Actigraphy: Analyzing patient movement

Grap, Mary Jo; Hamilton, V. Anne; McNallen, Ann; Ketchum, Jessica M.; Best, Al M.; Arief, Nyimas Y.; Wetzel, Paul A.

doi:10.1016/j.hrtlng.2009.12.013

Cited by 22 publications

(16 citation statements)

References 32 publications

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“…Wrist and ankle actigraphic data are highly correlated, although movement of the wrist is greater than movement of the ankle in critically ill patients. 18–20 The actigraph contains a single omnidirectional accelerometer that integrates occurrence, degree, and intensity of motion to produce activity counts. Associations between actigraphic measurements, scores on the Richmond Agitation-Sedation Scale, scores on the Comfort Scale, and direct observation have been described.…”

Section: Methodsmentioning

confidence: 99%

“…18 Behavior states based on movement counts per minute measured by using actigraphy have also been described, identifying movement means for calm (arm, 6.79; lower extremity, 3.53), restless (arm, 28.54; lower extremity, 18.70), and agitated (arm, 52.59; lower extremity, 37.65) behavior. 20 For this study, actigraphy movement counts of the lower extremity were collected every second via a wireless data transfer system.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Backrest Elevation and Tissue Interface Pressure by Anatomical Location During Mechanical Ventilation

Grap¹,

Munro²,

Wetzel³

et al. 2016

American Journal of Critical Care

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Background Backrest elevations less than 30° are recommended to reduce pressure ulcers, but positions greater than 30° are recommended during mechanical ventilation to reduce risk for ventilator-associated pneumonia. Interface pressure may vary with level of backrest elevation and anatomical location (eg, sacrum, heels). Objective To describe backrest elevation and anatomical location and intensity of skin pressure across the body in patients receiving mechanical ventilation. Methods In a longitudinal study, patients from 3 adult intensive care units in a single institution receiving mechanical ventilation were enrolled within 24 hours of intubation from February 2010 through May 2012. Backrest elevation (by inclinometer) and pressure (by a pressure-mapping system) were measured continuously for 72 hours. Mean tissue interface pressure was determined for 7 anatomical areas: left and right scapula, left and right trochanter, sacrum, and left and right heel. Results Data on 133 patients were analyzed. For each 1° increase in backrest elevation, mean interface pressure decreased 0.09 to 0.42 mm Hg. For each unit increase in body mass index, mean trochanter pressure increased 0.22 to 0.24 mm Hg. Knee angle (lower extremity bent at the knee) and mobility were time-varying covariates in models of the relationship between backrest elevation and tissue interface pressure. Conclusions Individual factors such as patient movement and body mass index may be important elements related to risk for pressure ulcers and ventilator-associated pneumonia, and a more nuanced approach in which positioning decisions are tailored to optimize outcomes for individual patients appears warranted.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Backrest Elevation and Tissue Interface Pressure by Anatomical Location During Mechanical Ventilation

Grap¹,

Munro²,

Wetzel³

et al. 2016

American Journal of Critical Care

View full text Add to dashboard Cite

show abstract

“…The actigraph is an automated watch that can be worn on the wrist or ankle and is a valid tool to measure rest-wake patterns and total rest time (58,59). In normal healthy adult populations, actigraphy has significant correlation and agreement with PSG (60).…”

Section: Actigraphymentioning

confidence: 99%

Sleep in the intensive Care Unit

Weinhouse¹

2011

Acute and Emergent Events in Sleep Disorders

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Sleep is an important physiologic process, and lack of sleep is associated with a host of adverse outcomes. Basic and clinical research has documented the important role circadian rhythm plays in biologic function. Critical illness is a time of extreme vulnerability for patients, and the important role sleep may play in recovery for intensive care unit (ICU) patients is just beginning to be explored. This concise clinical review focuses on the current state of research examining sleep in critical illness. We discuss sleep and circadian rhythm abnormalities that occur in ICU patients and the challenges to measuring alterations in circadian rhythm in critical illness and review methods to measure sleep in the ICU, including polysomnography, actigraphy, and questionnaires. We discuss data on the impact of potentially modifiable disruptors to patient sleep, such as noise, light, and patient care activities, and report on potential methods to improve sleep in the setting of critical illness. Finally, we review the latest literature on sleep disturbances that persist or develop after critical illness.

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“…Effective control of sedation in Intensive Care Units (ICUs) is performed in a closedloop to keep patients relaxed and mentally conscious [6]. Feedback is obtained from medical equipment that monitors vital signs and notes from medical staff who register the behavior of the patient.…”

Section: Introductionmentioning

confidence: 99%

“…Actigraphy, the measurement of physical activity, has been suggested as an objective indicator to be included in sedation scales [6]. Although actigraphy is extensively used in sleep monitoring laboratories, the procedure to attach all the required sensors to capture a meaningful actigraphic profile is costly.…”

Section: Introductionmentioning

confidence: 99%

“BAM!” Depth-Based Body Analysis in Critical Care

Martínez

Schauerte

Stiefelhagen

2013

Computer Analysis of Images and Patterns

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We investigate computer vision methods to monitor Intensive Care Units (ICU) and assist in sedation delivery and accident prevention. We propose the use of a Bed Aligned Map (BAM) to analyze the patient's body. We use a depth camera to localize the bed, estimate its surface and divide it into 10 cm × 10 cm cells. Here, the BAM represents the average cell height over the mattress. This depth-based BAM is independent of illumination and bed positioning, improving the consistency between patients. This representation allow us to develop metrics to estimate bed occupancy, body localization, body agitation and sleeping position. Experiments with 23 subjects show an accuracy in 4-level agitation tests of 88 % and 73 % in supine and fetal positions respectively, while sleeping position was recognized with a 100 % accuracy in a 4-class test.

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Actigraphy: Analyzing patient movement

Cited by 22 publications

References 32 publications

Backrest Elevation and Tissue Interface Pressure by Anatomical Location During Mechanical Ventilation

Backrest Elevation and Tissue Interface Pressure by Anatomical Location During Mechanical Ventilation

Sleep in the intensive Care Unit

“BAM!” Depth-Based Body Analysis in Critical Care

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