TY - JOUR
T1 - Use of actigraphy to characterize inactivity and activity in patients in a medical ICU
AU - Gupta, Prerna
AU - Martin, Jennifer L.
AU - Needham, Dale M.
AU - Vangala, Sitaram
AU - Colantuoni, Elizabeth
AU - Kamdar, Biren B.
N1 - Funding Information:
During this project, B.B.K. was supported by a grant through the UCLA Clinical Translational Research Institute (CTSI) and the National Institutes of Health / National Center for Advancing Translational Sciences (Grant number UL1TR000124 ); he is currently supported by a Paul B. Beeson Career Development Award through the National Institutes of Health / National Institute on Aging (Grant number K76AG059936 ). J.L.M. is supported by the National Heart Lung and Blood Institute (Grant number K24143055 ). D.M.N. is the principal investigator on a NIH -funded, multi-centered randomized trial ( R01HL132887 ) evaluating nutrition and exercise in acute respiratory failure. For purposes of this multi-site trial, Baxter Healthcare Corporation has provided an unrestricted research grant and donated amino acid product. In addition, two study sites (not this university or site) have received an equipment loan from Reck Medical Devices. E.C. is supported by a grant through the National Heart Lung and Blood Institute (Grant number AG061384 ).
Funding Information:
During this project, B.B.K. was supported by a grant through the UCLA Clinical Translational Research Institute (CTSI) and the National Institutes of Health/National Center for Advancing Translational Sciences (Grant number UL1TR000124); he is currently supported by a Paul B. Beeson Career Development Award through the National Institutes of Health/National Institute on Aging (Grant number K76AG059936). J.L.M. is supported by the National Heart Lung and Blood Institute (Grant number K24143055). D.M.N. is the principal investigator on a NIH-funded, multi-centered randomized trial (R01HL132887) evaluating nutrition and exercise in acute respiratory failure. For purposes of this multi-site trial, Baxter Healthcare Corporation has provided an unrestricted research grant and donated amino acid product. In addition, two study sites (not this university or site) have received an equipment loan from Reck Medical Devices. E.C. is supported by a grant through the National Heart Lung and Blood Institute (Grant number AG061384). None.
Publisher Copyright:
© 2020
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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.
AB - 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.
KW - Actigraphy
KW - Activity
KW - Critical illness
KW - ICU
KW - Inactivity
KW - Mobilization
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U2 - 10.1016/j.hrtlng.2020.02.002
DO - 10.1016/j.hrtlng.2020.02.002
M3 - Article
C2 - 32107065
AN - SCOPUS:85079904710
SN - 0147-9563
VL - 49
SP - 398
EP - 406
JO - Heart and Lung
JF - Heart and Lung
IS - 4
ER -