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With the growing amount of physical activity (PA) measures, the need for methods and algorithms that automatically analyze and interpret unannotated data increases. In this paper, PA is seen as a combination of multimodal constructs that can cooccur in different ways and proportions during the day. The design of a methodology able to integrate and analyze them is discussed, and its operation is illustrated by applying it to a dataset comprising data from COPD patients and healthy subjects acquired in daily life. The method encompasses different stages. The first stage is a completely automated method of labeling low-level multimodal PA measures. The information contained in the PA labels are further structured using topic modeling techniques, a machine learning method from the text processing community. The topic modeling discovers the main themes that pervade a large set of data. In our case, topic models discover PA routines that are active in the assessed days of the subjects under study. Applying the designed algorithm to our data provides new learnings and insights. As expected, the algorithm discovers that PA routines for COPD patients and healthy subjects are substantially different regarding their composition and moments in time in which transitions occur. Furthermore, it shows consistent trends relating to disease severity as measured by standard clinical practice.

Background: It is unclear whether participation in exercise programs specifically developed for elderly translates into a more active lifestyle., Objectives: To compare the objectively measured level of physical activity in daily life (PADL) between physically independent elderly who participate or do not participate in community-based exercise programs; and to evaluate which factors are associated with the higher level of PADL in these subjects., Method: 134 elderly participants in community-based exercise programs (PG) and 104 non-participants (NPG) had their level of PADL measured using pedometers during 7 days., Other Measurements: 6-minute walking test (6MWT), incremental shuttle walking test (ISWT), muscle strength, flexibility and balance., Results: The PG had higher 1-week mean daily step count than NPG (8314 [IQR 5971-10060] vs. 6250 [IQR 4346-8207] steps/day, p<0.0001), as well as higher step count in any day of the week. There was a higher proportion of physically active subjects (>8000 steps/day) in PG than in NPG (37% vs. 16%, respectively; p<0.001), as well as the proportion of sedentary subjects (<5000 steps/day) (14% vs. 33%, respectively; p<0.001). Participation in exercise programs, 6MWT and ISWT explained a higher daily steps count (model r(2)=0.56, p<0.0001)., Conclusions: In physically independent elderly, a higher level of physical activity in daily life occurs in those who participate in community-based exercise programs, regardless of the weekday and including non-program days. Participation of elderly in community-based exercise programs should be more systematically available and encouraged due to its close link to higher activity levels and better exercise capacity.

Despite the growing interest in sedentarism, there is no available information on the profile of patients with COPD according to sedentary behaviour (SB) and with a detailed analysis of minute-by-minute bouts. Hence, the aims of this study were to quantify the time spent in SB, light activities and moderate-to-vigorous physical activities (MVPA) and to verify the relationship of MVPA and SB in individuals with COPD, as well as to identify the profile of those physically (in)active and (non)-sedentary. A cross-sectional study in which physical activity in daily life was objectively assessed through the use of SenseWear Pro 2 Armband (BodyMedia) during 2 consecutive weekdays, 12 h/day. Analysis was performed minute-by-minute for each day of each patient. MVPA comprised time spent >3 metabolic equivalents (MET), whereas light activities corresponded to time spent between 1.5 and 3 MET and SB to time spent <1.5 MET. A total of 137 subjects with COPD (66 ± 8years; FEV1 46 [31-57] %pred; BMI 26 [22-30] kg/m2) were analysed. Time spent in MVPA and SB presented strong negative correlation (r = −0.72, P < 0.001). Minute-by-minute analysis showed that patients with COPD spend most of their time in SB. SB accounted for 40% of all bouts >1 minute, whereas only 14% these bouts concern MVPA. Patients combining two positive characteristics (physically active and non-sedentary) have better clinical profile than others. In conclusion, SB is negatively correlated with MVPA in patients with COPD. Furthermore, patients classified as physically active (i.e., those who reach MVPA recommendations) in combination with a non-sedentary lifestyle present markedly better clinical conditions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Different protocols for the sit-to-stand test (STS) are available for assessing functional capacity in COPD. We sought to correlate each protocol of the STS (ie, the 5-repetition [5-rep STS], the 30-s STS, and the 1-min STS) with clinical outcomes in subjects with COPD. We also aimed to compare the 3 protocols of the STS, to verify their association and agreement, and to verify whether the 3 protocols are able to predict functional exercise capacity and physical activity in daily life (PADL). METHODS: 23 subjects with COPD (11 men; FEV1 53 ± 15% predicted) performed 3 protocols of the STS. Subjects also underwent the following assessments: incremental shuttle walking test, 6-min walk test (6MWT), 4-m gait speed test (4MGS), 1-repetition maximum of quadriceps muscle, assessment of PADL, and questionnaires on health-related quality of life and functional status. RESULTS: The 1-min STS showed significant correlations with the 6MWT (r = 0.40), 4MGS (r = 0.64), and PADL (0.40 ≤ r ≤ 0.52), and the 5-rep STS and 30-s STS were associated with the 4MGS (r = 0.54 and r = 0.52, respectively). The speed differed for each protocol (5-rep STS 0.53 ± 0.16 rep/s, 30-s STS 0.48 ± 0.13 rep/s, 1-min STS 0.45 ± 0.11 rep/s, P = .01). However, they presented good agreement (intraclass correlation coefficient ≥ 0.73 for all) and correlated well with each other (r ≥ 0.68 for all). More marked changes in peripheral oxygen saturation (P = .004), heart rate (P < .001), blood pressure (P < .001), dyspnea (P < .001), and leg fatigue (P < .001) were found after the 1-min STS protocol. Furthermore, the 3 protocols were equally able to identify subjects with low exercise capacity or preserved exercise capacity. CONCLUSIONS: The 1-min STS generated higher hemodynamic demands and correlated better with clinical outcomes in subjects with COPD. Despite the difference in speed performance and physiological demands between the 5-rep STS and 1-min STS, there was a good level of agreement among the 3 protocols. In addition, all 3 tests were able to identify subjects with low exercise capacity or preserved exercise capacity. [ABSTRACT FROM AUTHOR]

BACKGROUND: A normal heart rate reflects the balance between the sympathetic and parasympathetic autonomic nervous system. When the difference between heart rate at the end of an exercise test and after 1 min of recovery, known as the 1-min heart rate recovery, is ≤ 12 beats/min, this may indicate an abnormal delay. We sought to compare physical activity patterns and subjects' functional status with COPD with or without delayed 1-min heart rate recovery after the 6-min walk test (6MWT). METHODS: 145 subjects with COPD (78 men, median [interquartile range (IQR)] age 65 [60-73] y, body mass index 25 [21-30] kg/m², FEV1 45 ± 15% predicted) were underwent the following assessments: spirometry, 6MWT, functional status, and physical activity in daily life (PADL). A delayed heart rate recovery of 1 min was defined as < 12 beats/min. RESULTS: Subjects with delayed 1-min heart rate recovery walked a shorter distance in the 6MWT compared to subjects without delayed heart rate recovery (median [IQR] 435 [390-507] m vs 477 [425-515] m, P = .01; 81 [71-87] vs 87 [79-98]% predicted, P = .002). Regarding PADL, subjects with delayed heart rate recovery spent less time in the standing position (mean ± SD 185 ± 89 min vs 250 ± 107 min, P = .002) and more time in sedentary positions (472 ± 110 min vs 394 ± 129 min, P = .002). Scores based on the self-care domain of the London Chest Activity of Daily Living questionnaire and the activity domain of the Pulmonary Functional Status and Dyspnea questionnaire were also worse in the group with delayed heart rate recovery (6 ± 2 points vs 5 ± 2 points; P = .039 and 29 ± 24 points vs 19 ± 17 points; P = .037, respectively). CONCLUSIONS: Individuals with COPD who exhibit delayed 1-min heart rate recovery after the 6MWT exhibited worse exercise capacity as well as a more pronounced sedentary lifestyle and worse functional status than those without delayed heart rate recovery. Despite its assessment simplicity, heart rate recovery after the 6MWT can be further explored as a promising outcome in COPD. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the relationship between oxygen desaturation episodes during a laboratory-based ADL protocol and in real-life routine in patients with stable chronic obstructive pulmonary disease (COPD).Methods: Twenty patients with stable COPD (12 men, 70 ± 7 years, FEV1% 54 ± 15 predicted) with no indication for long-term oxygen therapy (LTOT) were submitted to assessments including ADL performance by the Londrina ADL Protocol (LAP) and level of physical activity in daily life, both while submitted to simultaneous activity and pulse oximeter monitoring.Results: Episodes of desaturation ≥ 4% (ED ≥ 4%) during the LAP were correlated both with ED ≥ 4% in daily life (r = 0.45) and number of episodes of SpO2 under 88% (ED < 88%) in daily life (r = 0.59). ED < 88% during the LAP was also correlated with ED < 88% in daily life (r = 0.51), explaining 43% of its variance.Conclusion: In stable patients with COPD and no indication of LTOT, episodes of desaturation during a lab-based ADL protocol are moderately related to episodes of desaturation in daily (real) life, especially those episodes under 88%. [ABSTRACT FROM AUTHOR]

Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Seasonal changes in physical activity in daily life (PADL) of patients with Chronic Obstructive Pulmonary Disease (COPD) living in regions of the world with contrasting (i.e., mild or marked) weather variations have not been yet investigated. We aimed to quantify PADL and compare its variability caused by seasonality in patients with COPD who live in world regions with different summer-winter climatic variations (i.e. Londrina, Brazil and Leuven, Belgium). In a longitudinal, prospective and observational study, patients with COPD from Brazil and Belgium wore the SenseWear Armband for 7 days in summer and 7 days in winter. Active time (≥2METs) was the primary outcome. PADL data were matched day-by-day with weather information. Regarding the two assessment moments, median (min;max) temperatures were 11 (−5.5;27.2)°C in Leuven and 21 (7;27)°C in Londrina. Patients in Brazil (n= 19, 69 ± 7 years, FEV147 ± 15%pred) and Belgium (n= 18, 69 ± 6 years, FEV150 ± 15%pred) decreased their active time in winter compared to summer (p< 0.05), and this reduction was more pronounced in Brazil (p= 0.01, between group). Mean, minimum and maximum temperature, daylight duration and relative humidity were significantly related to active time. Patients with COPD decrease their PADL in winter even in a region with milder climatic variation. [ABSTRACT FROM AUTHOR]

BACKGROUND: It is important to assess activities of daily living (ADL) in older adults due to impairment of independence and quality of life. However, there is no objective and standardized protocol available to assess this outcome. Thus, the aim of this study was to verify the reproducibility and validity of a new protocol for ADL assessment applied in physically independent adults age ≥50 y, the Londrina ADL protocol, and to establish an equation to predict reference values of the Londrina ADL protocol. METHODS: Ninety-three physically independent adults age ≥50 y had their performance in ADL evaluated by registering the time spent to conclude the protocol. The protocol was performed twice. The 6-min walk test, which assesses functional exercise capacity, was used as a validation criterion. A multiple linear regression model was applied, including anthropometric and demographic variables that correlated with the protocol, to establish an equation to predict the protocol's reference values. RESULTS: In general, the protocol was reproducible (intraclass correlation coefficient 0.91). The average difference between the first and second protocol was 5.3%. The new protocol was valid to assess ADL performance in the studied subjects, presenting a moderate correlation with the 6-min walk test (r = -0.53). The time spent to perform the protocol correlated significantly with age (r = 0.45) but neither with weight (r = -0.17) nor with height (r = -0.17). A model of stepwise multiple regression including sex and age showed that age was the only determinant factor to the Londrina ADL protocol, explaining 21% (P < .001) of its variability. The derived reference equation was: Londrina ADL protocolpred (s) = 135.618 + (3.102 x age [y]). CONCLUSIONS: The Londrina ADL protocol was reproducible and valid in physically independent adults age ≥50 y. A reference equation for the protocol was established including only age as an independent variable (r² = 0.21), allowing a better interpretation of the protocol's results in clinical practice. [ABSTRACT FROM AUTHOR]

BACKGROUND: To avoid symptoms, patients with COPD may reduce the amount of activities of daily living (ADL). Therefore, the aim of the present study was to develop a standardized protocol to evaluate ADL performance in subjects with COPD (Londrina ADL protocol) and to assess the validity and reliability of the protocol in this population. METHODS: The Londrina ADL protocol was created based on activities included in previous studies aimed at investigating outcomes from ADL. Activities were included in the protocol because they could represent other activities of similar patterns and because they could be actually performed, not simulated. Twenty subjects with COPD (12 men, 70 ± 7 y old, FEV1 = 54 ± 15% predicted) wore 2 motion sensors while performing the protocol 4 times, 2 of them wearing a portable gas analyzer. Subjects were also submitted to assessments of lung function, functional exercise capacity, functional status, impact on health status, and physical activity in daily life. RESULTS: The Londrina ADL protocol comprised of 5 activities representing ADL, involving upper limbs, lower limbs, and trunk movements. Londrina ADL protocol duration presented high values of intraclass correlation coefficient, even using a mask for gas analysis (intraclass correlation coefficient >0.90, P < .001). Intensity of movement during the protocol performance was highly correlated to intensity of movement in daily life (r = 0.71). The protocol duration was correlated with functional status and impact on health status variables from questionnaires (0.36 ≤ r ≤ 0.59). There was also correlation between functional exercise capacity and the protocol duration (r = -0.64). CONCLUSIONS: The Londrina ADL protocol was a valid and reliable protocol to evaluate ADL performance in subjects with COPD. It is a protocol that can be used in clinical practice and in future studies to investigate ADL outcomes, including those studies that require gas analysis and the wearing of a mask. [ABSTRACT FROM AUTHOR]

Abstract: Sant''Anna T, Escobar VC, Fontana AD, Camillo CA, Hernandes NA, Pitta F. Evaluation of a new motion sensor in patients with chronic obstructive pulmonary disease. Objective: To assess the criterion validity and reproducibility of a new pedometer in patients with chronic obstructive pulmonary disease (COPD). Design: Cross-sectional study. Setting: Outpatient physiotherapy clinic from a university hospital. Participants: Patients with COPD (N=30; 17 men; forced expiratory volume in the first second, 44±17% predicted) were videotaped while performing 2 protocols: one including 2 slow and 2 fast 5-minute walks, and another including a circuit of activities of daily living (ADLs). Concomitantly, patients wore 2 motion sensors: the new pedometer and a multisensor accelerometer. Interventions: None. Main Outcome Measures: Step counting (SC), energy expenditure (EE), walking distance (WD), activity time (AT), and walking intensity (WI) registered by the pedometer were compared with video and the multisensor as criterion methods. Results: Correlations between the pedometer and the criterion method were high for SC during slow and fast walking (r=.79 and r=.95) and for EE during fast walking (r=.83). Correlation was more modest for EE during slow walking (r=.65) and for WD and WI during both speeds (.47.79 for all). During the ADLs circuit, the pedometer underestimated AT by an average of 55% but provided an acceptable EE estimation in a group basis (average difference of 6% with the multisensor). Conclusions: In patients with COPD, the new pedometer analyzed in the present study is reproducible for most outcomes and highly valid for SC during slow and fast walking and EE during fast walking. The device''s validity is more limited for EE during slow walking, and WD and WI at both speeds. Furthermore, during the performance of ADLs, it significantly underestimates activity time but provides an acceptable estimation of EE in a group basis. [Copyright &y& Elsevier]

Copyright of Brazilian Journal of Pulmonology / Jornal Brasileiro de Pneumologia is the property of Sociedade Brasileira de Pneumologia e Tisiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Assessment of functionality or function, through valid and reliable instruments, is essential during rehabilitation of adults after a burn injury. Currently, there is no consensus in the literature regarding the most appropriate tool that should be used to assess function or functionality; there is also no synthesis of the current studies published in this area.Objectives: To investigate and report the instruments used to assess function or functionality in adults after a burn injury; to identify the characteristics and evidence on their measurement properties; and to evaluate their clinical utility.Methods: We systematically searched the literature via six electronic databases and via screening reference lists of relevant studies. The review was registered in PROSPERO (CRD42016048065) and reported according to the PRISMA statement. Studies in which function or functionality of upper and/or lower limbs of adults after a burn injury was assessed were included. Exclusion criteria comprised studies in pediatric populations and conference abstracts.Results: Thirty-four studies were included. Twelve questionnaires and seven objective tests for function or functionality were identified. Three specific tools were found; four generic instruments have been validated in burns. Nine studies evaluated the instruments' measurement properties, presenting at least one property classified as 'fair' quality. Finally, 18 instruments demonstrated clinical utility.Conclusion: This systematic review demonstrated that most instruments used to assess function or functionality in adults with a burn injury have not been specifically developed for this population and had their measurement properties poorly studied. Conversely, almost all instruments had clinical utility. [ABSTRACT FROM AUTHOR]

Objective: To compare the profiles of patients with chronic obstructive pulmonary disease (COPD) considered physically active or inactive according to different classifications of the level of physical activity in daily life (PADL). Method: Pulmonary function, dyspnea, functional status, body composition, exercise capacity, respiratory and peripheral muscle strength, and presence of comorbidities were assessed in 104 patients with COPD. The level of PADL was quantified with a SenseWear Armband activity monitor. Three classifications were used to classify the patients as physically active or inactive: 30 minutes of activity/day with intensity >3.2 METs, if age ≥65 years, and >4 METs, if age <65 years; 30 minutes of activity/day with intensity >3.0 METs, regardless of patient age; and 80 minutes of activity/day with intensity >3.0 METs, regardless of patient age. Results: In all classifications, when compared with the inactive group, the physically active group had better values of anthropometric variables (higher fat-free mass, lower body weight, body mass index and fat percentage), exercise capacity (6-minute walking distance), lung function (forced vital capacity) and functional status (personal care domain of the London Chest Activity of Daily Living). Furthermore, patients classified as physically active in two classifications also had better peripheral and expiratory muscle strength, airflow obstruction, functional status, and quality of life, as well as lower prevalence of heart disease and mortality risk. Conclusion: In all classification methods, physically active patients with COPD have better exercise capacity, lung function, body composition, and functional status compared to physically inactive patients. [ABSTRACT FROM AUTHOR]