Remote Physical Activity Monitoring in Neurological Disease: A Systematic Review.

To perform a systematic review of studies using remote physical activity monitoring in neurological diseases, highlighting advances and determining gaps.Studies were systematically identified in PubMed/MEDLINE, CINAHL and SCOPUS from January 2004 to December 2014 that monitored physical activity for ≥24 hours in adults with neurological diseases. Studies that measured only involuntary motor activity (tremor, seizures), energy expenditure or sleep were excluded. Feasibility, findings, and protocols were examined.137 studies met inclusion criteria in multiple sclerosis (MS) (61 studies); stroke (41); Parkinson's Disease (PD) (20); dementia (11); traumatic brain injury (2) and ataxia (1). Physical activity levels measured by remote monitoring are consistently low in people with MS, stroke and dementia, and patterns of physical activity are altered in PD. In MS, decreased ambulatory activity assessed via remote monitoring is associated with greater disability and lower quality of life. In stroke, remote measures of upper limb function and ambulation are associated with functional recovery following rehabilitation and goal-directed interventions. In PD, remote monitoring may help to predict falls. In dementia, remote physical activity measures correlate with disease severity and can detect wandering.These studies show that remote physical activity monitoring is feasible in neurological diseases, including in people with moderate to severe neurological disability. Remote monitoring can be a psychometrically sound and responsive way to assess physical activity in neurological disease. Further research is needed to ensure these tools provide meaningful information in the context of specific neurological disorders and patterns of neurological disability

Remote Physical Activity Monitoring in Neurological Disease: A Systematic Review

<div><p>Objective</p><p>To perform a systematic review of studies using remote physical activity monitoring in neurological diseases, highlighting advances and determining gaps.</p><p>Methods</p><p>Studies were systematically identified in PubMed/MEDLINE, CINAHL and SCOPUS from January 2004 to December 2014 that monitored physical activity for ≥24 hours in adults with neurological diseases. Studies that measured only involuntary motor activity (tremor, seizures), energy expenditure or sleep were excluded. Feasibility, findings, and protocols were examined.</p><p>Results</p><p>137 studies met inclusion criteria in multiple sclerosis (MS) (61 studies); stroke (41); Parkinson's Disease (PD) (20); dementia (11); traumatic brain injury (2) and ataxia (1). Physical activity levels measured by remote monitoring are consistently low in people with MS, stroke and dementia, and patterns of physical activity are altered in PD. In MS, decreased ambulatory activity assessed via remote monitoring is associated with greater disability and lower quality of life. In stroke, remote measures of upper limb function and ambulation are associated with functional recovery following rehabilitation and goal-directed interventions. In PD, remote monitoring may help to predict falls. In dementia, remote physical activity measures correlate with disease severity and can detect wandering.</p><p>Conclusions</p><p>These studies show that remote physical activity monitoring is feasible in neurological diseases, including in people with moderate to severe neurological disability. Remote monitoring can be a psychometrically sound and responsive way to assess physical activity in neurological disease. Further research is needed to ensure these tools provide meaningful information in the context of specific neurological disorders and patterns of neurological disability.</p></div

Integrated cognitive and physical fitness training enhances attention abilities in older adults.

Preserving attention abilities is of great concern to older adults who are motivated to maintain their quality of life. Both cognitive and physical fitness interventions have been utilized in intervention studies to assess maintenance and enhancement of attention abilities in seniors, and a coupling of these approaches is a compelling strategy to buttress both cognitive and physical health in a time- and resource-effective manner. With this perspective, we created a closed-loop, motion-capture video game (Body-Brain Trainer: BBT) that adapts a player's cognitive and physical demands in an integrated approach, thus creating a personalized and cohesive experience across both domains. Older adults who engaged in two months of BBT improved on both physical fitness (measures of blood pressure and balance) and attention (behavioral and neural metrics of attention on a continuous performance task) outcome measures beyond that of an expectancy matched, active, placebo control group, with maintenance of improved attention performance evidenced 1 year later. Following training, the BBT group's improvement on the attention outcome measure exceeded performance levels attained by an untrained group of 20-year olds, and showed age-equilibration of a neural signature of attention shown to decline with age: midline frontal theta power. These findings highlight the potential benefits of an integrated, cognitive-physical, closed-loop training platform as a powerful tool for both cognitive and physical enhancement in older adults

PRISMA Flow Diagram.

<p>Notes: * 1 Article includes multiple groups of neurological diagnosis—MS, Parkinson’s and neuromuscular disease—(Busse et al, 2004) ^α 1 Article includes TBI and Stroke (Fulk et al, 2014)</p

Characteristics of Published Studies Recording Physical Activity via Remote Monitoring for >34 hours in People with Multiple Sclerosis.

<p>Characteristics of Published Studies Recording Physical Activity via Remote Monitoring for >34 hours in People with Multiple Sclerosis.</p

Characteristics of Published Studies Recording Physical Activity via Remote Monitoring for ≥24 hours in People with Stroke.

<p>Characteristics of Published Studies Recording Physical Activity via Remote Monitoring for ≥24 hours in People with Stroke.</p

Summary Characteristics of Studies by Neurological Diagnosis.

<p>Summary Characteristics of Studies by Neurological Diagnosis.</p

Characteristics of Published Studies Recording Physical Activity via Remote Monitoring for ≥24 hours in People with Parkinson’s Disease.

<p>Characteristics of Published Studies Recording Physical Activity via Remote Monitoring for ≥24 hours in People with Parkinson’s Disease.</p

Checklist for Standardization of Reporting for Remote Physical Activity Monitoring in Neurological Disease.

<p><i>From</i>: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(6): e1000097. doi:<a href="http://dx.doi.org/10.1371/journal.pmed1000097" target="_blank">10.1371/journal.pmed1000097</a> For more information, visit: <a href="http://www.prisma-statement.org" target="_blank">www.prisma-statement.org</a>.</p