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Annals of Physical and Rehabilitation... Mar 2020Gait impairment is a hallmark of multiple sclerosis (MS). InertiaLocoGraphy, the quantification of gait with inertial measurement units (IMUs), has been found useful to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Gait impairment is a hallmark of multiple sclerosis (MS). InertiaLocoGraphy, the quantification of gait with inertial measurement units (IMUs), has been found useful to detect early changes in gait in MS. Still, the potential use of IMUs as a reliable biomarker of disease severity in MS remains unknown.
OBJECTIVE
This systematic review and meta-analysis of observational studies aimed to describe IMU protocols used to assess gait in MS patients and calculate the effect sizes of IMU features associated with disease severity scale measures.
METHODS
We searched MEDLINE, Cochrane Central, EMBASE and grey literature to identify articles published before May 2, 2018 that measured gait in MS patients by using IMUs and correlated IMU parameters with disease severity scale measures. We excluded from the meta-analysis articles that did not provide enough data to evaluate the association between IMU parameters and disease severity scale measures. The study was registered with the International Prospective Register of Systematic Reviews on May 2, 2018 (Registration: CRD42018092651) and the protocol was published in Systematic Reviews on January 8, 2019.
RESULTS
We included 36 articles in the systematic review and pooled 12 for the meta-analysis. The risk of bias was moderate, with only 2 articles (none included in the meta-analysis) showing a bias score<50%. Among protocols tested, 2 were predominant (the Timed Up and Go test and 6-min walk test). Speed, step length and step time with IMUs were significantly correlated with the Expanded Disability Status Scale (EDSS) score, and speed and step length were significantly correlated with the Multiple Sclerosis Walking Scale-12 score.
CONCLUSION
IMU measurement has the potential to increase the sensitivity of clinical and performance tests to identify evolution in gait alteration in MS. Kinematic parameters easily accessible with IMUs, such as speed, step length and step duration, can help follow up disease severity in MS individuals with low to medium EDSS score (1.0-4.5).
Topics: Accelerometry; Equipment Design; Gait Disorders, Neurologic; Humans; Motion; Multiple Sclerosis; Observational Studies as Topic; Organ Specificity; Severity of Illness Index; Wearable Electronic Devices
PubMed: 31421274
DOI: 10.1016/j.rehab.2019.07.004 -
The International Journal of Behavioral... Jan 2021Research shows that part of the variation in physical activity and sedentary behaviour may be explained by genetic factors. Identifying genetic variants associated with...
BACKGROUND
Research shows that part of the variation in physical activity and sedentary behaviour may be explained by genetic factors. Identifying genetic variants associated with physical activity and sedentary behaviour can improve causal inference in physical activity research. The aim of this systematic review was to provide an updated overview of the evidence of genetic variants associated with physical activity or sedentary behaviour.
METHODS
We performed systematic literature searches in PubMed and Embase for studies published from 1990 to April 2020 using keywords relating to "physical activity", "exercise", "sedentariness" and "genetics". Physical activity phenotypes were either based on self-report (e.g., questionnaires, diaries) or objective measures (e.g., accelerometry, pedometer). We considered original studies aiming to i) identify new genetic variants associated with physical activity or sedentary behaviour (i.e., genome wide association studies [GWAS]), or ii) assess the association between known genetic variants and physical activity or sedentary behaviour (i.e., candidate gene studies). Study selection, data extraction, and critical appraisal were carried out by independent researchers, and risk of bias and methodological quality was assessed for all included studies.
RESULTS
Fifty-four out of 5420 identified records met the inclusion criteria. Six of the included studies were GWAS, whereas 48 used a candidate gene approach. Only one GWAS and three candidate gene studies were considered high-quality. The six GWAS discovered up to 10 single nucleotide polymorphisms (SNPs) associated with physical activity or sedentariness that reached genome-wide significance. In total, the candidate gene studies reported 30 different genes that were associated (p < 0.05) with physical activity or sedentary behaviour. SNPs in or close to nine candidate genes were associated with physical activity or sedentary behaviour in more than one study.
CONCLUSION
GWAS have reported up to 10 loci associated with physical activity or sedentary behaviour. Candidate gene studies have pointed to some interesting genetic variants, but few have been replicated. Our review highlights the need for high-quality GWAS in large population-based samples, and with objectively assessed phenotypes, in order to establish robust genetic instruments for physical activity and sedentary behaviour. Furthermore, consistent replications in GWAS are needed to improve credibility of genetic variants.
TRIAL REGISTRATION
Prospero CRD42019119456 .
Topics: Accelerometry; Actigraphy; Exercise; Genetic Variation; Genome-Wide Association Study; Humans; Polymorphism, Single Nucleotide; Sedentary Behavior
PubMed: 33482856
DOI: 10.1186/s12966-020-01077-5 -
BMJ Open Dec 2019Wearable motion sensors are used with increasing frequency in the evaluation of gait, function and physical activity within orthopaedics and sports medicine. The...
OBJECTIVES
Wearable motion sensors are used with increasing frequency in the evaluation of gait, function and physical activity within orthopaedics and sports medicine. The integration of wearable technology into the clinical pathway offers the ability to improve post-operative patient assessment beyond the scope of current, questionnaire-based patient-reported outcome measures. This scoping review assesses the current methodology and clinical application of accelerometers and inertial measurement units for the evaluation of patient activity and functional recovery following knee arthroplasty.
DESIGN
This is a systematically conducted scoping review following Joanna Briggs Institute methodology for scoping reviews and reported consulting the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for scoping reviews. A protocol for this review is registered with the Open Science Framework (https://osf.io/rzg9q).
DATA SOURCES
CINAHL, EMBASE, MEDLINE and Web of Science databases were searched for manuscripts published between 2008 and 2019.
ELIGIBILITY CRITERIA
We included clinical studies reporting the use of any combination of accelerometers, pedometers or inertial measurement units for patient assessment at any time point following knee arthroplasty.
DATA EXTRACTION AND SYNTHESIS
Data extracted from manuscripts included patient demographics, sensor technology, testing protocol and sensor-based outcome variables.
RESULTS
45 studies were identified, including 2076 knee arthroplasty patients, 620 patients with end-stage osteoarthritis and 449 healthy controls. Primary aims of the identified studies included functional assessment, physical activity monitoring and evaluation of knee instability. Methodology varied widely between studies, with inconsistency in reported sensor configuration, testing protocol and output variables.
CONCLUSIONS
The use of wearable sensors in evaluation of knee arthroplasty procedures is becoming increasingly common and offers the potential to improve clinical understanding of recovery and rehabilitation. While current studies lack consistency, significant opportunity exists for the development of standardised measures and protocols for function and physical activity evaluation.
Topics: Accelerometry; Arthroplasty, Replacement, Knee; Exercise; Gait; Humans; Treatment Outcome; Wearable Electronic Devices
PubMed: 31888943
DOI: 10.1136/bmjopen-2019-033832 -
Preventive Medicine Reports Dec 2020There is evidence that simply measuring physical activity alone can increase self-reported physical activity behaviour. The aim of this review was to describe changes in... (Review)
Review
There is evidence that simply measuring physical activity alone can increase self-reported physical activity behaviour. The aim of this review was to describe changes in objectively-measured physical activity within control groups in primary care physical activity intervention studies. Five electronic databases (PubMed, MEDLINE, SPORTDiscus, PsychINFO and CINAHL) were searched from inception to February 2019. Physical activity controlled intervention studies objectively measuring physical activity in primary care with adults were included and -analyses were completed. Thirty studies were eligible and 22 studies were included in the -analysis. No statistically significant change in steps.day, counts.day and counts.minute were found in the -analyses within control groups. Moderate-to-vigorous physical activity minutes.day significantly decreased (-3.97; 95% CI -6.31 to -1.64; P < 0.001). Sub-analyses revealed there was a trend for steps.day to increase in participants < 50 years old (504; 95% CI -20 to 1029; P = 0.06). Noteworthy increases (≥10%) in objectively-measured physical activity within control groups were found in 17% of studies. Noteworthy increases were reported in studies with younger participants, one-third of the pedometer studies, one-third of studies with participants at risk of chronic disease and in studies with a shorter duration between measurements. No control group improvements were found in participants with chronic disease. Overall, no significant improvements in objectively-measured physical activity were found within control groups in primary care. Further investigation of noteworthy increases in control group physical activity levels is indicated, particularly in certain sub-groups of participants as this may effect physical activity research and interventions in these populations.
PubMed: 33163332
DOI: 10.1016/j.pmedr.2020.101230 -
Parkinsonism & Related Disorders Aug 2021To guide the neurologist and neurophysiologist with interpretation and implementation of clinical neurophysiological examinations, we aim to provide a systematic review... (Comparative Study)
Comparative Study
INTRODUCTION
To guide the neurologist and neurophysiologist with interpretation and implementation of clinical neurophysiological examinations, we aim to provide a systematic review on evidence of electrophysiological features used to differentiate between hyperkinetic movement disorders.
METHODS
A PRISMA systematic search and QUADAS quality evaluation has been performed in PubMed to identify diagnostic test accuracy studies comparing electromyography and accelerometer features. We included papers focusing on tremor, dystonia, myoclonus, chorea, tics and ataxia and their functional variant. The features were grouped as 1) basic features (e.g., amplitude, frequency), 2) the influence of tasks on basic features (e.g., entrainment, distraction), 3) advanced analyses of multiple signals, 4) and diagnostic tools combining features.
RESULTS
Thirty-eight cross-sectional articles were included discussing tremor (n = 28), myoclonus (n = 5), dystonia (n = 5) and tics (n = 1). Fifteen were rated as 'high quality'. In tremor, the basic and task-related features showed great overlap between clinical tremor syndromes, apart from rubral and enhanced physiological tremor. Advanced signal analyses were best suited for essential, parkinsonian and functional tremor, and cortical, non-cortical and functional jerks. Combinations of electrodiagnostic features could identify essential, enhanced physiological and functional tremor.
CONCLUSION
Studies into the diagnostic accuracy of electrophysiological examinations to differentiate between hyperkinetic movement disorders have predominantly been focused on clinical tremor syndromes. No single feature can differentiate between them all; however, a combination of analyses might improve diagnostic accuracy.
Topics: Accelerometry; Cross-Sectional Studies; Diagnosis, Differential; Dystonia; Electromyography; Humans; Hyperkinesis; Movement Disorders; Myoclonus; Neurophysiology; Tics; Tremor
PubMed: 34362669
DOI: 10.1016/j.parkreldis.2021.07.033 -
Sports (Basel, Switzerland) Jan 2024Sedentary behavior and inadequate energy expenditure are serious global public health concerns among youngsters. The exponential growth in technology emerges as a... (Review)
Review
Sedentary behavior and inadequate energy expenditure are serious global public health concerns among youngsters. The exponential growth in technology emerges as a valuable opportunity to foster physical activity, particularly through active video games. We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in PubMed, Web of Science, Cochrane, and Scopus to provide a comprehensive view of the literature on energy expenditure levels among adolescents while playing active video games. Among the 574 manuscripts identified at the first screening stage, 23 were retained for analysis. Ten studies were characterized by longitudinal and thirteen by cross-sectional designs. The results showed that short-term active video games elicited energy expenditure values comparable to moderate-intensity physical activity (3-6 METs). However, in intervention programs (with at least six weeks) the results indicate no significant effects of active video games on youngsters' energy expenditure levels and physical activity profiles between baseline and follow-up assessments. Overall, active video games based on sports and dance were the most used, and boys tended to achieve higher energy expenditure than girls. The diversity of methods implemented limits comparing results and drawing generalized conclusions. However, considering its attractiveness to youth, active video games might emerge as a complementary tool to traditional physical activities promoted in schools and local communities. Details regarding gender differences and contradictory results of longitudinal approaches should be considered in future research based on standardized methods.
PubMed: 38393259
DOI: 10.3390/sports12020039 -
International Journal of Environmental... Aug 2020Despite the existence of global recommendations for physical activity and lifestyle to avoid childhood obesity, there are no specific recommendations for school-age... (Meta-Analysis)
Meta-Analysis
Despite the existence of global recommendations for physical activity and lifestyle to avoid childhood obesity, there are no specific recommendations for school-age children. The aim of this meta-analysis was to measure the effects of current interventions with a physical activity component on body mass index (BMI) Z-score and on the moderate and vigorous physical activity (MVPA) time, measured by accelerometry, and focused on children with obesity. Randomized controlled trial studies (RCTs) based on physical activity interventions focused on children with obesity (6 to 12 years old) from January 1991 to August 2018 were included. The post-intervention mean and standard deviation of the BMI Z-score and MVPA engaged time were extracted to calculate the results using random effects models. Of a total of 229 studies considered potentially eligible, only 10 RCTs met the inclusion criteria. There were improvements in the BMI Z-score for physical activity intervention groups, compared with non-intervention children in addition to a significant increase in time engaged in MVPA. In conclusion, interventions with a physical activity component in school-children with obesity seem to be effective at reducing BMI and producing an increase in time spent engaged in physical activity. Therefore, interventions based on physical activity should be considered one of the main strategies in treating childhood obesity.
Topics: Accelerometry; Body Mass Index; Child; Exercise; Female; Humans; Life Style; Male; Pediatric Obesity; Schools
PubMed: 32825085
DOI: 10.3390/ijerph17176031 -
Journal of Intensive Care Medicine Nov 2020In the intensive care unit (ICU), prolonged inactivity is common, increasing patients' risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions...
OBJECTIVE
In the intensive care unit (ICU), prolonged inactivity is common, increasing patients' risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions to minimize inactivity are gaining popularity, highlighting actigraphy, a measure of activity involving a wristwatch-like accelerometer, as a method to inform these efforts. Therefore, we performed a systematic review of studies that used actigraphy to measure patient activity in the ICU setting.
DATA SOURCES
We searched PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest from inception until December 2016.
STUDY SELECTION
Two reviewers independently screened studies for inclusion. A study was eligible for inclusion if it was published in a peer-reviewed journal and used actigraphy to measure activity in ≥5 ICU patients.
DATA EXTRACTION
Two reviewers independently performed data abstraction and risk of bias assessment. Abstracted actigraphy-based activity data included total activity time and activity counts.
RESULTS
Of 16 studies (607 ICU patients) identified, 14 (88%) were observational, 2 (12%) were randomized control trials, and 5 (31%) were published after 2009. Mean patient activity levels per 15 to 60 second epoch ranged from 25 to 37 daytime and 2 to 19 nighttime movements. Actigraphy was evaluated in the context of ICU and post-ICU outcomes in 11 (69%) and 5 (31%) studies, respectively, and demonstrated potential associations between actigraphy-based activity levels and delirium, sedation, pain, anxiety, time to extubation, and length of stay.
CONCLUSION
Actigraphy has demonstrated that patients are profoundly inactive in the ICU with actigraphy-based activity levels potentially associated with important measures, such as delirium, sedation, and length of stay. Larger and more rigorous studies are needed to further evaluate these associations and the overall utility of actigraphy in the ICU setting.
Topics: Actigraphy; Airway Extubation; Critical Care; Exercise; Humans; Intensive Care Units; Length of Stay; Randomized Controlled Trials as Topic
PubMed: 31331220
DOI: 10.1177/0885066619863654 -
Journal of Clinical Epidemiology Sep 2021The later-age shift towards physical inactivity and sedentary behaviour is associated with comorbidity and reduced function: markers of frailty. Whether these behaviours...
OBJECTIVE
The later-age shift towards physical inactivity and sedentary behaviour is associated with comorbidity and reduced function: markers of frailty. Whether these behaviours relate to frailty has yet to be thoroughly studied using objective measurements. This study aimed to summarise the associations of objectively measured habitual physical activity and sedentary behaviour with frailty in community-dwelling older adults.
STUDY DESIGN AND SETTING
Six databases were searched from inception to July 21st 2020. Articles analyzing objectively measured physical activity and/or sedentary behaviour with frailty in community-dwelling adults ≥60 years old were included. Synthesis of included articles was performed using effect direction heat maps and albatross plots.
RESULTS
The search identified 23 articles across 18 cohorts, including 7,696 total participants with a mean age of 69.3±8.1 years, and 56.9% female. All but one article were cross-sectional. Lower moderate-to-vigorous and total physical activity, steps, postural transitions, and energy expenditure were associated with frailty. The use of multifactorial or physical frailty definitions did not alter associations. Median effect sizes for the associations of all physical activity and sedentary behaviour measures with frailty were β = -0.272 [-0.381, -0.107] and β = 0.100 [0.001, 0.249], respectively.
CONCLUSION
Objective measures of physical activity are associated with frailty, regardless of frailty definition.
Topics: Aged; Exercise; Female; Frailty; Humans; Independent Living; Male; Middle Aged; Sedentary Behavior
PubMed: 33915264
DOI: 10.1016/j.jclinepi.2021.04.009 -
Developmental Medicine and Child... Aug 2019To evaluate the effectiveness of pharmacological interventions for managing non-respiratory sleep disturbances in children with neurodisabilities. (Meta-Analysis)
Meta-Analysis
AIM
To evaluate the effectiveness of pharmacological interventions for managing non-respiratory sleep disturbances in children with neurodisabilities.
METHOD
We performed a systematic review and meta-analyses of randomized controlled trials (RCTs). We searched 16 databases, grey literature, and reference lists of included papers up to February 2017. Data were extracted and assessed for quality by two researchers (B.B., C.M., G.S., A.S., A.P.).
RESULTS
Thirteen trials were included, all evaluating oral melatonin. All except one were at high or unclear risk of bias. There was a statistically significant increase in diary-reported total sleep time for melatonin compared with placebo (pooled mean difference 29.6min, 95% confidence interval [CI] 6.9-52.4, p=0.01). Statistical heterogeneity was high (97%). For the single RCT with low risk of bias, the unadjusted mean difference in total sleep time was 13.2 minutes (95% CI -13.3 to 39.7) favouring melatonin, while the mean difference adjusted for baseline total sleep time was statistically significant (22.4min, 95% CI 0.5-44.3, p=0.04). Adverse event profile suggested that melatonin was well-tolerated.
INTERPRETATION
There is a paucity of evidence on managing sleep disturbances in children with neurodisabilities, and it is mostly of limited scope and poor quality. There is evidence of the benefit and safety of melatonin compared with placebo, although the extent of this benefit is unclear.
WHAT THIS PAPER ADDS
Melatonin for the management of non-respiratory sleep disturbances in children with neurodisabilities was well tolerated with minimal adverse effects. The extent of benefit and which children might benefit most from melatonin use is uncertain. Benefit may be greatest in those with autism spectrum disorder; however, this finding should be interpreted with caution.
Topics: Actigraphy; Autism Spectrum Disorder; Child; Humans; Melatonin; Sleep Wake Disorders; Treatment Outcome
PubMed: 30710339
DOI: 10.1111/dmcn.14157