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This study compares the performance of algorithms for body-worn sensors used with a spatiotemporal gait analysis platform to the GAITRite electronic walkway. The mean error in detection time (true error) for heel strike and toe-off was 33.9 ± 10.4 ms and 3.8 ± 28.7 ms, respectively. The ICC for temporal parameters step, stride, swing and stance time was found to be greater than 0.84, indicating good agreement. Similarly, for spatial gait parameters-stride length and velocity-the ICC was found to be greater than 0.88. Results show good to excellent concurrent validity in spatiotemporal gait parameters, at three different walking speeds (best agreement observed at normal walking speed). The reported algorithms for body-worn sensors are comparable to the GAITRite electronic walkway for measurement of spatiotemporal gait parameters in healthy subjects. [ABSTRACT FROM AUTHOR]

Background: frailty is an important geriatric syndrome linked to increased mortality, morbidity and falls risk.Methods: a total of 399 community-dwelling older adults were assessed using Fried's frailty phenotype and the timed up and go (TUG) test. Tests were quantified using shank-mounted inertial sensors. We report a regression-based method for assessment of frailty using inertial sensor data obtained during TUG. For comparison, frailty was also assessed using the same method based on grip strength and manual TUG time.Results: using inertial sensor data, participants were classified as frail or non-frail with mean accuracy of 75.20% (stratified by gender). Using TUG time alone, frailty status was classified correctly with mean classification accuracy of 71.82%. Similarly, using grip strength alone, the frailty status was classified correctly with mean classification accuracy of 77.65%. Stratifying sensor data by gender yielded significantly (p<0.05) increased accuracy in classifying frailty when compared with equivalent manual TUG time-based models.Conclusion: results suggest that a simple protocol involving assessment using a well-known mobility test (Timed Up and Go (TUG)) and inertial sensors can be a fast and effective means of automatic, non-expert assessment of frailty. [ABSTRACT FROM AUTHOR]

Summary: The high prevalence of obstructive sleep apnea has led to increasing interest in ambulatory diagnosis. The SleepMinder™ (SM) is a novel non‐contact device that employs radiofrequency wave technology to assess the breathing pattern, and thereby estimate obstructive sleep apnea severity. We assessed the performance of SleepMinder™ in the home diagnosis of obstructive sleep apnea. One‐hundred and twenty‐two subjects were prospectively recruited in two protocols, one from an unselected sleep clinic cohort (n = 67, mean age 51 years) and a second from a hypertension clinic cohort (n = 55, mean age 58 years). All underwent 7 consecutive nights of home monitoring (SMHOME) with the SleepMinder™ as well as inpatient‐attended polysomnography in the sleep clinic cohort or cardiorespiratory polygraphy in the hypertension clinic cohort with simultaneous SleepMinder™ recordings (SMLAB). In the sleep clinic cohort, median SMHOME apnea–hypopnea index correlated significantly with polysomnography apnea–hypopnea index (r =.68; p <.001), and in the hypertension clinic cohort with polygraphy apnea–hypopnea index (r =.7; p <.001). The median SMHOME performance against polysomnography in the sleep clinic cohort showed a sensitivity and specificity of 72% and 94% for apnea–hypopnea index ≥ 15. Device performance was inferior in females. In the hypertension clinic cohort, SMHOME showed a 50% sensitivity and 72% specificity for apnea–hypopnea index ≥ 15. SleepMinder™ classified 92% of cases correctly or within one severity class of the polygraphy classification. Night‐to‐night variability in home testing was relatively high, especially at lower apnea–hypopnea index levels. We conclude that the SleepMinder™ device provides a useful ambulatory screening tool, especially in a population suspected of obstructive sleep apnea, and is most accurate in moderate–severe obstructive sleep apnea. [ABSTRACT FROM AUTHOR]

Study Objectives: Wearable devices that monitor sleep stages and heart rate offer the potential for longitudinal sleep monitoring in patients with neurodegenerative diseases. Sleep quality reduces with disease progression in Huntington's disease (HD). However, the involuntary movements characteristic of HD may affect the accuracy of wrist-worn devices. This study compares sleep stage and heart rate data from the Fitbit Charge 4 (FB) against polysomnography (PSG) in participants with HD., Methods: Ten participants with manifest HD wore an FB during overnight hospital-based PSG, and 9 of these participants continued to wear the FB for 7 nights at home. Sleep stages (30-second epochs) and minute-by-minute heart rate were extracted and compared against PSG data., Results: FB-estimated total sleep and wake times and sleep stage times were in good agreement with PSG, with intraclass correlations of 0.79-0.96. However, poor agreement was observed for wake after sleep onset and the number of awakenings. FB detected waking with 68.6 ± 15.5% sensitivity and 93.7 ± 2.5% specificity, rapid eye movement sleep with high sensitivity and specificity (78.7 ± 31.9%, 95.6 ± 2.3%), and deep sleep with lower sensitivity but high specificity (56.4 ± 28.8%, 95.0 ± 4.8%). FB heart rate was strongly correlated with PSG, and the mean absolute error between FB and PSG heart rate data was 1.16 ± 0.42 beats/min. At home, longer sleep and shorter wake times were observed compared with hospital data, whereas percentage sleep stage times were consistent with hospital data., Conclusions: Results suggest the potential for long-term monitoring of sleep patterns using wrist-worn wearable devices as part of symptom management in HD., Citation: Doheny EP, Renerts K, Braun A, et al. Assessment of Fitbit Charge 4 for sleep stage and heart rate monitoring against polysomnography and during home monitoring in Huntington's disease. J Clin Sleep Med . 2024;20(7):1163-1171., (© 2024 American Academy of Sleep Medicine.)

In Huntington's disease (HD), wearable inertial sensors could capture subtle changes in motor function. However, disease-specific validation of methods is necessary. This study presents an algorithm for walking bout and gait event detection in HD using a leg-worn accelerometer, validated only in the clinic and deployed in free-living conditions. Seventeen HD participants wore shank- and thigh-worn tri-axial accelerometers, and a wrist-worn device during two-minute walk tests in the clinic, with video reference data for validation. Thirteen participants wore one of the thigh-worn tri-axial accelerometers (AP: ActivPAL4) and the wrist-worn device for 7 days under free-living conditions, with proprietary AP data used as reference. Gait events were detected from shank and thigh acceleration using the Teager-Kaiser energy operator combined with unsupervised clustering. Estimated step count (SC) and temporal gait parameters were compared with reference data. In the clinic, low mean absolute percentage errors were observed for stride (shank/thigh: 0.6/0.9%) and stance (shank/thigh: 3.3/7.1%) times, and SC (shank/thigh: 3.1%). Similar errors were observed for proprietary AP SC (3.2%), with higher errors observed for the wrist-worn device (10.9%). At home, excellent agreement was observed between the proposed algorithm and AP software for SC and time spent walking (ICC [Formula: see text]). The wrist-worn device overestimated SC by 34.2%. The presented algorithm additionally allowed stride and stance time estimation, whose variability correlated significantly with clinical motor scores. The results demonstrate a new method for accurate estimation of HD gait parameters in the clinic and free-living conditions, using a single accelerometer worn on either the thigh or shank.

Gait analysis has many potential applications in understanding the activity profiles of individuals in their daily lives, particularly when studying the progression of recovery following injury, or motor deterioration in pathological conditions. One of the many challenges of conducting such analyses in the home environment is the correct and automatic identification of bouts of gait activity. To address this, a novel method for determining bouts of gait from accelerometer data recorded from the shank is presented. This method is fully automated and includes an adaptive thresholding approach which avoids the necessity for identifying subject-specific thresholds. The algorithm was tested on data recorded from 15 healthy subjects during self-selected slow, normal and fast walking speeds ranging from 0.48 ± 0.19 to 1.38 ± 0.33m/s and a single subject with PD walking at their normal walking speed (1.41 ± 0.08m/s) using accelerometers on the shanks. Intra-Class Correlation (ICC) confirmed high levels of agreement between bout onset/offset times and durations estimated using the algorithm, experimentally recorded stopwatch times and manual annotation for the healthy subjects (r=0.975, p <; 0.001; r=0.984, p<; 0.001) and moderate agreement for the PD subject (r=0.663, p<; 0.001). Mean absolute errors between accelerometer-derived and manually-annotated times were calculated, and ranged from 0.91 ± 0.05 s to 1.17 ± 2.26 s for bout onset detection, 0.80 ± 0.23 s to 2.41 ± 3.77 s for offset detection and 1.27 ± 0.13 s to 3.67 ± 4.59 s for bout durations.

Wearable inertial sensors offer the possibility to monitor sleeping position and respiration rate during sleep, enabling a comfortable and low-cost method to remotely monitor patients. Novel methods to estimate respiration rate and position during sleep using accelerometer data are presented, with algorithm performance examined for two sensor locations, and accelerometer-derived respiration rate compared across sleeping positions. Eleven participants (9 male; aged: 47.82±14.14 years; BMI 30.9±5.27 kg/m 2 ; AHI 5.77±4.18) undergoing a scheduled clinical polysomnography (PSG) wore a tri-axial accelerometer on their chest and upper abdomen. PSG cannula flow and position data were used as benchmark data for respiration rate (breaths per minute, bpm) and position. Sleeping position was classified using logistic regression, with features derived from filtered acceleration and orientation. Accelerometer-derived respiration rate was estimated for 30 s epochs using an adaptive peak detection algorithm which combined filtered acceleration and orientation data to identify individual breaths. Sensor-derived and PSG respiration rates were then compared. Mean absolute error (MAE) in respiration rate did not vary between sensor locations (abdomen: 1.67±0.37 bpm; chest: 1.89±0.53 bpm; p=0.52), while reduced MAE was observed when participants lay on their side (1.58±0.54 bpm) compared to supine (2.43±0.95 bpm), p<0.01. MAE was less than 2 bpm for 83.6% of all 30 s windows across all subjects. The position classifier distinguished supine and left/right with a ROC AUC of 0.87, and between left and right with a ROC AUC of 0.94. The proposed methods may enable a low-cost solution for in-home, long term sleeping posture and respiration monitoring.

Wearable accelerometers can be used to quantify movement during swimming, enabling objective performance analysis. This study examined arm acceleration during front crawl swimming, and investigated how accelerometer-derived features change with lap times. Thirteen participants swam eight 50m laps using front crawl with a tri-axial accelerometer attached to each upper arm. Data were segmented into individual laps; lap times estimated and individual strokes extracted. Stroke times, root mean squared (RMS) acceleration, RMS jerk and spectral edge frequencies (SEF) were calculated for each stroke. Movement symmetry was assessed as the ratio of the minimum to maximum feature value for left and right arms. A regularized multivariate regression model was developed to estimate lap time using a subset of the accelerometer-derived features. Mean lap time was 56.99±11.99s. Fifteen of the 42 derived features were significantly correlated with lap time. The regression model included 5 features (stroke count, mean SEF of the X and Z axes, stroke count symmetry, and the coefficient of variation of stroke time symmetry) and estimated 50m lap time with a correlation coefficient of 0.86, and a cross-validated RMS error of 6.38s. The accelerometer-derived features and developed regression model may provide a useful tool to quantitatively evaluate swimming performance.