Original article
Activity Monitoring for Assessment of Physical Activities in Daily Life in Patients With Chronic Obstructive Pulmonary Disease

https://doi.org/10.1016/j.apmr.2005.04.016Get rights and content

Abstract

Pitta F, Troosters T, Spruit MA, Decramer M, Gosselink R. Activity monitoring for assessment of physical activities in daily life in patients with chronic obstructive pulmonary disease.

Objective

To investigate the degree of agreement between different methods of assessing physical activities in daily life in patients with chronic obstructive pulmonary disease (COPD): video recordings (criterion standard), the DynaPort Activity Monitor (DAM), and patient self-report.

Design

Study A: outcomes from video recordings were compared with DAM outcomes and with patient estimation of time spent on each activity after a 1-hour protocol including walking, cycling, standing, sitting, and lying. Study B: DAM outcomes and patient self-report were compared during 1 day in real life.

Setting

Outpatient clinic in a university hospital.

Participants

Study A: 10 patients with COPD (mean age, 62±6y; forced expiratory volume in the first second [FEV1]=40%±16% of predicted). Study B: 13 patients with COPD (mean age, 61±8y; FEV1=33%±10% of predicted).

Interventions

Not applicable.

Main Outcome Measures

Time spent on different activities and movement intensity during walking and cycling.

Results

Study A: time estimated by the patients in the sitting position was significantly lower than the time showed by the video recordings and the DAM (both P<.001). For the other variables, there were no statistically significant differences (all P>.05). However, Bland and Altman plots and intraclass correlation coefficients showed large disagreement between video recordings and patients’ estimations, in contrast to the high degree of agreement between video recordings and DAM. Changes in walking speed correlated highly to changes in DAM movement intensity (r=.81, P<.01). Study B: patients significantly overestimated walking time (22±47min, P=.04) and underestimated standing time (–45±71min, P=.04).

Conclusions

The DAM showed high accuracy in objectively assessing time spent on different activities and changes in walking speed in patients with COPD. Patients’ estimations of time spent on physical activities in daily life disagreed with objective assessment.

Section snippets

Participants and Design

All patients who volunteered to take part in the study were recruited from the outpatient rehabilitation program at the University Hospital Gasthuisberg, Leuven, Belgium. All of them gave informed consent to participate in the study. Patients all were retired or disabled and no longer employed. The inclusion criteria were (1) clinically stable condition, with no infection or exacerbation in the last 3 months before inclusion; (2) no recent cardiac complaints; and (3) absence of other pathologic

Results

Patients reported that the DAM did not hinder them notably in their activities. In study A, 2 patients reported being unable to differentiate the time spent among the different activities performed, choosing not to fill out the patient’s estimation report. These patients were excluded from the ANOVA procedure, which was performed with 8 patients. In study B, several patients reported having difficulties filling out the logbook at home, mostly because it was time consuming. Baseline

Discussion

The results of our study show 2 main findings. First, the DAM is an accurate method for measuring the time spent in walking, cycling, standing, sitting, and lying in patients with COPD, as well as changes in movement intensity during walking. Important aspects of the device’s validity were shown: its high degree of agreement with the criterion standard and its stability, with high ICCs and narrow CIs. Second, patients’ estimations of time spent on these activities show important inaccuracy

Conclusions

The DAM accurately assessed the time spent in different postures and activities in patients with COPD. Therefore, it is a promising tool for providing accurate data on the amount of daily activity in these patients. The estimations by patients with COPD of time spent in different physical activities in daily life had large disagreement compared with objective assessment.

Acknowledgments

We thank the physiotherapists Iris Coosemans, Veronica Barbier, Luk Herremans, Vanessa Probst, Sofie Mortier, Anja Bocken, and Pau Villela, from the UZ Gasthuisberg’s Respiratory Rehabilitation Division, for the great help in the assessments; Silvia Cecere, from the Biostatistical Center (KU Leuven), for the statistical assistance; and Joris Snaet, for drawing figure 1.

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    Supported in part by CAPES/Brasil, the Fonds voor Wetenschappelijk Onderzoek (Levenslijn grant nos. 7.0007.00, G.0237.01), Katholieke Universiteit Leuven (grant no. PDM/04/230), and the Foundation Van Goethem-Brichant.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

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