Objective identification of upper limb tremor in multiple sclerosis using a wrist-worn motion sensor: establishing validity and reliability

Introduction Over 25% of people with multiple sclerosis experience tremor, which may impact on activities of daily living and quality of life. Yet there is no method to objectively measure tremor and effectiveness of interventions on tremor. This study aimed to test validity and reliability of a new objective measurement for upper limb tremor in people with multiple sclerosis. Method Twelve participants with multiple sclerosis who self-reported tremor were observed performing standardised tasks. Validity and reliability of a new method to detect tremor from wrist movement was established against occupational therapist observation of tremor (FAHN). Concurrent validity of severity (displacement) of tremor was assessed. Responsiveness to change in tremor characteristics was explored in a sub-set of participants using weighted wrist-cuffs. Results The new method correctly predicted 98.2% of tremor cases identified by the occupational therapist, with high sensitivity (0.988) and specificity (0.976). Calculated displacement of tremor correlated with FAHN tremor severity scores moderately (rs = .452, p = .004). The new measure was responsive to changes in tremor characteristics due to change in weight of wrist-cuffs. Conclusion The new method of characterising tremor in those with multiple sclerosis demonstrated excellent validity and reliability in relation to tremor identified by an occupational therapist, and could provide valuable objective insight into the efficacy of interventions. </jats:sec

Older adult requirement data - what designers want!

It is well recognised that many products do not meet the requirements of the rapidly growing older adult population. The research described in this paper aims to provide designers with relevant and useable older adult requirement data. Data relating to older adults capabilities is being produced largely by the biomechanics community however, there is little evidence of its adoption in the design of everyday products. This project focused specifically on the design of everyday consumer packaging. Poorly designed packaging can present a significant barrier to achieving one of the most important basic activities of daily living - being able to feed oneself. Initially, a study of practicing packaging designers was conducted to establish how they currently design for older adults, what data they use and why. Relevant "new" design data was developed from biomechanical analysis undertaken in this project. This was presented to packaging designers in a series of interviews which established exactly what data designers want and the best formats for integration in the design process. This paper focuses on the findings of the initial study of practicing designers and the follow up interviews

The accumulation of physical activity and sedentary behaviour in children with cerebral palsy and their typically developing peers aged 6–12 years

Background: Physical activity and sedentary behaviour are usually described using daily volume indicators. However, for young children (6–12 years) and specifically those with conditions such as Cerebral Palsy, exploration of how physical behaviours are accumulated may provide valuable insight for behaviour change intervention planning. Research question: How are physical activity and sedentary behaviour accumulated by 6–12 year old children with Cerebral Palsy and is this different from their typically developing peers? Methods: A cross-sectional study of a convenience sample of ambulatory children with CP (CP) and typically developing (TD) children, 6–12 years, was recruited. Children wore a thigh worn activity monitor (activPAL4) during typical daily activities. Overall volume of daily sedentary, upright and stepping time was characterised as well as how this was accumulated in bouts of activity. Results: There were no differences (p&lt;0.05) in either volume or accumulation measures of physical behaviours between TD (n=14, 8.2±1.8 years) and children with CP (n=15, 8.6±1.4 years). However, there was wide variation in activity accumulation patterns between individuals. The mean proportion of daily time in each physical behaviour, accumulated in bouts above set times was: Upright time: bouts &gt;5 mins 46 % TD &amp; CP, bouts &gt;20 mins 9 % TD &amp; CP; Stepping time: bouts &gt;0.5 mins 50 % TD, 45 % CP, bouts &gt;2 mins 10 % TD, 9 % CP; Sedentary time: bouts &gt;5 mins 77 % TD, 76 % CP, bouts &gt;30 mins 26 % TD, 29 % CP. Significance: Young children with CP aged 6–12 years do not appear to have different physical behaviours to their TD peers. However, for individuals, descriptors of accumulation of physical activity and sedentary behaviour bouts provides additional information over and above volume measures, giving insight into behaviour which may be used to inform intervention planning.</p

Full-day physical activity and sedentary behaviour levels of typically developing children and adolescents in the middle east: a systematic review

Physical activity (PA) and sedentary behaviour (SB) are important components of physical behaviour associated with long-term health outcomes. Environmental and cultural factors may influence physical behaviour. To explore full day PA and SB in children and adolescents (2–18 years old) in the Middle East, a systematic literature review was performed including 183 journal articles. A wide range of PA and SB outcomes were reported, in some cases making synthesis of results difficult. As a consequence, results were generally reported narratively (MVPA time, total PA, SB time). Meta-regression of daily step count revealed females took 4600 fewer steps than males, with 3000 fewer steps on weekdays than weekends, and overweight individuals taking 2800 fewer steps/day. Steps decreased with age. Meta-regression for TV viewing time demonstrated an increase by 0.04 h per year of age. Even though environmental and cultural conditions may be different, PA and SB of children and adolescents in the Middle East were largely comparable to those of Europeans and North Americans. The wide range of data collection instruments used (both self-report questionnaire and body-worn devices) and heterogeneity of data made synthesis of reported data across studies very difficult, suggesting a need for greater standardisation of data collection methods.</p