The interrater reliability of rating non-exercise activity of inpatients with eating disorders using a visual analogue scale

Mazloum, A.; Johnston, Megan; Lundrigan, M.; Birmingham, C. Laird

doi:10.1007/bf03327513

Cited by 5 publications

(3 citation statements)

References 2 publications

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“…In addition to deliberate exercise, it has long been noted that patients with AN appear to engage in high levels of non-exercise PA, such as walking, standing, fidgeting, and general restlessness, 14 although these behaviors remain difficult to measure. 15 Non-exercise activity is of growing interest in the study of weight regulation in overweight individuals, 16,17 but surprisingly little is known about its role in AN. To date, no study to our knowledge has employed an objective monitor of PA type and postural allocation in the investigation of PA in AN, and no study has sought to determine whether these measures differ between AN patients and HC.…”

Section: Introductionmentioning

confidence: 99%

Physical activity and post‐treatment weight trajectory in anorexia nervosa

Gianini

Klein

Call

et al. 2015

Intl J Eating Disorders

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Objective-This study compared an objective measurement of physical activity (PA) in individuals with anorexia nervosa (AN) at low-weight, weight-restored, and post-treatment time points, and also compared PA in AN with that of healthy controls (HC).Method-Sixty-one female inpatients with AN wore a novel accelerometer (the IDEEA) which measured PA at three time points: a) low-weight, b) weight-restored, and c) one month posthospital discharge. Twenty-four HCs wore the IDEEA at one time point.Results-Inpatients with AN became more physically active than they were at low-weight at weight restoration and following treatment discharge. Post-treatment patients with AN were more physically active than HCs during the day and less active at night, which was primarily accounted for by amount of time spent on feet, including standing and walking. Greater time spent on feet during the weight-restoration time point of inpatient treatment was associated with more rapid decrease in BMI over the 12 months following treatment discharge. Fidgeting did not differ between patients and controls, did not change with weight restoration, and did not predict posttreatment weight change.Discussion-Use of a novel accelerometer demonstrated greater PA in AN than in healthy controls. PA following weight restoration in AN, particularly time spent in standing postures, may contribute to weight loss in the year following hospitalization. Keywords Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptAnorexia Nervosa (AN) is a serious psychiatric illness marked by self-starvation and overvaluation of shape and weight. There has been a longstanding interest in the role of physical activity (PA) in the etiology, maintenance, and prognosis of AN. A range of methods has been used to assess PA in AN, from subjective patient report of exercise frequency and drive to exercise, to objective devices such as accelerometers, which can quantify the frequency and duration of PA.Despite low weight, a significant subset of individuals with AN report that they engage in "excessive" or "compulsive" exercise (1), with one of the earliest clinical observations of a patient with AN by Dr. William Gull from 1868 noting that despite extremely low weight, the patient was "restless and active...it seemed hardly possible that a body so wasted could undergo the exercise which seemed agreeable"(2). This elevated level of exercise is associated with heightened psychopathology, such as depression, anxiety, and eating disorder symptomatology (3-6). Compulsive exercise during treatment is also negatively associated with improvements in eating disorder pathology by treatment discharge (3) and subjective report of compulsive exercise is associated with long-term lack of recovery from AN (7).Notwithstanding the longstanding clinical observation of heightened PA in AN, investigation of objective activity levels in patients with AN has yielded mixed results. While some studies have found that patients with AN are more active than healthy controls (8), oth...

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Section: Introductionmentioning

confidence: 99%

Physical activity and post‐treatment weight trajectory in anorexia nervosa

Gianini

Klein

Call

et al. 2015

Intl J Eating Disorders

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“…This advance over devices insensitive to position is critical, because it permits automation of activity monitoring with minimal burden to participants or to researchers. It is also critical because a growing body of evidence shows the inadequacy of inter-rater reliability in assessing non-exercise activity [3], and the inferiority of self-report measures of physical activity as compared with objective assessments [13], [14]. Not surprisingly, the SWA did not capture movement while seated at the parameters set, though it was able to detect differences in walking intensity, and showed a high degree of association with the other monitors on this measure.…”

Section: Discussionmentioning

confidence: 97%

“…Specifically, energy expenditure related to "active" postures (walking, standing), activities of daily living, and movements such as fidgeting, termed Non-Exercise Activity Thermogenesis (NEAT), are thought to play a role in weight regulation and may distinguish lean from obese individuals [1], [2]. Such activity likely plays a role in disorders of underweight such as Anorexia Nervosa, possibly contributing to difficulty with weight gain encountered by some patients and to susceptibility to relapse [3].…”

Section: Introductionmentioning

confidence: 98%

Validation of two novel monitoring devices to measure physical activity in healthy women

Klein

Levine

Walsh

et al. 2014

2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Measurement of physical activity is increasingly important in health research. We sought to determine the accuracy and sensitivity to non-exercise activity of three activity monitors worn simultaneously by healthy adult women participating in a structured activity protocol. Ten normal-weight women wore the Intelligent Device for Energy Expenditure and Activity (IDEEA), the SmartShoe, and the SenseWear Armband, during activities that included standing, sitting still, sitting and fidgeting, lying down, and walking at varying speeds. Percentage of time postures correctly identified was determined for the IDEEA and the SmartShoe, and activity counts collected from all three devices were compared. Posture was detected with high accuracy by both the IDEEA and the SmartShoe (97.4% and 94.2% accuracy, respectively). The SmartShoe showed superior sensitivity to movement while seated ("fidgeting") compared with the IDEEA (p=0.004 and 0.049 difference between postures, respectively); all three devices distinguished between fast and slow walking. Data support the ability of the IDEEA and the SmartShoe to recognize basic postures in healthy normal-weight women, as well as to detect fidgeting within the seated position.

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Medical Complications and Diagnosing Eating Disorders

Birmingham

2015

The Wiley Handbook of Eating Disorders

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The interrater reliability of rating non-exercise activity of inpatients with eating disorders using a visual analogue scale

Abstract: The ratings of NEAT using a VAS were not reliable between clinicians. This indicates that the ward staff, even on a specialized ED unit, cannot reliably estimate non-exercise activity and physiological measurements should be used.

Cited by 5 publications

References 2 publications

Physical activity and post‐treatment weight trajectory in anorexia nervosa

Physical activity and post‐treatment weight trajectory in anorexia nervosa

Validation of two novel monitoring devices to measure physical activity in healthy women

Medical Complications and Diagnosing Eating Disorders

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