Feasibility of a physiotherapist-supervised walking program with telephone coaching to increase physical activity following acquired brain injury.

Background Physical activity has health benefits for adults with acquired brain injury, but it is a challenge to increase physical activity during inpatient rehabilitation. The objectives of this pilot study were to determine whether a physiotherapy-supervised inpatient walking program was feasible and able to improve physical activity and sedentary behaviour in the short and medium term. Methods Adults with acquired brain injury receiving inpatient rehabilitation undertook twice-weekly supervised walks plus behavioural therapy for 4 weeks. Feasibility was measured via recruitment, participation and drop out rates, adverse events and intervention delivery costs. Physical activity and sedentary behaviour were measured with an activPAL. Assessments were conducted at baseline, post-intervention and 3-6 months post-intervention. Results The program was safe to deliver (no adverse events), recruitment rate was 55% (16/29) and the participation rate for eligible individuals was high (14/19, 74%). However, the program had a high drop out rate (7/16, 44%) and physical activity and sedentary behaviour did not significantly change during the 4-week intervention. Costs were AU$427.71/participant. Physical activity and sedentary behaviour did improve 3-6 months after the intervention (vs baseline, on average: +3913 steps per day, 95% CI: 671, 7156). Conclusion This pilot study demonstrated a supervised physiotherapy walking program is safe and feasible to recruit in an inpatient setting. However, drop out during the study was high and behaviour change did not occur. More work is required to boost physical activity during sub-acute rehabilitation for acquired brain injury.

Accuracy of wearable physical activity trackers in people with Parkinson's disease.

INTRODUCTION: The purpose of this study was to determine the accuracy of the Fitbit Charge HR™ and Garmin vívosmart® HR in measuring steps and reflecting intensity of activity in people with Parkinson's disease (PD). METHODS: Thirty-three people with mild-moderate PD performed six, two-minute indoor walks at their self-selected walking pace, and at target cadences of 60, 80, 100, 120 and 140 beats/min. A 500 m outdoor walk with terrain challenges was also performed. Step count was recorded by the two wrist-worn activity trackers (Fitbit Charge HR™ and Garmin vívosmart® HR) and compared to an accelerometer (ActivPAL3™). Intensity was recorded by a portable breath-by-breath gas analyser (VO2), heart rate and Borg scale. RESULTS: Both commercial activity trackers had low error (<3%) and moderate to high consistency at self-selected pace both indoors and outdoors (ICC 0.88-0.97; p < 0.05) compared to the ActivPAL3™. The Garmin recorded low error (<5%) and high agreement (ICCs > 0.68; p < 0.001) for all target cadences ≥80steps/min. The Fitbit had higher error was less consistent for all target cadences ≥80steps/min. Cadence measured by the Fitbit and Garmin weakly reflected increases in heart rate (ICCs 0.27-0.28; p < 0.05), and did not reflect VO2 or Borg (ICCs 0.08-0.15, p > 0.05). CONCLUSION: The Garmin device was more accurate at reflecting step count across a broader range of walking cadences than the Fitbit, but neither strongly reflected intensity of activity. While not intended to replace research grade devices, these wrist-worn devices may be a clinically useful adjunct to exercise therapy to increase physical activity in people with PD.