A Novel Tool for Quantifying and Promoting Physical Activity in Youths With Typical Development and Youths Who Are Ambulatory and Have Motor Disability

Kristel Lankhorst, Rita J van den Berg-Emons, Johannes B J Bussmann, Herwin L D Horemans, Janke F de Groot Physical Therapy, Volume 99, Issue 3, March 2019, Pages 354–363, https://doi.org/10.1093/ptj/pzy152

Several device-based instruments have been validated in the pediatric population, but none of these are clinically applicable and provide real-time feedback on actual physical activity in terms of postures and movements. A new device (Activ8) is promising for that purpose. The objective was to investigate the criterion validity of the Activ8 for measuring static (sitting, standing) and dynamic (walking, bicycling, running) activities, and for separating postures and movements within basic and complex activities in children and adolescents (youths) with typical development (TD) and peers with motor disability (not typical development [NTD]).

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Validity of consumer-grade activity monitor to identify manual wheelchair propulsion in standardized activities of daily living

Marika T. Leving1*, Henricus L. D. Horemans2, Riemer J. K. Vegter1, Sonja de Groot1,3, Johannes B. J. Bussmann2, Lucas H. V. van der Woude1,4

1 Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands, 2 Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands, 3 Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands, 4 Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

Hypoactive lifestyle contributes to the development of secondary complications and lower quality of life in wheelchair users. There is a need for objective and user-friendly physical activity monitors for wheelchair-dependent individuals in order to increase physical activity through self-monitoring, goal setting, and feedback provision.

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The Accuracy of the Detection of Body Postures and Movements Using a Physical Activity Monitor in People after a Stroke

Malou H. J. Fanchamps 1,2 ID , Herwin L. D. Horemans 1, Gerard M. Ribbers 1,2 ID , Henk J. Stam 1 and Johannes B. J. Bussmann 1,*

1

Department of Rehabilitation Medicine, Erasmus MC University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands; m.fanchamps@erasmusmc.nl (M.H.J.F.); h.l.d.horemans@erasmusmc.nl (H.L.D.H.); gribbers@rijndam.nl (G.M.R.); h.j.stam@erasmusmc.nl (H.J.S.) Rijndam Rehabilitation, Westersingel 300, 3015 LJ Rotterdam, The Netherlands

2
* Correspondence: j.b.j.bussmann@erasmusmc.nl; Tel.: +31-10-703-3906

Received: 31 May 2018; Accepted: 3 July 2018; Published: 5 July 2018

In stroke rehabilitation not only are the levels of physical activity important, but body postures and movements performed during one’s daily-life are also important. This information is provided by a new one-sensor accelerometer that is commercially available, low-cost, and user-friendly. The present study examines the accuracy of this activity monitor (Activ8) in detecting several classes of body postures and movements in people after a stroke. Methods: Twenty-five people after a stroke participated in an activity protocol with either basic activities or daily-life activities performed in a laboratory and/or at home. Participants wore an Activ8 on their less-affected thigh. The primary outcome was the difference in registered time for the merged class “upright position” (standing/walking/running) between the Activ8 and the video recording (the reference method). Secondary analyses focused on classes other than “upright position”. Results: The Activ8 underestimated the merged class “upright position” by 3.8% (775 s). The secondary analyses showed an overestimation of “lying/sitting” (4.5% (569 s)) and of “cycling” (6.5% (206 s)). The differences were lowest for basic activities in the laboratory and highest for daily-life activities at home. Conclusions: The Activ8 is sufficiently accurate in detecting different classes of body postures and movements of people after a stroke during basic activities and daily-life activities in a laboratory and/or at home.

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Detection of body postures and movements in ambulatory adults with cerebral palsy: a novel and valid measure of physical behaviour

Everett A. Claridge , Rita J. G. van den Berg-Emons , Herwin L. D. Horemans , Wilma M. A. van der Slot ,

3 1 2,5 1,2 3* Nick van der Stam , Ada Tang , Brian W. Timmons , Jan Willem Gorter and Johannes B. J. Bussmann

Claridge et al. Journal of NeuroEngineering and Rehabilitation (2019) 16:125 https://doi.org/10.1186/s12984-019-0594-9

Accurate measurement of physical behaviour is paramount to better understand lifestyle, health, and functioning, particularly in adults with physical disability as they may be at higher risk of sedentary lifestyle and subsequent negative health consequences. This study aimed: 1) to evaluate the criterion validity of a novel and clinically applicable activity monitor (AM, Activ8), in the detection of body postures and movements in adults with spastic cerebral palsy (CP); and 2) to evaluate the extent that the AMs positioning affects validity.

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Accuracy of energy expenditure in daily activities

Activ8 compared to the Actigraph GTX3 +, heart rate measurement and indirect calorimetry

Objective information about sedentary behaviour and physical activity can make contributions to health. Researchers get insight into the dose-response relationship between physical activity and health and an individual gets information about his own physical activity for selfmonitoring and goal setting. The Activ8, a triaxial accelerometer, that can be carried in a subject’s trouser pocket, recognizes postures and types of physical activity (lying, sitting, standing, walking, running and cycling) Based on the registered time, in a posture or activity, and the measured accelerations (m/s2) the energy expenditure is estimated

Method & results study

19 adults performed three walking activities at 2 km/h, 4 km/h and 6 km/h, three running activities at 8 km/h, 11km/h and 14 km/h on a treadmill and three cycling activities at 50 watt (40rpm), 125 watt (60rpm) and 200 watt (80rpm) on a stationary bike2 . Physical activity energy expenditure (PAEE) was estimated by heart rate, Activ8 and Actigraph in kJ/kg/min.

Validation of physical activity monitor
Estimation of energy expenditure in kJ/kg/min by heart rate, Activ8 and Actigraph for different exercise activities.
Objective information about sedentary behaviour and physical activity can make contributions to health. Researchers get insight into the dose-response relationship between physical activity and health and an individual gets information about his own physical activity for self monitoring and goal setting. The Activ8, a triaxial accelerometer, that can be carried in a subject’s trouser pocket, recognizes postures and types of physical activity (lying, sitting, standing, walking, running and cycling) Based on the registered time, in a posture or activity, and the measured accelerations (m/s2) the energy expenditure is estimated.

Method & results study

19 adults performed three walking activities at 2 km/h, 4 km/h and 6 km/h, three running activities at 8 km/h, 11km/h and 14 km/h on a treadmill and three cycling activities at 50 watt (40rpm), 125 watt (60rpm) and 200 watt (80rpm) on a stationary bike2 . Physical activity energy expenditure (PAEE) was estimated by heart rate, Activ8 and Actigraph in kJ/kg/min. Physical activity energy expenditure (PAEE) was estimated by indirect calorimetry (Cortex) and the Activ8 in kJ/kg/min.

Discussion and conclusion

With regard tot walking and running the instruments show high correlations, although both accelerometers estimate energy expenditure using different methods. The Activ8 seems tot recognize and measure cycling activities more accurate than the Actigraph. These differences may be related to the (recommended) placement of the Actigraph on the hip, and activity recognition capacity of the Activ8. The results from study 2 reveal that the estimated energy expenditure by the Activ8 is largely in line with indirect calorimetry. At higher running speeds an adjustment in the Activ8 algorithm might improve the estimation of energy expenditure. The workrate (energy expenditure) of cycling is determined by force x acceleration (RPM). Acceleration can be low but with a great force (cycling uphill). The Activ8 only registers acceleration and no force. Therefore the development of a validation protocol in real-life conditions is needed to have accurate estimations of energy expenditure.

Relevance

The Activ8 is an affordable activity monitor which is easy to use and seems to make acceptable estimations of energy expenditure. This makes it a promising device for both large scale research purposes and the consumer market. The Activ8 also has two additional features; it recognizes different postures and types of physical activity (lying, sitting, standing, walking, running and cycling) and is supported by an online coaching module that allows the use of the Activ8 as a means for interventions. Future research will have to demonstrate the accuracy of the Activ8 in real life validation studies and its potential as a coaching tool.
Download the poster of the Energy Expenditure validation study (pdf)..