in a group of patients with diabetes. This thesis systematically highlighted potential and actual limitations in the use of wearable sensors for gait monitoring in daily life, providing clear practical indications and normative values which are essential for the widespread informed and effective clinical adoption of this technology

The effects of a program of exercise and nutrition on body composition in adolescents and young adults with moderate cognitive disabilities: A descriptive study.

Individuals with cognitive disabilities appear to age at a faster rate and experience chronic health problems earlier than the general population. The Surgeon General's 2000 Gap Report emphasized disparities in healthcare. The lifestyle of these individuals tends to be sedentary, with high incidence of obesity and low level of fitness. Only a handful of studies have investigated issues concerning health-related fitness in these individuals. Most were focused on examining the prevalence of obesity or behavioral interventions to ameliorate obesity.Significant improvements in body fat percentage and basic health knowledge were obtained by participants (11) receiving an intervention of exercise training and instruction in nutrition and health concepts, when compared to the control group (7). Adolescents and young adults with moderate cognitive disabilities took part in this 12-week study with follow-up. Difference between measures used was not significant.Over the past two decades, the prevalence of overweight and obese persons has increased dramatically and affects nearly 59 million U.S. citizens in all segments of the population. Obesity-related chronic health conditions account for 300,000 deaths annually, ranking second only to smoking as the leading preventable cause of morbidity and mortality. The most common health issue facing children is obesity, largely a result of inactivity and excessive food intake. Obesity's prevalence is rapidly increasing in minority populations that include the elderly and disabled

Mobile Health Technologies

Mobile Health Technologies, also known as mHealth technologies, have emerged, amongst healthcare providers, as the ultimate Technologies-of-Choice for the 21st century in delivering not only transformative change in healthcare delivery, but also critical health information to different communities of practice in integrated healthcare information systems. mHealth technologies nurture seamless platforms and pragmatic tools for managing pertinent health information across the continuum of different healthcare providers. mHealth technologies commonly utilize mobile medical devices, monitoring and wireless devices, and/or telemedicine in healthcare delivery and health research. Today, mHealth technologies provide opportunities to record and monitor conditions of patients with chronic diseases such as asthma, Chronic Obstructive Pulmonary Diseases (COPD) and diabetes mellitus. The intent of this book is to enlighten readers about the theories and applications of mHealth technologies in the healthcare domain