Observational Study

. 2020 Jul-Aug;49(4):398-406.

doi: 10.1016/j.hrtlng.2020.02.002. Epub 2020 Feb 24.

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

Prerna Gupta¹, Jennifer L Martin², Dale M Needham³, Sitaram Vangala⁴, Elizabeth Colantuoni⁵, Biren B Kamdar⁶

Affiliations

¹ Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA. Electronic address: prernagupta@mednet.ucla.edu.
² Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA; VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA. Electronic address: jennifer.martin@va.gov.
³ Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, 1830 E Monument St, Baltimore, MD 21287, USA; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, 1830 E Monument St, Baltimore, MD 21287, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287, USA. Electronic address: dale.needham@jhmi.edu.
⁴ Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA; Department of Biostatistics, UCLA Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA. Electronic address: svangala@mednet.ucla.edu.
⁵ Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, 1830 E Monument St, Baltimore, MD 21287, USA; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA. Electronic address: ejohnson@jhsph.edu.
⁶ Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego School of Medicine, 9300 Campus Point Dr. #7381, La Jolla, CA 92037, USA; VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161. Electronic address: kamdar@ucsd.edu.

PMID: 32107065
PMCID: PMC7305977
DOI: 10.1016/j.hrtlng.2020.02.002

Observational Study

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

Prerna Gupta et al. Heart Lung. 2020 Jul-Aug.

. 2020 Jul-Aug;49(4):398-406.

doi: 10.1016/j.hrtlng.2020.02.002. Epub 2020 Feb 24.

Authors

Prerna Gupta¹, Jennifer L Martin², Dale M Needham³, Sitaram Vangala⁴, Elizabeth Colantuoni⁵, Biren B Kamdar⁶

Affiliations

¹ Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA. Electronic address: prernagupta@mednet.ucla.edu.
² Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA; VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA. Electronic address: jennifer.martin@va.gov.
³ Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, 1830 E Monument St, Baltimore, MD 21287, USA; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, 1830 E Monument St, Baltimore, MD 21287, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287, USA. Electronic address: dale.needham@jhmi.edu.
⁴ Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA; Department of Biostatistics, UCLA Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA. Electronic address: svangala@mednet.ucla.edu.
⁵ Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, 1830 E Monument St, Baltimore, MD 21287, USA; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA. Electronic address: ejohnson@jhsph.edu.
⁶ Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego School of Medicine, 9300 Campus Point Dr. #7381, La Jolla, CA 92037, USA; VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161. Electronic address: kamdar@ucsd.edu.

PMID: 32107065
PMCID: PMC7305977
DOI: 10.1016/j.hrtlng.2020.02.002

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.

Keywords: Actigraphy; Activity; Critical illness; ICU; Inactivity; Mobilization.

Published by Elsevier Inc.

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Conflict of interest statement

Declaration of Competing Interest The authors have no conflicts of interest to declare.

Figures

**Figure 2.**
Proportion of zero-activity epochs

**Figure 3.**
Actigraphy-based non-zero activity levels over the 24-hour day, expressed as a linear prediction plot with 95% confidence interval

See this image and copyright information in PMC

References

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources