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Epilepsia Aug 2022This study was undertaken to review the reported performance of noninvasive wearable devices in detecting epileptic seizures and psychogenic nonepileptic seizures (PNES). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study was undertaken to review the reported performance of noninvasive wearable devices in detecting epileptic seizures and psychogenic nonepileptic seizures (PNES).
METHODS
We conducted a systematic review and meta-analysis of studies reported up to November 15, 2021. We included studies that used video-electroencephalographic (EEG) monitoring as the gold standard to determine the sensitivity and false alarm rate (FAR) of noninvasive wearables for automated seizure detection.
RESULTS
Twenty-eight studies met the criteria for the systematic review, of which 23 were eligible for meta-analysis. These studies (1269 patients in total, median recording time = 52.9 h per patient) investigated devices for tonic-clonic seizures using wrist-worn and/or ankle-worn devices to measure three-dimensional accelerometry (15 studies), and/or wearable surface devices to measure electromyography (eight studies). The mean sensitivity for detecting tonic-clonic seizures was .91 (95% confidence interval [CI] = .85-.96, I = 83.8%); sensitivity was similar between the wrist-worn (.93) and surface devices (.90). The overall FAR was 2.1/24 h (95% CI = 1.7-2.6, I = 99.7%); FAR was higher in wrist-worn (2.5/24 h) than in wearable surface devices (.96/24 h). Three of the 23 studies also detected PNES; the mean sensitivity and FAR from these studies were 62.9% and .79/24 h, respectively. Four studies detected both focal and tonic-clonic seizures, and one study detected focal seizures only; the sensitivities ranged from 31.1% to 93.1% in these studies.
SIGNIFICANCE
Reported noninvasive wearable devices had high sensitivity but relatively high FARs in detecting tonic-clonic seizures during limited recording time in a video-EEG setting. Future studies should focus on reducing FAR, detection of other seizure types and PNES, and longer recording in the community.
Topics: Accelerometry; Electroencephalography; Epilepsy; Humans; Psychogenic Nonepileptic Seizures; Seizures; Wearable Electronic Devices
PubMed: 35545836
DOI: 10.1111/epi.17297 -
Sleep Sep 2021Sleep quantity and continuity vary across the lifespan. Actigraphy is a reliable and widely used behavioral measure of sleep in research and personal health monitoring.... (Meta-Analysis)
Meta-Analysis
STUDY OBJECTIVES
Sleep quantity and continuity vary across the lifespan. Actigraphy is a reliable and widely used behavioral measure of sleep in research and personal health monitoring. This meta-analysis provides a novel examination of whether age (in years) is associated with actigraphy-assessed sleep across the lifespan.
METHODS
A systematic search of PubMed, Embase.com, Cochrane CENTRAL, and PsycINFO using "actigraphy" and "sleep" terms provided 7079 titles/abstracts; studies of individuals with known psychiatric or medical comorbidities were excluded. Ninety-one articles (N = 23 365) provided data for six meta-analyses examining sleep duration (k = 89), sleep efficiency (k = 58), bedtime (k = 19) and waketime (k = 9) for individuals ages 6-21, and bedtime (k = 7) and waketime (k = 7) for individuals ages 22 and older.
RESULTS
At older ages, sleep duration was shorter (r = -0.12) and sleep efficiency was lower (r = -0.05). Older age was associated with later bedtime (r = 0.37) and wake-up time (r = 0.24) from ages 6-21, whereas older age was associated with earlier bedtime (r = -0.66) and wake-up time (r = -0.59) for ages 22 and above. The strength of these associations was modified by study continent, but not by any other moderator.
CONCLUSIONS
Age was negatively associated with actigraphy-assessed sleep duration and efficiency, but the effects were small in magnitude. On the other hand, large associations were observed between age and sleep timing, despite a smaller literature and the absence of analyzable data for ages 30-60. Changes in sleep timing, rather than changes in sleep duration or continuity, may better characterize the effects of age on human sleep.
Topics: Actigraphy; Adolescent; Adult; Aged; Child; Humans; Longevity; Middle Aged; Sleep; Surveys and Questionnaires; Time; Young Adult
PubMed: 33823052
DOI: 10.1093/sleep/zsab088 -
Journal of Physical Activity & Health Jan 2021To examine the reliability and convergent validity of self-reported questionnaires (SRQs) to measure physical activity (PA). (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To examine the reliability and convergent validity of self-reported questionnaires (SRQs) to measure physical activity (PA).
METHODS
Systematic review with meta-analysis. The validity and reliability of SRQs to assess PA in people with mental disorders (January 20, 2020). Random-effects meta-analyses were performed pooling (1) test-retest correlations or (2) the convergent validity between the SRQs and objective measures (eg, accelerometry). Associations were provided in r values with the 95% confidence interval. Methodological quality was assessed.
RESULTS
A total of 9 unique studies (N = 1344; 40.5% females) were included. The authors found a moderate correlation test-retest reliability for PA SRQs in the assessment of vigorous PA (r = .69 [.38 to .85]; P = .001), moderate to vigorous PA (r = .63 [.25 to .84]; P = .003), moderate PA (r = .63 [.39 to .79]; P = .001), and good correlation total PA (r = .75 [.37 to .92]; P = .001). The SRQs have moderate correlations with objective measures for moderate to vigorous PA (r = .25 [.18 to .32]; P = .0001) and total PA (r = .47 [.28 to .62]; P = .005), a poor correlation for moderate PA (r = .18 [.03 to .36]; P = .047), and no correlation with vigorous PA (r = .06 [-.10 to .22]; P = .440).
CONCLUSION
Current evidence indicates that SRQs are reliable over time to assess moderate, vigorous, and total PA levels and valid when assessing moderate PA.
Topics: Accelerometry; Exercise; Female; Health Promotion; Humans; Male; Mental Disorders; Middle Aged; Motor Activity; Reproducibility of Results; Self Report; Surveys and Questionnaires
PubMed: 33260145
DOI: 10.1123/jpah.2020-0312 -
Sleep Health Aug 2021Social inequities have many health effects; one of these is a potential relationship to sleep disturbances. Socioeconomic status (SES) is an important factor that... (Meta-Analysis)
Meta-Analysis Review
Social inequities have many health effects; one of these is a potential relationship to sleep disturbances. Socioeconomic status (SES) is an important factor that contributes to social inequities. SES is a marker of living conditions and habits that influence health by way of different processes, including stress-related mechanisms. However, a systematic review of the relationship between SES and objectively measured sleep parameters has not been conducted. Therefore, a systematic review and meta-analysis were performed to examine the relationship between SES and sleep parameters measured with actigraphy in the general population. Nineteen articles were identified and included from a keyword search in Medline/PubMed, Web of Science, and SCOPUS, following PRISMA guidelines. For an article to be included, it had to have a measure of SES and also, an actigraphy-based measure of sleep. For, included studies, qualitative and quantitative data were extracted, and study quality was assessed with The National Institute of Health's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Bivariate correlations were extracted and entered into a meta-analysis, along with a qualitative review of articles. These analyses revealed that SES was associated with sleep parameters in the predicted direction, with lower SES associated with worse sleep parameters. Specifically, lower SES was associated with lower total sleep time, longer sleep latency, greater sleep fragmentation, and higher variability in sleep onset and sleep latency. Higher education, higher perceived economic well-being, and higher income were significantly associated with improved sleep efficiency and longer sleep duration. For the 19 articles included, 10 were rated as fair or poor in study quality. Thus, higher quality studies in this area are needed. This meta-analysis and systematic review demonstrated that social inequities of sleep can be measured objectively, opening the path to the development and integration of methodologies combining actigraphy with current subjective measures for utilization in clinical practice.
Topics: Actigraphy; Cross-Sectional Studies; Humans; Income; Sleep; Social Class
PubMed: 34266774
DOI: 10.1016/j.sleh.2021.05.005 -
The International Journal of Behavioral... Jul 2022Early childhood education and care (ECEC) settings offer a potentially cost-effective and sustainable solution for ensuring children have opportunities to meet physical... (Review)
Review
Environmental and practice factors associated with children's device-measured physical activity and sedentary time in early childhood education and care centres: a systematic review.
BACKGROUND
Early childhood education and care (ECEC) settings offer a potentially cost-effective and sustainable solution for ensuring children have opportunities to meet physical activity (PA) and sedentary time (ST) guidelines. This paper systematically reviewed the association between childcare environment and practice and children's PA and ST.
METHODS
Three electronic databases were searched, and citation tracking of eligible studies performed between June-July 2020 (updated March 2022). Studies were eligible when (i) participants attended ECEC settings, (ii) they reported the association between use of outdoor space, including factors of time, availability, play, size and equipment, and children's device-measured PA and ST, and (iii) where applicable, they compared the exposure to use of indoor space. Risk of bias was assessed using the Critical Appraisal Skills Program (CASP) tools. A synthesis was performed using effect direct plots and charts to visualise effect sizes.
RESULTS
Of 1617 reports screened, 29 studies met the inclusion criteria. Studies provided data on outdoor versus indoor time (n = 9; 960 children), outdoor versus indoor play (n = 3; 1104 children), outdoor play space (n = 19; 9596 children), outdoor space use external to ECEC (n = 2; 1148 children), and portable (n = 7; 2408 children) and fixed (n = 7; 2451 children) outdoor equipment. Time spent outdoors versus indoors was associated with increased moderate-to-vigorous PA (MVPA), light PA (LPA) and total PA, while the association with ST was inconclusive. The mean (standard deviation) levels of outdoor MVPA (4.0 ± 3.2 to 18.6 ± 5.6 min/h) and LPA (9.9 ± 2.6 to 30.8 ± 11.8 min/h) were low, and ST high (30.0 ± 6.5 to 46.1 ± 4.3 min/h). MVPA levels doubled when children played outdoors versus indoors. Outdoor play space, and outdoor portable equipment, were associated with increased MVPA. A dose-response relationship for outdoor play area size was observed, demonstrating increased MVPA with areas ≥505m (5436 ft), but no further increases when areas were > 900m (9688 ft). No studies reported on injuries in outdoor settings.
CONCLUSIONS
ECEC policies and practices should promote not only outdoor time but also the availability of resources such as portable play equipment and sufficient size of outdoor play areas that enable children to be physically active for sustained periods while outdoors.
SYSTEMATIC REVIEW REGISTRATION
International prospective register of systematic reviews (PROSPERO) Registration Number: CRD42020189886.
Topics: Child; Child, Preschool; Humans; Accelerometry; Child Care; Exercise; Sedentary Behavior
PubMed: 35836231
DOI: 10.1186/s12966-022-01303-2 -
Journal of Sport and Health Science Mar 2022This systematic review and meta-analysis aimed to evaluate the effect of wearable devices for improving physical activity and health-related outcomes in cancer survivors. (Meta-Analysis)
Meta-Analysis Review
Effect and feasibility of wearable physical activity trackers and pedometers for increasing physical activity and improving health outcomes in cancer survivors: A systematic review and meta-analysis.
PURPOSE
This systematic review and meta-analysis aimed to evaluate the effect of wearable devices for improving physical activity and health-related outcomes in cancer survivors.
METHODS
CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, ScienceDirect, and SPORTDiscus databases were searched for randomized controlled trials published before September 1, 2020, that evaluated interventions involving wearable devices in cancer survivors. Standardized mean differences (SMDs) were calculated to assess effects on physical activity and health-related outcomes. Subgroup analyses were conducted to assess whether the effects differed by interventions and cancer characteristics. Risk of bias was assessed using the Cochrane risk of bias tool.
RESULTS
Thirty-five trials were included (breast cancer, n = 15, 43%). Intervention durations ranged between 4 weeks and 1 year. Most trials (n = 25, 71%) involved pedometer-based physical activity interventions. Seven (20%) involved Fitbit-based interventions, and 3 (9%) involved other wearable physical activity trackers (e.g., Polar, Garmin). Compared to usual care, wearable devices had moderate-to-large effects (SMD range 0.54-0.87, p < 0.001) on moderate-intensity physical activity, moderate-to-vigorous-intensity physical activity, total physical activity, and daily steps. Compared to usual care, those in the intervention had higher quality of life, aerobic fitness, physical function, and reduced fatigue (SMD range = 0.18-0.66, all p < 0.05).
CONCLUSION
Wearable physical activity trackers and pedometers are effective tools that increase physical activity and improve health-related outcomes in individuals with cancer. Identifying how these devices can be implemented for longer-term use with other intervention components remains an area for future research.
Topics: Actigraphy; Cancer Survivors; Exercise; Feasibility Studies; Fitness Trackers; Humans; Neoplasms; Outcome Assessment, Health Care; Quality of Life; Wearable Electronic Devices
PubMed: 34314878
DOI: 10.1016/j.jshs.2021.07.008 -
Public Health Sep 2020To synthesize evidence on accelerometer-measured moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) levels of Chinese children and adolescents. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To synthesize evidence on accelerometer-measured moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) levels of Chinese children and adolescents.
STUDY DESIGN
This is both a systematic review and meta-analysis study.
METHODS
Online databases were searched for studies published from January 2009 up to February 2019. These studies reported accelerometer-measured daily minutes of MVPA and/or SB among Chinese children and adolescents. Random-effects meta-analysis was used to separately pool the time spent in MVPA and SB.
RESULTS
Of 4754 records, 20 studies were included in the meta-analysis. Sample sizes ranged from 96 to 2163. The meta-analysis showed that Chinese children and adolescents spent 41.11 min/day in MVPA and 529.83 min/day in SB averagely. Boys spent more time in MVPA compared with girls (P = 0.01). Children accumulated more MVPA time than adolescents (P = 0.05), and children spent less time in SB than adolescents (P = 0.05). Unlike weekdays, SB was lower on weekends (P = 0.02). There were significant differences in children and adolescents' MVPA time in regions (P < 0.001).
CONCLUSIONS
MVPA level in Chinese children and adolescents is well below international recommendations, and their SB level is very high.
Topics: Accelerometry; Adolescent; Age Factors; Asian People; Child; China; Databases, Factual; Exercise; Female; Humans; Male; Sedentary Behavior; Sex Factors; Surveys and Questionnaires
PubMed: 32784098
DOI: 10.1016/j.puhe.2020.07.001 -
Journal of Medical Internet Research Jul 2023Wearable sensor technologies have the potential to improve monitoring in people with multiple sclerosis (MS) and inform timely disease management decisions. Evidence of... (Review)
Review
BACKGROUND
Wearable sensor technologies have the potential to improve monitoring in people with multiple sclerosis (MS) and inform timely disease management decisions. Evidence of the utility of wearable sensor technologies in people with MS is accumulating but is generally limited to specific subgroups of patients, clinical or laboratory settings, and functional domains.
OBJECTIVE
This review aims to provide a comprehensive overview of all studies that have used wearable sensors to assess, monitor, and quantify motor function in people with MS during daily activities or in a controlled laboratory setting and to shed light on the technological advances over the past decades.
METHODS
We systematically reviewed studies on wearable sensors to assess the motor performance of people with MS. We scanned PubMed, Scopus, Embase, and Web of Science databases until December 31, 2022, considering search terms "multiple sclerosis" and those associated with wearable technologies and included all studies assessing motor functions. The types of results from relevant studies were systematically mapped into 9 predefined categories (association with clinical scores or other measures; test-retest reliability; group differences, 3 types; responsiveness to change or intervention; and acceptability to study participants), and the reporting quality was determined through 9 questions. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines.
RESULTS
Of the 1251 identified publications, 308 were included: 176 (57.1%) in a real-world context, 107 (34.7%) in a laboratory context, and 25 (8.1%) in a mixed context. Most publications studied physical activity (196/308, 63.6%), followed by gait (81/308, 26.3%), dexterity or tremor (38/308, 12.3%), and balance (34/308, 11%). In the laboratory setting, outcome measures included (in addition to clinical severity scores) 2- and 6-minute walking tests, timed 25-foot walking test, timed up and go, stair climbing, balance tests, and finger-to-nose test, among others. The most popular anatomical landmarks for wearable placement were the waist, wrist, and lower back. Triaxial accelerometers were most commonly used (229/308, 74.4%). A surge in the number of sensors embedded in smartphones and smartwatches has been observed. Overall, the reporting quality was good.
CONCLUSIONS
Continuous monitoring with wearable sensors could optimize the management of people with MS, but some hurdles still exist to full clinical adoption of digital monitoring. Despite a possible publication bias and vast heterogeneity in the outcomes reported, our review provides an overview of the current literature on wearable sensor technologies used for people with MS and highlights shortcomings, such as the lack of harmonization, transparency in reporting methods and results, and limited data availability for the research community. These limitations need to be addressed for the growing implementation of wearable sensor technologies in clinical routine and clinical trials, which is of utmost importance for further progress in clinical research and daily management of people with MS.
TRIAL REGISTRATION
PROSPERO CRD42021243249; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=243249.
Topics: Humans; Reproducibility of Results; Sclerosis; Wearable Electronic Devices; Gait; Exercise; Multiple Sclerosis
PubMed: 37498655
DOI: 10.2196/44428 -
Sensors (Basel, Switzerland) Dec 2021Neurodegenerative disorders (NDDs) constitute an increasing global burden and can significantly impair an individual's mobility, physical activity (PA), and... (Review)
Review
Neurodegenerative disorders (NDDs) constitute an increasing global burden and can significantly impair an individual's mobility, physical activity (PA), and independence. Remote monitoring has been difficult without relying on diaries/questionnaires which are more challenging for people with dementia to complete. Wearable global positioning system (GPS) sensors and accelerometers present a cost-effective and noninvasive way to passively monitor mobility and PA. In addition, changes in sensor-derived outcomes (such as walking behaviour, sedentary, and active activity) may serve as potential biomarkers of disease onset, progression, and response to treatment. We performed a systematic search across four databases to identify papers published within the past 5 years, in which wearable GPS or accelerometers were used to monitor mobility or PA in patients with common NDDs (Parkinson's disease, Alzheimer's disease, motor neuron diseases/amyotrophic lateral sclerosis, vascular parkinsonism, and vascular dementia). Disease and technology-specific vocabulary were searched singly, and then in combination, identifying 4985 papers. Following deduplication, we screened 3115 papers and retained 28 studies following a full text review. One study used wearable GPS and accelerometers, while 27 studies used solely accelerometers in NDDs. GPS-derived measures had been validated against current gold standard measures in one Parkinson's cohort, suggesting that the technology may be applicable to other NDDs. In contrast, accelerometers are widely utilised in NDDs and have been operationalised in well-designed clinical trials.
Topics: Accelerometry; Exercise; Geographic Information Systems; Humans; Neurodegenerative Diseases; Technology; Wearable Electronic Devices
PubMed: 34960353
DOI: 10.3390/s21248261 -
Sensors (Basel, Switzerland) Sep 2023Measurement of real-world physical activity (PA) data using accelerometry in older adults is informative and clinically relevant, but not without challenges. This review... (Review)
Review
Measurement of real-world physical activity (PA) data using accelerometry in older adults is informative and clinically relevant, but not without challenges. This review appraises the reliability and validity of accelerometry-based PA measures of older adults collected in real-world conditions. Eight electronic databases were systematically searched, with 13 manuscripts included. Intraclass correlation coefficient (ICC) for were: walking duration (0.94 to 0.95), lying duration (0.98 to 0.99), sitting duration (0.78 to 0.99) and standing duration (0.98 to 0.99). ICCs for ranged from 0.24 to 0.82 for step counts and 0.48 to 0.86 for active calories. ranged from 5864 to 10,832 steps and for active calories from 289 to 597 kcal. ICCs for for step count were 0.02 to 0.41, and for active calories 0.07 to 0.93. for step count ranged from 0.83 to 0.98. Percentage of agreement for walking ranged from 63.6% to 94.5%; for lying 35.6% to 100%, sitting 79.2% to 100%, and standing 38.6% to 96.1%. between step count and criteria for moderate-to-vigorous PA was = 0.68 and 0.72. Inter-rater reliability and criterion validity for walking, lying, sitting and standing duration are established. Criterion validity of step count is also established. Clinicians and researchers may use these measures with a limited degree of confidence. Further work is required to establish these properties and to extend the repertoire of PA measures beyond "volume" counts to include more nuanced outcomes such as intensity of movement and duration of postural transitions.
Topics: Independent Living; Reproducibility of Results; Exercise; Walking; Accelerometry
PubMed: 37688071
DOI: 10.3390/s23177615