Validity of the detection of wheelchair propulsion as measured with an Activity Monitor in patients with spinal cord injury

Abstract

Study design: Validation study. Objectives: An accelerometry-based Activity Monitor (AM) has proven to be a valid instrument to quantify mobility-related activities (lying, sitting, standing, walking, cycling, general (noncyclic) movement). The aim of this study was to assess whether, additional to other activities, wheelchair propulsion (hand-rim wheelchair propulsion and handbiking) can be validly detected by the AM in patients with spinal cord injury (SCI). Setting: Rehabilitation center. Methods: In all, 10 patients with SCI (aged 19-63 years; five patients with poor triceps strength and five patients with good triceps strength) participated. Patients performed a series of representative daily life activities (involving wheelchair propulsion and nonwheelchair propulsion activities), according to a standard protocol, in a seminatural setting. Continuous registrations of signals from body-fixed accelerometers were made and the AM output (after automatic analysis) was compared with visual analysis of simultaneously made video recordings (reference method). Validity scores (agreement, sensitivity, specificity) between the output of the AM and the video analysis were calculated. Results: Agreement, sensitivity and specificity for the detection of wheelchair propulsion were overall 92 (range, 87-96)%, 87 (76-99)% and 92 (85-98)%, respectively. Sensitivity was smaller in patients with poor triceps strength compared to patients with good triceps strength; 81 (76-89)% and 95 (89-99)%, respectively (Po0.01). Mean overestimation in duration of wheelchair propulsion by the AM was 3.9% (Po0.05). Conclusion: Besides already validated other activities, wheelchair propulsion (hand-rim wheelchair propulsion and handbiking) can be validly detected by the AM in patients with SCI, both with good and poor triceps strength. Therefore, the AM offers the possibility to obtain objective and detailed information on all major mobility-related activities performed by patients with SCI. Sponsorship: Stichting Rotterdams Kinderrevalidatie Fonds Adriaanstichting.

Fatigue in persons with subacute spinal cord injury who are dependent on a manual wheelchair

“…17,18 The system consists of three recorders that are wirelessly connected and synchronized every 10 s. One recorder was attached to the sternum and another to each wrist using specially developed belts. The activity monitor was worn continuously for 96 h on four week days, except during swimming, bathing and sleeping.…”

Methods of analysis of physical activity among persons with spinal cord injury: A review

“…Jsou uváděny pod sdružujícím názvem Accelerometer based Activity Monitors. Akcelerometry se upínají na tělo probanda, a to na zápěstí, stehno nebo hrudní koš (Masso et al, 2013;Postma et al, 2005;Wilson, Hasler, Dall, & Granat, 2008). Masso et al (2013) se ve své studii zaměřili na mož-nost získání nepřímých dat o množství spotřebovaného kyslíku z dat naměřených akcelerometry umístěných na těle paraplegiků.…”

“…pohybovou aktivitu daného probanda. Snímače jsou natolik citlivé, že dovedou rozlišit cyklický pohyb rukou při pohánění kola mechanického vozíku od cyklického pohybu rukou při jízdě na handbiku (Postma et al, 2005). Masso et al (2013) uvádí, že nejcitlivěji a nejpřesněji snímá akcelerometr umístěný na nedominantním zápěstí.…”

Randomized controlled trial of a self-management intervention in persons with spinal cord injury: design of the HABITS (Healthy Active Behavioural IntervenTion in SCI) study

“…The calculations are based on levels of daily physical activity as found in persons with SCI in previous studies of our department [7,44].…”