Development and validation of a clinically applicable ARM use monitor for people after stroke

Objective: To develop and validate a clinically applicable and easy-to-use accelerometry-based device to measure arm use in people after stroke; the Ac-tiv8 arm use monitor (Activ8-AUM). Design: Development and validation study. Patients: A total of 25 people at different stages of rehabilitation after stroke were included in this study. Methods: The Activ8-AUM consists of 3 single-sensor Activ8s: one on the unaffected thigh and one on each wrist. Arm use was calculated by combining movement intensity of the arms with data from body posture and movements on the leg sensor. Data were divided into 2 sets: one for determining situation-specific movement intensity thresholds for arm use, and the other to validate the Activ8-AUM using video recordings. Results: Overall agreement between the Activ8-AUM and video recordings was 75%, sensitivity was 73% and specificity was 77%. Agreement between the different categories of arm use ranged from 42% to 93% for the affected arm and from 24% to 82% for the unaffected arm. Conclusion: By combining the movement intensity threshold with body posture and movements, good agreement was reached between the Activ8-AUM and video recordings. This result, together with the easy-to-use configuration, makes the Activ8-AUM a promising device to measure arm use in people after stroke

Small Increase of Actual Physical Activity 6 Months After Total Hip or Knee Arthroplasty

Limitation in daily physical activity is one of the reasons for total hip arthroplasty (THA) or total knee arthroplasty (TKA). However, studies of the effects of THA or TKA generally do not determine actual daily activity as part of physical functioning. We determined the effect of THA or TKA on patients’ actual physical activity and body function (pain, stiffness), capacity to perform tasks, and self-reported physical functioning. We also assessed whether there are differences in the effect of the surgery between patients undergoing THA or TKA and whether the improvements vary between these different outcome measures. We recruited patients with long-standing end-stage osteoarthritis of the hip or knee awaiting THA or TKA. Measurements were performed before surgery and 3 and 6 months after surgery. Actual physical activity improved by 0.7%. Patients’ body function, capacity, and self-reported physical functioning also improved. The effects of the surgery on these aspects of physical functioning were similar for THA and TKA. The effect on actual physical activity (8%) was smaller than on body function (80%–167%), capacity (19%–36%), and self-reported physical functioning (87%–112%). Therefore, in contrast to the large effect on pain and stiffness, patients’ capacity, and their self-reported physical functioning, the improvement in actual physical activity of our patients was less than expected 6 months after surgery

Effect of different operationalizations of sedentary behavior in people with chronic stroke

Purpose: Sedentary behavior is common in people with stroke and has devastating impact on their health. Quantifying it is important to provide people with stroke with adequate physical behavior recommendations. Sedentary behavior can be quantified in terms of posture (sitting) or intensity (low energy expenditure). We compared the effect of different operationalizations of sedentary behavior on sedentary behavior outcomes (total time; way of accumulation) in people with stroke. Methods: Sedentary behavior was analyzed in 44 people with chronic stroke with an activity monitor that measured both body postures and movement intensity. It was operationalized as: (1) combining postural and intensity data; (2) using only postural data; (3) using only intensity data. For each operationalization, we quantified a set of outcomes. Repeated measures ANOVA and Bland–Altman plots were used to compare the operationalizations. Results: All sedentary behavior outcomes differed significantly between all operationalizations (p < 0.01). Bland–Altman plots showed large limits of agreement for all outcomes, showing large individual differences between operationalizations. Conclusions: Although it was neither possible nor our aim to investigate the validity of the two-component definition of sedentary behavior, our study shows that the type of operationalization of sedentary behavior si

Ambulatory Activity Monitoring Progress in Measurement of Activity, Posture, and Specific Motion Patterns in Daily Life

Behavior is central to psychology in almost any definition. Although observable activity is a core aspect of behavior, assessment strategies have tended to focus on emotional, cognitive, or physiological responses. When physical activity is assessed, it is done so mostly with questionnaires. Converging evidence of only a moderate association between self-reports of physical activity and objectively measured physical activity does raise questions about the validity of these self-reports. Ambulatory activity monitoring, defined as the measurement strategy to assess physical activity, posture, and movement patterns continuously in everyday life, has made major advances over the last decade and has considerable potential for further application in the assessment of observable activity, a core aspect of behavior. With new piezoresistive sensors and advanced computer algorithms, the objective measurement of physical activity, posture, and movement is much more easily achieved and measurement precision has improved tremendously. With this overview, we introduce to the reader some recent developments in ambulatory activity monitoring. We will elucidate the discrepancies between objective and subjective reports of activity, outline recent methodological developments, and offer the reader a framework for developing insight into the state of the art in ambulatory activity-monitoring technology, discuss methodological aspects of time-based design and psychometric properties, and demonstrate recent applications. Although not yet main stream, ambulatory activity monitoring - especially in combination with the simultaneous assessment of emotions, mood, or physiological variables - provides a comprehensive methodology for psychology because of its suitability for explaining behavior in context

Ambulatory activity monitoring: Progress in measurement of activity, posture, and specific motion patterns in daily life

Behavior is central to psychology in almost any definition. Although observable activity is a core aspect of behavior, assessment strategies have tended to focus on emotional, cognitive, or physiological responses. When physical activity is assessed, it is done so mostly with questionnaires. Converging evidence of only a moderate association between self-reports of physical activity and objectively measured physical activity does raise questions about the validity of these self-reports. Ambulatory activity monitoring, defined as the measurement strategy to assess physical activity, posture, and movement patterns continuously in everyday life, has made major advances over the last decade and has considerable potential for further application in the assessment of observable activity, a core aspect of behavior. With new piezoresistive sensors and advanced computer algorithms, the objective measurement of physical activity, posture, and movement is much more easily achieved and measurement precision has improved tremendously. With this overview, we introduce to the reader some recent developments in ambulatory activity monitoring. We will elucidate the discrepancies between objective and subjective reports of activity, outline recent methodological developments, and offer the reader a framework for developing insight into the state of the art in ambulatory activity-monitoring technology, discuss methodological aspects of time-based design and psychometric properties, and demonstrate recent applications. Although not yet main stream, ambulatory activity monitoring - especially in combination with the simultaneous assessment of emotions, mood, or physiological variables - provides a comprehensive methodology for psychology because of its suitability for explaining behavior in context