Review article (meta-analysis)
Review of Accelerometry for Determining Daily Activity Among Elderly Patients

https://doi.org/10.1016/j.apmr.2010.12.040Get rights and content

Abstract

Cheung VH, Gray L, Karunanithi M. Review of accelerometry for determining daily activity among elderly patients.

Objectives

To review studies that used accelerometers to classify human movements and to appraise their potential to determine the activities of older patients in hospital settings.

Data Sources

MEDLINE, CINAHL, and Web of Science electronic databases. A search constraint of articles published in English language between January 1980 and March 2010 was applied.

Study Selection

All studies that validated the use of accelerometers to classify human postural movements and mobility were included. Studies included participants from any age group. All types of accelerometers were included. Outcome measures criteria explored within the studies were comparisons of derived classifications of postural movements and mobility against those made by using observations. Based on these criteria, 54 studies were selected for detailed review from 526 initially identified studies.

Data Extraction

Data were extracted by the first author and included characteristics of study participants, accelerometers used, body positions of device attachment, study setting, duration, methods, results, and limitations of the validation studies.

Data Synthesis

The accelerometer-based monitoring technique was investigated predominantly on a small sample of healthy adult participants in a laboratory setting. Most studies applied multiple accelerometers on the sternum, wrists, thighs, and shanks of participants. Most studies collected validation data while participants performed a predefined standardized activity protocol.

Conclusions

Accelerometer devices have the potential to monitor human movements continuously to determine postural movements and mobility for the assessment of functional ability. Future studies should focus on long-term monitoring of free daily activity of a large sample of mobility-impaired or older hospitalized patients, who are at risk for functional decline. Use of a single waist-mounted triaxial accelerometer would be the most practical and useful option.

Section snippets

Search Strategy

This literature search was conducted using the MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) electronic databases provided by the EBSCOHost Research Database platform and the Web of Science electronic database from the ISI Web of Knowledge platform. To retrieve all relevant publications, key word searches were used to match words in the title, abstract, or key words field. These key words included activities of daily living, activity pattern, activity level,

Results

The literature search identified 54 journal articles that described the use of raw acceleration data to classify postures and mobility of human subjects. Raw acceleration data have been used in activity monitoring research since 1996. Data extracted from these journal articles included subjects' health status, sample size, age range, accelerometer devices used in studies (type, number, body positions of attachment), collection of validation data (study setting, duration of data collection), and

Discussion

The need for activity measurement in older patients in the hospital setting is a critical ingredient of assessment before discharge. In the absence of such measurement, the relationship between activity (or lack of it) cannot be related to length of stay and more specific clinical outcomes. To date, there is no routine procedure available to measure activity in a clinical setting. Attempts to overcome this predominantly have been through archaic methods by using observations and surveys by

Conclusions

Accelerometry activity monitoring has the potential to be a practical approach to study activity levels of older patients in everyday rehabilitation settings. It might provide useful information to clinical staff to assist in promoting and managing activity. This literature review examined the application of raw acceleration data from accelerometer devices to detect basic postures, postural transitions, and walking in daily activity. Few studies were in frail older or rehabilitation patients in

References (92)

  • B. Bertozzi et al.

    Factors related to length of stay in a geriatric evaluation and rehabilitation unit

    Aging Clin Exp Res

    (1996)
  • H.M. Hodkinson et al.

    Making hospital geriatrics work

    Br Med J

    (1972)
  • H.L. Elphick et al.

    The determinants of successful in-hospital rehabilitation in people aged 90 years and older

    Gerontology

    (2007)
  • E. Gorgon et al.

    Mobility on discharge from an aged care unit

    Physiother Res Int

    (2007)
  • R. McCloskey

    Functional and self-efficacy changes of patients admitted to a geriatric rehabilitation unit

    J Adv Nurs

    (2004)
  • F. Patterson et al.

    An investigation into activity levels of older people on a rehabilitation ward: an observational study

    Physiotherapy

    (2005)
  • R. Birchall et al.

    What do elderly people do in hospital?

    J Clin Nurs

    (1996)
  • P. Smith et al.

    Physical activity by elderly patients undergoing inpatient rehabilitation is low: an observational study

    Aust J Physiother

    (2008)
  • D. Tucker et al.

    Walking for wellness: a collaborative program to maintain mobility in hospitalized older adults

    Geriatr Nurs (Lond)

    (2004)
  • C.H. Hirsch et al.

    The natural-history of functional morbidity in hospitalized older patients

    J Am Geriatr Soc

    (1990)
  • H.M. Hoenig et al.

    Hospital-associated deconditioning and dysfunction

    J Am Geriatr Soc

    (1991)
  • H.Y. Wu et al.

    Factors associated with functional decline of hospitalised older persons following discharge from an acute geriatric unit

    Ann Acad Med Singapore

    (2006)
  • M.A. Sager et al.

    Measurement of activities of daily living in hospitalized elderly: a comparison of self-report and performance-based methods

    J Am Geriatr Soc

    (1992)
  • L.Z. Rubenstein et al.

    Systematic biases in functional status assessment of elderly adults: effects of different data sources

    J Gerontol

    (1984)
  • Ogawa M, Togawa T. Monitoring daily activities and behaviors at home by using brief sensors. In: Dittmar A, Beebe D,...
  • Ogawa M, Ochia S, Otsuka K, Togawa T. Remote monitoring of daily activities and behaviors at home. Proceedings of the...
  • Ogawa M, Suzuki R, Otake S, Izutsu T, Iwaya T, Togawa T. Long-term remote behavioral monitoring of the elderly using...
  • R. Suzuki et al.

    Analysis of activities of daily living in elderly people living alone: single-subject feasibility study

    Telemed J E Health

    (2004)
  • Segen J, Pingali SG. A camera-based system for tracking people in real time. In Kavanaugh ME, Werner B, editors....
  • Utsumi A, Mori H, Ohya J, Yachida M. Multiple-human tracking using multiple cameras. In Storms P, editor. Proceedings...
  • Haritaoglu I, Harwood D, Davis LS. W4: Who? When? Where? What? A real time system for detecting and tracking people. In...
  • K.J. Saunders et al.

    Automated measurement of patient activity on a hospital rehabilitation ward

    Arch Phys Med Rehabil

    (1978)
  • D.J. Macfarlane et al.

    Convergent validity of six methods to assess physical activity in daily life

    J Appl Physiol

    (2006)
  • J.T. Cavanaugh et al.

    Using step activity monitoring to characterize ambulatory activity in community-dwelling older adults

    J Am Geriatr Soc

    (2007)
  • J.E. Berlin et al.

    Using activity monitors to measure physical activity in free-living conditions

    Phys Ther

    (2006)
  • P.S. Freedson et al.

    Objective monitoring of physical activity using motion sensors and heart rate

    Res Q Exerc Sport

    (2000)
  • B.E. Ainsworth et al.

    Accuracy of recall of occupational physical activity by questionnaire

    J Clin Epidemiol

    (1999)
  • M.S. Bray et al.

    Caltrac versus calorimeter determination of 24-h energy-expenditure in female-children and adolescents

    Med Sci Sports Exerc

    (1994)
  • E.Y.W. Chu et al.

    Calibration of the RT3 accelerometer for ambulation and nonambulation in children

    Med Sci Sports Exerc

    (2007)
  • P.C. Fehling et al.

    Comparison of accelerometers with oxygen consumption in older adults during exercise

    Med Sci Sports Exerc

    (1999)
  • S.E. Crouter et al.

    Estimating energy expenditure using accelerometers

    Eur J Appl Physiol

    (2006)
  • S.J. Strath et al.

    Comparison of MTI accelerometer cut-points for predicting time spent in physical activity

    Int J Sports Med

    (2003)
  • C.E. Matthews

    Calibration of accelerometer output for adults

    Med Sci Sports Exerc

    (2005)
  • J.J. McClain et al.

    Actigraph accelerometer interinstrument reliability during free-living in adults

    Med Sci Sports Exerc

    (2007)
  • S.G. Trost et al.

    Predictive validity of three ActiGraph energy expenditure equations for children

    Med Sci Sports Exerc

    (2006)
  • D.R. Bassett et al.

    Validity of four motion sensors in measuring moderate intensity physical activity

    Med Sci Sports Exerc

    (2000)
  • J.B.J. Bussmann et al.

    Ambulatory accelerometry to quantify motor behaviour in patients after failed back surgery: a validation study

    Pain

    (1998)
  • K. Aminian et al.

    Physical activity monitoring based on accelerometry: validation and comparison with video observation

    Med Biol Eng Comput

    (1999)
  • F. Foerster et al.

    Detection of posture and motion by accelerometry: a validation study in ambulatory monitoring

    Comput Hum Behav

    (1999)
  • B. Najafi et al.

    Ambulatory system for human motion analysis using a kinematic sensor: Monitoring of daily physical activity in the elderly

    IEEE Trans Biomed Eng

    (2003)
  • K.M. Culhane et al.

    Long-term mobility monitoring of older adults using accelerometers in a clinical environment

    Clin Rehabil

    (2004)
  • M.J. Mathie et al.

    Classification of basic daily movements using a triaxial accelerometer

    Med Biol Eng Comput

    (2004)
  • G.M. Lyons et al.

    A description of an accelerometer-based mobility monitoring technique

    Med Eng Phys

    (2005)
  • F.R. Allen et al.

    Classification of a known sequence of motions and postures from accelerometry data using adapted Gaussian mixture models

    Physiol Meas

    (2006)
  • A. Salarian et al.

    Ambulatory monitoring of physical activities in patients with Parkinson's disease

    IEEE Trans Biomed Eng

    (2007)
  • N. Wang et al.

    Accelerometry based classification of walking patterns using time-frequency analysis

    Proceedings of the 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society: Aug 22–26, 2007, Lyon, France. New York: IEEE

    (2007)

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