DIFFERENTIATING BETWEEN LOW LEVEL ACTIVITIES IN SEDENTARY OCCUPATIONS UTILIZING FITBITS

Objective: Fitbits are popular devices used to track personal activity throughout the day. The potential usage of these devices in tracking sedentary activities in research studies rely on the validity and accuracy of the devices. The objectives of this study are to investigate if changes in daily activity is associated with changes in duration of standing time using a sit-to-stand workstation. Also to establish if an accelerometer may be used to detect differences between sitting and standing sedentary positions. Methods: Sixteen participants wore Fitbit accelerometers throughout the workday and were emailed surveys on a weekly basis to report their sitting and standing percentages. Spearman correlation was used to compare mean daily step counts and mean standing percentages. A subsample of seven participants wore Fitbit and completed log sheets detailing precise periods of sitting and standing while at work. The number of steps registered during sitting and standing periods was compared for each individual using a paired t-test. Results: No statistically significant correlation was found between a participant’s mean standing percentage and mean daily step count (p-value = 0.563). Paired t-test analysis of participants found no statistically significant difference between the total number of steps registered while sitting and the total number of steps registered while standing (p-value = 0.034). Conclusions: No observable association between daily activity and duration of standing time was found. The number of steps measured using a Fitbit accelerometer may not be a useful method to assess sit-to-stand workstation usage. Limitations with the study included possible selection bias, incomplete self-reporting surveys, low sample sizes and short study durations. Future studies accounting for these limitations may prove to yield more statistically significant results regarding the use of Fitbits in assessing sedentary activity

April 15, 2004

The Breeze is the student newspaper of James Madison University in Harrisonburg, Virginia

Recommendations for exercise adherence measures in musculoskeletal settings : a systematic review and consensus meeting (protocol)

Background: Exercise programmes are frequently advocated for the management of musculoskeletal disorders; however, adherence is an important pre-requisite for their success. The assessment of exercise adherence requires the use of relevant and appropriate measures, but guidance for appropriate assessment does not exist. This research will identify and evaluate the quality and acceptability of all measures used to assess exercise adherence within a musculoskeletal setting, seeking to reach consensus for the most relevant and appropriate measures for application in research and/or clinical practice settings. Methods/design: There are two key stages to the proposed research. First, a systematic review of the quality and acceptability of measures used to assess exercise adherence in musculoskeletal disorders; second, a consensus meeting. The systematic review will be conducted in two phases and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure a robust methodology. Phase one will identify all measures that have been used to assess exercise adherence in a musculoskeletal setting. Phase two will seek to identify published and unpublished evidence of the measurement and practical properties of identified measures. Study quality will be assessed against the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. A shortlist of best quality measures will be produced for consideration during stage two: a meeting of relevant stakeholders in the United Kingdom during which consensus on the most relevant and appropriate measures of exercise adherence for application in research and/or clinical practice settings will be sought. Discussion: This study will benefit clinicians who seek to evaluate patients’ levels of exercise adherence and those intending to undertake research, service evaluation, or audit relating to exercise adherence in the musculoskeletal field. The findings will impact upon new research studies which aim to understand the factors that predict adherence with exercise and which test different adherence-enhancing interventions. PROSPERO reference: CRD4201300621

Quality and acceptability of measures of exercise adherence in musculoskeletal settings: a systematic review

Objective. To recommend robust and relevant measures of exercise adherence for application in the musculoskeletal field. Method. A systematic review of measures was conducted in two phases. Phase 1 sought to identify all reproducible measures used to assess exercise adherence in a musculoskeletal setting. Phase 2 identified published evidence of measurement and practical properties of identified measures. Eight databases were searched (from inception to February 2016). Study quality was assessed against the Consensus-based Standards for the Selection of Health Measurement Instruments guidelines. Measurement quality was assessed against accepted standards. Results. Phase 1: from 8511 records, 326 full-text articles were reviewed; 45 reproducible measures were identified. Phase 2: from 2977 records, 110 full-text articles were assessed for eligibility; 10 articles provided evidence of measurement/practical properties for just seven measures. Six were exercise adherence-specific measures; one was specific to physical activity but applied as a measure of exercise adherence. Evidence of essential measurement and practical properties was mostly limited or not available. Assessment of relevance and comprehensiveness was largely absent and there was no evidence of patient involvement during the development or evaluation of any measure. Conclusion. The significant methodological and quality issues encountered prevent the clear recommendation of any measure; future applications should be undertaken cautiously until greater clarity of the conceptual underpinning of each measure is provided and acceptable evidence of essential measurement properties is established. Future research should seek to engage collaboratively with relevant stakeholders to ensure that exercise adherence assessment is high quality, relevant and acceptable

A falls prevention programme to improve quality of life, physical function and falls efficacy in older people receiving home help services: study protocol for a randomised controlled trial

BACKGROUND: Falls and fall-related injuries in older adults are associated with great burdens, both for the individuals, the health care system and the society. Previous research has shown evidence for the efficiency of exercise as falls prevention. An understudied group are older adults receiving home help services, and the effect of a falls prevention programme on health-related quality of life is unclear. The primary aim of this randomised controlled trial is to examine the effect of a falls prevention programme on quality of life, physical function and falls efficacy in older adults receiving home help services. A secondary aim is to explore the mediating factors between falls prevention and health-related quality of life. METHODS: The study is a single-blinded randomised controlled trial. Participants are older adults, aged 67 or older, receiving home help services, who are able to walk with or without walking aids, who have experienced at least one fall during the last 12 months and who have a Mini Mental State Examination of 23 or above. The intervention group receives a programme, based on the Otago Exercise Programme, lasting 12 weeks including home visits and motivational telephone calls. The control group receives usual care. The primary outcome is health-related quality of life (SF-36). Secondary outcomes are leg strength, balance, walking speed, walking habits, activities of daily living, nutritional status and falls efficacy. All measurements are performed at baseline, following intervention at 3 months and at 6 months' follow-up. Sample size, based on the primary outcome, is set to 150 participants randomised into the two arms, including an estimated 15-20% drop out. Participants are recruited from six municipalities in Norway. DISCUSSION: This trial will generate new knowledge on the effects of an exercise falls prevention programme among older fallers receiving home help services. This knowledge will be useful for clinicians, for health managers in the primary health care service and for policy makers

Mutual shaping in the design of socially assistive robots: A case study on social robots for therapy

This paper offers a case study in undertaking a mutual shaping approach to the design of socially assistive robots. We consider the use of social robots in therapy, and we present our results regarding this application, but the approach is generalisable. Our methodology combines elements of user-centered and participatory design with a focus on mutual learning. We present it in full alongside a more general guide for application to other areas. This approach led to valuable results concerning mutual shaping effects and societal factors regarding the use of such robots early in the design process. We also measured a significant shift in participant robot acceptance pre-/post-study, demonstrating that our approach led to the two-way sharing and shaping of knowledge, ideas and acceptance

Housebound patients' experiences of a falls service provided by a team of community physiotherapists

Background/ aims: To explore the experiences of patients of a falls service provided by a community physiotherapy team to elderly, housebound people who have fallen. Methods: Six housebound, elderly patients who had been referred to the service were interviewed in their own homes. The interviews were transcribed and a thematic analysis framework was used to analyse the data. Codes were identified and developed into key themes which addressed the overall research question. Results: The analysis revealed that the participants presented with multiple risk factors including recurrent falls and comorbidities and were at high risk of falls. Exercise was understood to increase their mobility and the majority expressed a fear of falling. They appeared to have a limited understanding of the referral process, the cause of their falls and the interventions that may reduce their risk of falling. Conclusions: A multidisciplinary falls team, established and recognised as a central point of referral for the care of people who have fallen could enhance the care of elderly, housebound people who have fallen. The team with their specialist knowledge and understanding of the multifactorial nature of falls and appropriate interventions could co-ordinate and monitor the assessments and interventions needed with the relevant professionals and services

Anomaly detection in elderly daily behavior in ambient sensing environments

Current ubiquitous computing applications for smart homes aim to enhance people’s daily living respecting age span. Among the target groups of people, elderly are a population eager for “choices for living arrangements”, which would allow them to continue living in their homes but at the same time provide the health care they need. Given the growing elderly population, there is a need for statistical models able to capture the recurring patterns of daily activity life and reason based on this information. We present an analysis of real-life sensor data collected from 40 different households of elderly people, using motion, door and pressure sensors. Our objective is to automatically observe and model the daily behavior of the elderly and detect anomalies that could occur in the sensor data. For this purpose, we first introduce an abstraction layer to create a common ground for home sensor configurations. Next, we build a probabilistic spatio-temporal model to summarize daily behavior. Anomalies are then defined as significant changes from the learned behavioral model and detected using a cross-entropy measure. We have compared the detected anomalies with manually collected annotations and the results show that the presented approach is able to detect significant behavioral changes of the elderly

Predictors of adherence to a multifaceted podiatry intervention for the prevention of falls in older people

<p>Abstract</p> <p>Background</p> <p>Despite emerging evidence that foot problems and inappropriate footwear increase the risk of falls, there is little evidence as to whether foot-related intervention strategies can be successfully implemented. The aim of this study was to evaluate adherence rates, barriers to adherence, and the predictors of adherence to a multifaceted podiatry intervention for the prevention of falls in older people.</p> <p>Methods</p> <p>The intervention group (n = 153, mean age 74.2 years) of a randomised trial that investigated the effectiveness of a multifaceted podiatry intervention to prevent falls was assessed for adherence to the three components of the intervention: (i) foot orthoses, (ii) footwear advice and footwear cost subsidy, and (iii) a home-based foot and ankle exercise program. Adherence to each component and the barriers to adherence were documented, and separate discriminant function analyses were undertaken to identify factors that were significantly and independently associated with adherence to the three intervention components.</p> <p>Results</p> <p>Adherence to the three components of the intervention was as follows: foot orthoses (69%), footwear (54%) and home-based exercise (72%). Discriminant function analyses identified that being younger was the best predictor of orthoses use, higher physical health status and lower fear of falling were independent predictors of footwear adherence, and higher physical health status was the best predictor of exercise adherence. The predictive accuracy of these models was only modest, with 62 to 71% of participants correctly classified.</p> <p>Conclusions</p> <p>Adherence to a multifaceted podiatry intervention in this trial ranged from 54 to 72%. People with better physical health, less fear of falling and a younger age exhibited greater adherence, suggesting that strategies need to be developed to enhance adherence in frailer older people who are most at risk of falling.</p> <p>Trial registration</p> <p>Australian New Zealand Clinical Trials Registry <a href="http://www.anzctr.org.au/ACTRN12608000065392.aspx">ACTRN12608000065392</a>.</p