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      Validity and Usability of Low-Cost Accelerometers for Internet-Based Self-Monitoring of Physical Activity in Patients With Chronic Obstructive Pulmonary Disease

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          Abstract

          Background

          The importance of regular physical activity for patients with chronic obstructive pulmonary disease (COPD) is well-established. However, many patients do not meet the recommended daily amount. Accelerometers might provide patients with the information needed to increase physical activity in daily life.

          Objective

          Our objective was to assess the validity and usability of low-cost Internet-connected accelerometers. Furthermore we explored patients’ preferences with regards to the presentation of and feedback on monitored physical activity.

          Methods

          To assess concurrent validity we conducted a field validation study with patients who wore two low-cost accelerometers, Fitbit and Physical Activity Monitor (PAM), at the same time along with a sophisticated multisensor accelerometer (SenseWear Armband) for 48 hours. Data on energy expenditure assessed from registrations from the two low-cost accelerometers were compared to the well validated SenseWear Armband which served as a reference criterion. Usability was examined in a cross-over study with patients who, in succession, wore the Fitbit and the PAM for 7 consecutive days and filled out a 16 item questionnaire with regards to the use of the corresponding device

          Results

          The agreement between energy expenditure (METs) from the SenseWear Armband with METs estimated by the Fitbit and PAM was good ( r=.77) and moderate ( r=.41), respectively. The regression model that was developed for the Fitbit explained 92% whereas the PAM-model could explain 89% of total variance in METs measured by the SenseWear. With regards to the usability, both the Fitbit and PAM were well rated on all items. There were no significant differences between the two devices.

          Conclusions

          The low-cost Fitbit and PAM are valid and usable devices to measure physical activity in patients with COPD. These devices may be useful in long-term interventions aiming at increasing physical activity levels in these patients.

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          Most cited references21

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          IBM computer usability satisfaction questionnaires: Psychometric evaluation and instructions for use

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            Characteristics of physical activities in daily life in chronic obstructive pulmonary disease.

            Quantification of physical activities in daily life in patients with chronic obstructive pulmonary disease has increasing clinical interest. However, detailed comparison with healthy subjects is not available. Furthermore, it is unknown whether time spent actively during daily life is related to lung function, muscle force, or maximal and functional exercise capacity. We assessed physical activities and movement intensity with the DynaPort activity monitor in 50 patients (age 64 +/- 7 years; FEV1 43 +/- 18% predicted) and 25 healthy elderly individuals (age 66 +/- 5 years). Patients showed lower walking time (44 +/- 26 vs. 81 +/- 26 minutes/day), standing time (191 +/- 99 vs. 295 +/- 109 minutes/day), and movement intensity during walking (1.8 +/- 0.3 vs. 2.4 +/- 0.5 m/second2; p < 0.0001 for all), as well as higher sitting time (374 +/- 139 vs. 306 +/- 108 minutes/day; p = 0.04) and lying time (87 +/- 97 vs. 29 +/- 33 minutes/day; p = 0.004). Walking time was highly correlated with the 6-minute walking test (r = 0.76, p < 0.0001) and more modestly to maximal exercise capacity, lung function, and muscle force (0.28 < r < 0.64, p < 0.05). Patients with chronic obstructive pulmonary disease are markedly inactive in daily life. Functional exercise capacity is the strongest correlate of physical activities in daily life.
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              Physical activity in patients with COPD.

              The present study aimed to measure physical activity in patients with chronic obstructive pulmonary disease (COPD) to: 1) identify the disease stage at which physical activity becomes limited; 2) investigate the relationship of clinical characteristics with physical activity; 3) evaluate the predictive power of clinical characteristics identifying very inactive patients; and 4) analyse the reliability of physical activity measurements. In total, 163 patients with COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I-IV; BODE (body mass index, airway obstruction, dyspnoea, exercise capacity) index score 0-10) and 29 patients with chronic bronchitis (normal spirometry; former GOLD stage 0) wore activity monitors that recorded steps per day, minutes of at least moderate activity, and physical activity levels for 5 days (3 weekdays plus Saturday and Sunday). Compared with patients with chronic bronchitis, steps per day, minutes of at least moderate activity and physical activity levels were reduced from GOLD stage II/BODE score 1, GOLD stage III/BODE score 3/4 and from GOLD stage III/BODE score 1, respectively. Reliability of physical activity measurements improved with the number of measured days and with higher GOLD stages. Moderate relationships were observed between clinical characteristics and physical activity. GOLD stages III and IV best predicted very inactive patients. Physical activity is reduced in patients with chronic obstructive pulmonary disease from Global Initiative for Chronic Obstructive Lung Disease stage II/ body mass index, airway obstruction, dyspnoea, exercise capacity score 1. Clinical characteristics of patients with chronic obstructive pulmonary disease only incompletely reflect their physical activity.
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                Author and article information

                Contributors
                Journal
                Interact J Med Res
                Interact J Med Res
                IJMR
                Interactive Journal of Medical Research
                JMIR Publications Inc. (Toronto, Canada )
                1929-073X
                Oct-Dec 2014
                27 October 2014
                : 3
                : 4
                : e14
                Affiliations
                [1] 1Rijnlands Rehabilitation Center Department of Cardiac and Pulmonary Rehabilitation LeidenNetherlands
                [2] 2Leiden University Medical Center Department of Medical Decision Making LeidenNetherlands
                [3] 3TNO Expertise Center Life Style LeidenNetherlands
                Author notes
                Corresponding Author: Martijn Vooijs m.vooijs@ 123456rrc.nl
                Author information
                http://orcid.org/0000-0002-3303-7171
                http://orcid.org/0000-0002-8243-0607
                http://orcid.org/0000-0002-3598-7971
                http://orcid.org/0000-0002-8998-3407
                http://orcid.org/0000-0003-0005-4407
                http://orcid.org/0000-0002-0397-5554
                http://orcid.org/0000-0002-5840-0651
                http://orcid.org/0000-0002-6226-2060
                Article
                v3i4e14
                10.2196/ijmr.3056
                4259960
                25347989
                ccb94b55-7ddc-48b1-8f4f-3062644f38d9
                ©Martijn Vooijs, Laurence L. Alpay, Jiska B. Snoeck-Stroband, Thijs Beerthuizen, Petra C. Siemonsma, Jannie J. Abbink, Jacob K. Sont, Ton A. Rövekamp. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 27.10.2014.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Interactive Journal of Medical Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.i-jmr.org/, as well as this copyright and license information must be included.

                History
                : 12 November 2013
                : 09 January 2014
                : 22 March 2014
                : 04 August 2014
                Categories
                Original Paper
                Original Paper

                accelerometers,activity monitoring,chronic obstructive pulmonary disease,validity,usability

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