Comparação entre processamentos de dados do acelerômetro gt3x+ para atividade física moderada e vigorosa / Comparison between data processing from gt3x+ accelerometer for vigorous and moderate physical activity

RESUMO O uso do acelerômetro para mensurar a atividade física em pesquisas epidemiológicas, apresenta desafios para aumentar a comparabilidade entre os estudos que utilizam esse equipamento. Nesse sentido o objetivo deste trabalho é comparar estimativas de tempo em AFMV para adultos provenientes de diferentes métodos de processamentos de dados, através do acelerômetro Actigraph GT3X+. Trata-se de um estudo transversal, da linha de base do estudo piloto do Estudo Longitudinal dos Determinantes da Atividade Física. Amostra contou com 31 funcionários terceirizados de ambos os sexos, com idade média de 47.05anos (DP=9.35). Os participantes utilizaram acelerômetros do modelo GT3X+ durante sete dias consecutivos. A estimativa de tempo de AFMV foi gerada através de software Actilife e R-package GGIR. Análises estatísticas descritivas, ANOVA e pos-hoc de Bonferroni para comparabilidade foram realizadas no software R. Análise de Bland-Altman foi realizado no SigmaPlot para avaliação de viés e concordância. Houve diferença significativa no tempo médio de AFMV entre os dados baseados em counts e dados brutos (p<0,001). O tempo médio em AFMV foi menor a partir do processamento por dados brutos do que o em counts (-264,81min/dia; p<0,001). Concluindo que os achados sugerem não haver, estatisticamente, equivalência entre os métodos comparados para estimar tempo de AFMV.

ABSTRACT The use of accelerometers to measure physical activity in epidemiological research presents challenges to increase comparability between studies that use this equipment. In this sense, the objective of this work is to compare time estimates in MVPA for adults from different data processing methods, using the Actigraph GT3X+ accelerometer. This is a cross-sectional study, from the baseline of the pilot study of the Longitudinal Study of the Determinants of Physical Activity. Sample had 31 outsourced employees of both genders, with an average age of 47.05 years (SD=9.35). Participants used GT3X+ model accelerometers for seven consecutive days. The MVPA time estimate was generated using Actilife and R-package GGIR software. Descriptive statistical analyses, ANOVA and Bonferroni post-hoc for comparability were performed in the R software. Bland-Altman analysis was performed in SigmaPlot to assess bias and agreement. There was a significant difference in the mean time of MVPA between count-based data and raw data (p<0.001). The average time in MVPA was shorter from processing by raw data than in counts (-264.81 min/day; p<0.001). Concluding that the findings suggest that there is no statistically equivalence between the methods compared to estimate MVPA time.

Reversed Hand Movement during Sleep in Patients with Obstructive Sleep Apnea

OBJECTIVE: Previous findings suggest that hand movement laterality is reversed during sleep. The present study aimed to verify this phenomenon and evaluate whether the extent of reversal is correlated with the severity of sleep apnea. METHODS: A total of 184 participants (mean age: 44.5±13.0 years; 81.5% males) wore actigraphs on both hands during sleep, and nocturnal polysomnography was simultaneously performed. RESULTS: Actigraphic indices of hand movement were significantly higher for the left hand than those for the right hand (p < 0.001), including total activity score, mean activity score, mean score in active periods and fragmentation index. Additionally, calculated differences between the fragmentation index for the left versus right hands were significantly correlated with the apnea-hypopnea index (AHI, r=0.149, p=0.032). The AHI was not significantly correlated with differences in hand movement between both hands movement assessed by total activity score (r=0.004, p=0.957), mean activity score (r=0.011, p=0.876), mean score in active periods (r=-0.080, p=0.255). CONCLUSION: More severe symptoms of obstructive sleep apnea was associated with larger degree of hand movement reversal at night. This result support the theory that homeostatic deactivation occurs in the dominant hemisphere during sleep.

Sleep, activity and fatigue reported by Postgraduate Year 1 residents: a prospective cohort study comparing the effects of night float versus the traditional overnight on-call system

INTRODUCTION@#As the traditional overnight call system was shown to contribute to fatigue, Singapore implemented a shift system in 2014. We aimed to compare activity levels, sleep (using a wrist actigraph), fatigue and professional quality of life between residents working on night float and those on overnight calls.@*METHODS@#All Postgraduate Year 1 (PGY1) residents at our institution were invited to participate. Participants were required to wear a wrist actigraph for four months and complete two validated surveys (Epworth Sleepiness Scale [ESS] and Professional Quality of Life [ProQOL] scale) once each at the start and end of the study.@*RESULTS@#49 residents were recruited. Night float and on-call residents showed a comparable median (range) number of steps (10,061 [1,195-15,923] vs. 10,649 [308-21,910]; p = 0.429), amount of sleep logged (361 [149-630] minutes vs. 380 [175-484] minutes; p = 0.369) and time taken to fall asleep (6 [0-14] minutes vs. 6 [range 0-45] minutes; p = 0.726), respectively. Night float residents had less efficient sleep, with 90.5% having sleep efficiency of over 85% compared to 100% of on-call residents (p = 0.127). More night float residents reported ESS scores > 10 (73.1% vs. 38.5%) and higher burnout scores on ProQOL scale (41.4% vs. 21.4%) at the start of the study. However, this was similar to the end of the study and not statistically significant.@*CONCLUSION@#Physical activity and amount of sleep were not significantly different between night float and on-call residents. Residents on night float reported comparatively more fatigue and burnout.

Physical Activity Assessment of Preschool Children Using Accelerometer: Including Comparison of Reintegrating Counts of Different Epoch Lengths

The purpose of this study was to assess the physical activity of preschool children using an accelerometer and investigate differences related to epoch length setting during use of the accelerometer. Subjects of the study were 26 children (12 boys and 14 girls) at the age of 5, enrolled in one preschool located in Gangneung. From 9:00 a.m. to 4:00 p.m. (7 hours period), every child wore a total of four accelerometers (ActiGraph GT3X⁺, USA), including three attached to the left hip (with epoch length set at 5 seconds, 15 seconds, and 30 seconds). For comparison purposes, a forth was attached to the opposite position, with epoch length set at 5 seconds. Data collected using 15s epoch and 30s epoch (single larger epoch) were compared with those obtained after reintegration of 5s to 15s epoch, 5s to 30s epoch, and 15s to 30s epoch, respectively (smaller epochs reintegrated). According to the results of this study, there were no significant differences in VM between 30s epoch and 5s to 30s epoch reintegrated and in MVPA (moderate-to-vigorous physical activity), between 15s epoch and 5s to 15s epoch reintegrated. From the Bland-Altman plot, reintegration of 15s to 30s epoch in VM and reintegrations of 15s to 30s epoch and 5s to 15s epoch in MVPA can be recommended for assessing physical activity in preschool children. Further research is needed into the reintegration method while using an accelerometer for assessment of energy expenditure in children.

Motor Activity in Adult Patients with Attention Deficit Hyperactivity Disorder

OBJECTIVE: Hyperactivity is a core symptom of attention-deficit hyperactivity disorder (ADHD), but limited information is available on analysis of activity patterns in this disorder. The aim of the study was to analyze motor activity during daily living in adult patients with ADHD. METHODS: Patients (n=76) from the private psychiatric practice of two of the authors were recruited, and were compared to patients with other psychiatric disorders and to normal controls. Actigraphs were used to record motor activity for six days, with one minute intervals, and data were analysed using linear and non-linear mathematical methods. RESULTS: For short recording periods (300 minutes) the activity levels of ADHD patients do not differ from normal controls, but the autocorrelation (lag 1) is lower and Fourier analysis shows higher power in the high frequency range, corresponding to the period from 2-8 min. During recordings for six days there are no significant differences between ADHD patients and the control groups. The combined and inattentive subgroups differ only in the six days recordings. The Fourier analyses show that the combined type has lower power in the high frequency range, corresponding to the period from 4-8 hours, and in the analysis of rhythms the intra-daily variability is lower, compared to the inattentive type. CONCLUSION: Adult ADHD patients do not show evidence of hyperactivity, but have levels of activity similar to normal controls. However, on several measures ADHD patients display altered activity patterns, indicating that the regulation of motor activity in this disorder is different from controls.

Excessive Daytime Sleepiness Case Confounding with Thyrotoxicosis / 수면정신생리

Narcolepsy is a sleep disorder, which is characterized by excessive daytime sleepiness (EDS) that is typically associated with cataplexy, sleep fragmentation and other REM sleep-related phenomenon such as sleep paralysis and hypnagogic hallucination. Narcoleptic symptoms can be developed from various medical or neurological disorders. A 17-year-old male patient admitted for the evaluation of EDS which started three-month ago. He slept more than 18 hours a day with cataplexy and hypnagogic hallucination. He was obese with body mass index (BMI) of 30.4 kg/m2. After admission he was newly diagnosed to the thyrotoxicosis. T3 391.2 ng/dL (60-181), free T4 4.38 ng/dL (0.89-1.76), TSH <0.01 microIU/mL (0.35-5.5) were measured. His pulse rate ranged 70-90 beats per minute and blood pressure ranged 150/100-120/70 mmHg. Polysomnography revealed many fragmentations in sleep with many positional changes (81 times/h). Sleep onset latency was 33.5 min, sleep efficiency was 47.9%, and REM latency from sleep onset was delayed to 153.6 min. REM sleep percent was increased to 27.1%. Periodic limb movement index was 13.4/h. In the multiple sleep latency test (MSLT), average sleep latency was 0.4 min and there were noted 3 SOREMPs (Sleep Onset REM sleep period) on 5 trials. We couldn't discriminate the obvious sleep-wake pattern in the actigraph and his HLA DQB1 *0602 type was negative. His thyroid function improved following treatment with methimazole and propranolol. Vital sign maintained within normal range. Cataplexy was controlled with venlafaxine 75 mg. Subjective night sleep continuity and PLMS were improved with clonazepam 0.5 mg, but the EDS were partially improved with modafinil 200-400 mg. Thyrotoxicosis might give confounding role when we were evaluating the EDS, though sleep fragmentation was one of the major symptoms of narcolepsy, but enormous amount of it made us think of the influence of thyroid hormone. The loss of sleep-wake cycle, limited improvement of EDS to the stimulant treatment, and the cataplexy not supported by HLA DQB1 *0602 should be answered further. We still should rule out idiopathic hypersomnia and measuring CSF hypocretin level would be helpful.

Improvement of Sleep and Circadian Rhythm Disturbance in Nursing Home Residents by Aromatherapy Massage: A Preliminary Study / 日本補完代替医療学会誌

We examined the effect of aromatherapy massage on the circadian rhythm in 8 elderly subjects in an open semi-comparative trial, comparing the parameters in the 2^nd week during which the aromatherapy massage sessions were performed, with 1-week periods (1^st and 3^rd weeks) before and after the sessions. Time spent asleep while in-bed and the sleep efficiency during the sleep time increased significantly in the 2^nd week compared with those in the 1^st and/or 3^rd weeks. A higher peak of the 24-h cycle circadian rhythm was noted following aromatherapy massage in elderly people, who often exhibit circadian rhythm disturbance. Furthermore, the peaks of the spectrum cycle in the 2^nd week were significantly closer to 24 h than those in the 1^st and 3^rd weeks. These results suggest that aromatherapy massage improves sleep and circadian rhythm disturbance.<br>

The Accuracy of the Accelerometers (Actical and Actigraph) among Korean People

BACKGROUND: Nowadays, decreased physical activity is considered to be a contributor to increase the prevalence of many diseases such as obesity, coronary heart disease and so on. Many researches demonstrated that regular physical activity reduce all cause mortality. To increase the physical activities of the population, accurate estimation of the activities is needed. Actical and actigraph are confirmed as accurate tools to measure physical activities. But the target populations of the validity studies were not Asian people. Therefore, the accuracy of the accelerometers should be confirmed in Asian people. The accuracy of the tools could be different. Therefore head to head comparison study between the tools would be needed. METHODS: Thirty volunteers from the community, ages over 20 yrs, were recruited. The participants put on the two accelerometers (Actical, Actigraph) on the waists, secured with elastic belts, and performed a session of rest and three structured activities (two walking speeds, 4 km/hr and 6 km/hr, and one jogging speed, 8 km/hr). During each activity, expired respiratory gases were collected, and oxygen consumption (VO2) was measured by indirect calorimetry (Model Quark beta2(R)). The calories measured by gas analyzer and two accelerometers were compared by correlation analysis using SPSS program. RESULTS: Pearson correlation coefficient between gas analyzer and two accelerometers was calculated at three structured activities. The r in Actical was 0.747, 0.785, and 0.677, at speed of 4, 6, 8 km/hr, respectively (P<0.05), and the same measures in Actigraph was 0.617, 0.737, and 0.530 (P<0.05), respectively. Pearson correlation coefficient was also calculated between the two accelerometers, and the r was 0.881, 0.927, and 0.824, at each speed. CONCLUSION: The Actical and Actigraph are valid tools for measuring physical activities in Korean people.

Comparison of Sleep Indices between Both Wrist Actigraphies and Nocturnal Polysomnography / 수면정신생리

The present study compared the actigraphic indices between both wrist actigraphies (WATGs), and the sleep estimates between each WATG and nocturnal polysomnography (NPSG) to assess their differences and consistencies. We studied 22 right-handed subjects (mean age 43.9+/-13.3 years, M:F=14:8) with untreated primary sleep disorders (primary insomnia=8, simple snorer=2, obstructive sleep apnea=12) undergone by overnight both WATGs and NPSG, simultaneously. Comparison and correlation were analyzed between right and left wrist actigraphic data. In the sleep estimates of both WATGs and NPSG, each WATG was compared and correlated with NPSG in sleep period time (SPT), total sleep time (TST), sleep latency (SL), sleep efficiency (SE) and wake time (WT). Sleep indices between both WATGs showed significant positive correlations with no correlations in SL and fragmentation index (FI). There were no differences in sleep indices between both WATGs. SPTs of both WATGs, SL of left WATG, and TST of right WATG showed positively significant correlations, and SE of right WATG did negatively significant correlation in sleep indices between each WATG and NPSG. As each WATG was compared to PSG, SPTs of both WATGs and WT of right WATG were decreased, and TST and SE of right WATG and SL of left WATG were increased. Inconsistent SL and FI between both WATGs indicate that the activities between both WATGs can differentially happen during wake or arousal. Inconsistent sleep estimates between each WATG and NPSG may indicate the limited usefulness in measuring and analyzing one-night sleep by using WATG.

Effects of Footbath on Sleeping Time in the Elderly / 日本温泉気候物理医学会雑誌

Effect of foot bath on sleeping time in 3 old patients (70, 82, 84 years old) was investigated. After 2-days control period, feet were immersed in a water bath containing about 1, 000ppm CO₂ at 40-41°C for 15 minutes at 17:00 for 3 consecutive days. Wrist Mini-motion-logger actigraph was used for recording their activities. The hour for lights-out was 21:00 and that of rising was 06:00. They went to bed between 20:30-20:50 and woke up at 05:30 next morning. In 2 patients, sleeping time at night began to increase on the second immersion day, which continued even on the following 2 days without foot bath. All the patients showed no changes in daytime activities. They were satisfied with foot bath and felt warmth not only in their feet but also in their bodies. No remarkable side effects were observed in the present study. Foot bath is thought to be effective to treat insomnia.