Free-Living Physical Activity Monitoring in Adult US Patients with Multiple Sclerosis Using a Consumer Wearable Device.
Free-Living Physical Activity Monitoring in Adult US Patients with Multiple Sclerosis Using a Consumer Wearable Device.
复制标题
DOI：
10.1159/000488040
复制
发表时间：
2018-01-01
影响因子：
--
通讯作者：
Rhodes, Jane
中科院分区：
文献类型：
--
作者：
DasMahapatra, Pronabesh;Chiauzzi, Emil;Rhodes, Jane
引言：可穿戴设备已被用于表征多发性硬化症（MS）的身体活动。本研究的目的是推进文献的效用自由生活的体力活动跟踪从二次分析的试点研究在MS patients.METHOD：原来的观察性研究进行了参与者MS在PatientsLikeMe（PatientsLikeMe（www.PatientsLikeMe.com），慢性疾病患者的在线网络。参与者完成了基线自我评估，并收到了Fitbit OneTM可穿戴设备，其中包含上传数据的说明。合格受试者（1）自我报告MS，（2）在入组前90天登录PatientsLikeMe网站，（3）同意以电子方式参与。参与者（1）< 18岁，（2）居住在美国境外，（3）需要轮椅辅助进行大多数日常活动。次要分析仅限于具有MS类型、疾病持续时间和多发性硬化评定量表（MSRS）完整数据以及至少7天可穿戴数据的参与者。步数被用作身体活动的衡量标准。结果：114名参与者的分析队列在23天的研究中上传了平均20.1天的可穿戴数据（87%的依从性）;参与者平均每天4，393步。参与者的平均年龄为52岁，主要是女性（75%），复发缓解型（79%），平均病程为16年。基线30天内的平均MSRS评分为32; 72%报告轻度至中度行走残疾。采用组内相关法测量的步数的可靠性为：单日0.55，2天平均≥0.7，7天平均≥0.9。在控制协变量后，自我报告的疾病严重程度（MSRS四分位数）是步数的独立预测因子（p < 0.001）。残疾程度最低（最低四分位数）的参与者的最小二乘均值（LS均值）为5，937步，显著高于第二，第三和第四分位数的参与者（分别为4，570，3，490和3，272）。同样，无行走残疾的受试者的LS均值（通过MSRS步行分量测量）为6，931步，显着高于严重残疾的参与者（有症状、轻度和中度残疾的参与者分别为4，743、4，394、2，727步，p < 0.001）。讨论：使用交互式平台，本研究捕获了MS患者的自由生活移动数据。重要的指标，如使用至少2天的估计和自我报告的残疾被认为是强大的指标和相关性，分别参与者的活动水平。这些度量的进一步三角测量可以减少患者、临床医生和研究人员在监测临床状态时的负担。
INTRODUCTION: Wearable devices have been used to characterize physical activity in multiple sclerosis (MS). The objectives of this study were to advance the literature on the utility of free-living physical activity tracking from secondary analyses of a pilot study in MS patients.METHOD: The original observational study was conducted in participants with MS at PatientsLikeMe (PatientsLikeMe (www.PatientsLikeMe.com), an online network of patients with chronic diseases. Participants completed a baseline self-assessment, and received a Fitbit OneTM wearable device with instructions to upload data. Eligible participants (1) self-reported MS, (2) logged on to the PatientsLikeMe website 90 days prior to enrollment, and (3) consented to participate electronically. Participants (1) < 18 years, (2) living outside the United States, and (3) requiring wheelchair assistance for most daily activities were excluded. The secondary analyses were limited to participants with complete data on MS type, disease duration, and Multiple Sclerosis Rating Scale (MSRS) and at least 7 days of wearable data. Step count was used as a measure of physical activity.RESULTS: The analysis cohort of 114 participants uploaded a mean of 20.1 days of wearable data over the 23-day study (87% adherence); participants averaged 4,393 steps per day. The mean age of participants was 52 years, predominantly female (75%), relapsing-remitting type (79%), with mean disease duration of 16 years. Mean MSRS score within 30-day of baseline was 32; 72% reported mild-moderate walking disability. The reliability of step count measured by intraclass correlation was 0.55 for a single day, ≥0.7 for 2-day average, and ≥0.9 for 7-day average. After controlling for covariates, self-reported disease severity (MSRS quartile) was an independent predictor of step count (p < 0.001). Least square means (LS means) for participants that were least disabled (lowest quartile) was 5,937 steps, which was significantly higher than participants in the second, third, and fourth quartiles (4,570, 3,490, and 3,272, respectively). Similarly, LS means of participants with no ambulatory disability (measured by MSRS walk component) was 6,931 steps, significantly higher than participants with greater disability (4,743, 4,394, 2,727 steps for symptomatic, mild, and moderate disability, respectively, p < 0.001).DISCUSSION: Using an interactive platform, this study captured free-living mobility data in MS patients. Important metrics such as the use of a minimum of 2-day estimates and self-reported disability were found to be robust indicators and correlates, respectively, of participant activity levels. Further triangulation of such metrics may reduce the burden on patients, clinicians, and researchers when monitoring clinical status.