Use of actigraphy to characterize inactivity and activity in patients in a medical ICU

Prerna Gupta, Jennifer L. Martin, Dale M. Needham, Sitaram Vangala, Elizabeth Colantuoni, Biren B. Kamdar

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In the intensive care unit (ICU), inactivity is common, contributing to ICU-acquired weakness and poor outcomes. Actigraphy may be useful for measuring activity in the ICU. Objectives: To use actigraphy to characterize inactivity and activity in critically ill patients. Methods: This prospective observational study involved 48-h wrist actigraphy in medical ICU (MICU) patients, with activity data captured across 30-s epochs. Inactivity (zero-activity epochs) and activity (levels of non-zero activity) were summarized across key patient (e.g., age) and clinical (e.g., mechanical ventilation status) variables, and compared using multivariable regression. Results: Overall, 189,595 30-s epochs were collected in 34 MICU patients. Zero-activity (inactivity) comprised 122,865 (65%) of epochs; these epochs were 24% and 13% more prevalent, respectively, in patients receiving mechanical ventilation (versus none, p < 0.001) and in the highest (versus lowest) organ failure score tertile (p = 0.03). Ambulatory (versus non-ambulatory) patients exhibited more non-zero activity (35 more movements per epoch, p < 0.001), while those in the highest (versus lowest) organ failure score tertile exhibited less activity (22 fewer movements per epoch, p = 0.03). Significant inactivity/activity differences were not observed when evaluated based on age, sedation, or restraint status. Conclusions: Actigraphy demonstrated that MICU patients are profoundly inactive, including those who are young, non-sedated and non-restrained. Hence, ICU-specific, non-patient-related factors may contribute to inactivity, an issue requiring further investigation.

Original languageEnglish (US)
Pages (from-to)398-406
Number of pages9
JournalHeart and Lung
Volume49
Issue number4
DOIs
StatePublished - Jul 1 2020

Keywords

  • Actigraphy
  • Activity
  • Critical illness
  • ICU
  • Inactivity
  • Mobilization

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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