A phase 1 validation study- Work in progress. Connell... · 2020. 9. 5. · responses using the...
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Measuring physical activity levels and intensity using an ActivPal™ accelerometer, a cardiac holter monitor and a behavioural map in a stroke population. Hayley Connell School of Heath and life Science Dr. Sivaramkumar Shanmugam Prof. Frederike van Wijck Glasgow Caledonian University Prof. Malcolm Granat [email protected] 1- Background - Early onset of physical activity post stroke will prevent neuromuscular disuse and improve outcomes, however research shows that stroke patients spend their time in hospital inactive and alone (Bernhardt et al 2004, Saunders et al 2013). - Quantitative data about physical activity intensity has not yet been collected. - It is important to collect information about the amount, type and intensity of physical activity of acute stroke patients, to develop, implement and evaluate a physical activity intervention. In order to collect this information we must use a set of validated tools. 2- Aims To validate in a stroke population: - The ActivPal™ Accelerometer against video. - A behavioural map against video. - A behavioural map physical activity intensity categories against cardiovascular responses using the Lifecard CF holter. 3- Method Design: Observational study. Setting: Hospital simulation lab at Glasgow Caledonian University (Figure 1). Participants: 22 stroke participants recruited from stroke support groups. Data collection: Data was collected using the unique and comprehensive tool kit that has been developed (Figure 2). Testing was conducted in 3 stages as follows; Stage 1- Participants carried out a 10 meter walk test while wearing an ActivPal™ accelerometer aiming to validate the step count. Stage 2- Participants carried out a sit to stand test while wearing an ActivPal™ accelerometer aiming to validate transitions. Stage 3- Participants took part in a behavioural simulation. This stage re-creates behaviours that are probable within an acute stroke ward. Toolkit 4- Preliminary results 1. To date 13 participants have been tested and preliminary analysis has been undertaken on the ActivPal™ and heart rate data. 2. Step count (Figure 3) - Preliminary data suggest that differences in step count were small. 3. Transitions (Figure 4 & 5) - Preliminary analysis of the transitions recorded by the ActivPal™ (Fig, 4) shows that in most participants the ActivPal™ underestimates the number of transitions. - However if the raw data(Fig,5) is analysed, preliminary analysis suggests the ActivPal™ is 100% accurate in recording transitions. The underestimation is likely due to a software algorithm based on default settings used in the analysis. - 4. Intensity (Figure 6) - Heart rate analysis (Figure 6) examines cardiac responses to different activity levels. Initial results suggest that standing up increases heart rate to recommended levels (50% of HR max) in some participants. 0 20 40 60 80 100 120 140 160 180 200 1 2 3 4 5 6 7 8 9 10 Step Count Participant Video count Activpal count 0 2 4 6 8 10 12 14 16 18 1 2 3 4 5 6 7 8 9 Sit to stand transitions Participants Activpal Video 5- What’s next? Once these tools have been validated, they will be used to measure the amount, types, and intensity of physical activity within an acute stroke ward, and develop an intervention to increase this. References • Bernhardt J, Dewey H, Thrift A, Donnan G. Inactive and Alone. Physical Activity Within the First 14 Days of Acute Stroke Unit Care. Stroke 2004;35:1007. doi: 10.1161/01.STR.0000120727.40792.40 • PAL technologies Ltd.. (NA). ActivPal™ . Available: http://www.paltechnologies.com/products/. Last accessed 02 June 2014. • Saunders DH, Sanderson M, Brazzelli M, Greig CA, Mead GE. Physical fitness training for stroke patients. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD003316. DOI: 10.1002/14651858.CD003316.pub5. Figure 2: Toolkit used to collect data. Figure 1: The hospital simulation lab at Glasgow Caledonian University. A phase 1 validation study- Work in progress Figure 3: Step count comparison between ActivPAL and video count. Figure 4: Sit to stand transitions- a comparison between the ActivPal™ count and the video count. Figure 5: Raw data from the ActivPal™ showing 10 transitions. The ActivPal™ uses 3 axis to measure movement. Axis x,y and z can be seen on the vertical axis above against time on the horizontal axis of the graph. Figure 6: Heart rate recording from the Lifecard CF holter monitor. The event marker represents the start of the simulation aspect of testing. During this stage clear peaks in heart rate response can be seen. ActivPal™ accelerometer. Behavioural Map. Lifecard CF holter monitor.
Transcript of A phase 1 validation study- Work in progress. Connell... · 2020. 9. 5. · responses using the...
Measuring physical activity levels and intensity
using an ActivPal™ accelerometer, a cardiac
holter monitor and a behavioural map in a stroke
population.
Hayley Connell School of Heath and life Science
Dr. Sivaramkumar Shanmugam
Prof. Frederike van Wijck Glasgow Caledonian University
Prof. Malcolm Granat
1- Background
- Early onset of physical activity post stroke will prevent neuromuscular
disuse and improve outcomes, however research shows that stroke patients spend
their time in hospital inactive and alone (Bernhardt et al 2004, Saunders et al
2013).
- Quantitative data about physical activity intensity has not yet been collected.
- It is important to collect information about the amount, type and intensity of
physical activity of acute stroke patients, to develop, implement and evaluate a
physical activity intervention. In order to collect this information we must use a
set of validated tools.
2- Aims
To validate in a stroke population:
- The ActivPal™ Accelerometer against video.
- A behavioural map against video.
- A behavioural map physical activity intensity categories against cardiovascular
responses using the Lifecard CF holter.
3- Method
Design: Observational study.
Setting: Hospital simulation lab at Glasgow Caledonian University (Figure 1).
Participants: 22 stroke participants recruited from stroke support groups.
Data collection: Data was collected using the unique and comprehensive tool kit that
has been developed (Figure 2). Testing was conducted in 3 stages as follows;
Stage 1- Participants carried out a 10 meter walk test while wearing an ActivPal™
accelerometer aiming to validate the step count.
Stage 2- Participants carried out a sit to stand test while wearing an ActivPal™
accelerometer aiming to validate transitions.
Stage 3- Participants took part in a behavioural simulation. This stage re-creates
behaviours that are probable within an acute stroke ward.
Toolkit
4- Preliminary results
1. To date 13 participants have been tested and preliminary analysis has been
undertaken on the ActivPal™ and heart rate data.
2. Step count (Figure 3)
- Preliminary data suggest that differences in step count were small.
3. Transitions (Figure 4 & 5)
- Preliminary analysis of the transitions recorded by the ActivPal™ (Fig, 4)
shows that in most participants the ActivPal™ underestimates the number
of transitions.
- However if the raw data(Fig,5) is analysed, preliminary analysis suggests
the ActivPal™ is 100% accurate in recording transitions. The
underestimation is likely due to a software algorithm based on default
settings used in the analysis.
-
4. Intensity (Figure 6) - Heart rate analysis (Figure 6) examines cardiac responses to different
activity levels. Initial results suggest that standing up increases heart rate
to recommended levels (50% of HR max) in some participants.
0
20
40
60
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100
120
140
160
180
200
1 2 3 4 5 6 7 8 9 10
Ste
p C
ou
nt
Participant
Video count
Activpal count
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Sit
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Participants
Activpal
Video
5- What’s next? Once these tools have been validated, they will be used to measure the amount,
types, and intensity of physical activity within an acute stroke ward, and develop
an intervention to increase this.
References
• Bernhardt J, Dewey H, Thrift A, Donnan G. Inactive and Alone. Physical Activity Within the First 14 Days of Acute Stroke Unit Care. Stroke 2004;35:1007. doi:
10.1161/01.STR.0000120727.40792.40
• PAL technologies Ltd.. (NA). ActivPal™ . Available: http://www.paltechnologies.com/products/. Last accessed 02 June 2014.
• Saunders DH, Sanderson M, Brazzelli M, Greig CA, Mead GE. Physical fitness training for stroke patients. Cochrane Database of Systematic Reviews 2013, Issue 10. Art.
No.: CD003316. DOI: 10.1002/14651858.CD003316.pub5.
Figure 2: Toolkit used to collect data.
Figure 1: The hospital simulation lab at Glasgow Caledonian University.
A phase 1 validation study- Work in progress
Figure 3: Step count comparison between ActivPAL and video
count.
Figure 4: Sit to stand transitions- a comparison between the ActivPal™
count and the video count.
Figure 5: Raw data from the ActivPal™ showing 10
transitions. The ActivPal™ uses 3 axis to measure
movement. Axis x,y and z can be seen on the vertical axis
above against time on the horizontal axis of the graph.
Figure 6: Heart rate recording from the Lifecard CF holter monitor. The event marker represents the start of the
simulation aspect of testing. During this stage clear peaks in heart rate response can be seen.
ActivPal™ accelerometer.
Behavioural Map.
Lifecard CF holter monitor.
