Variability in Emotional Symptoms and Fatigue Measured via Mobile Ecological Momentary Assessment after TBI

Juengst, Shannon B.; Terhorst, Lauren; Arenth, Patricia M.; Wagner, Amy

doi:10.1016/j.apmr.2017.08.424

Cited by 6 publications

(12 citation statements)

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“…Leveraging technology for community-based symptom monitoring may improve efficiency and effectiveness of long-term clinical surveillance, especially for neurobehavioral symptoms that fluctuate considerably from day to day and are therefore more prone to recall bias. 8,9 Mobile technology now facilitates ecological momentary assessment (EMA; also called experience sampling or ambulatory assessment) of subjective states, as they occur naturally over time and in the varied contexts of daily life. In EMA, respondents receive notifications on mobile devices, such as smartphones, according to a fixed or random schedule, and are asked to respond to prompts about target symptoms, behaviors, or experiences.…”

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confidence: 99%

Neurobehavioral Symptoms and Heart Rate Variability: Feasibility of Remote Collection Using Mobile Health Technology

Nabasny¹,

Rabinowitz²,

Wright³

et al. 2022

Journal of Head Trauma Rehabilitation

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Objectives: To determine the covariance of heart rate variability (HRV) and self-reported neurobehavioral symptoms after traumatic brain injury (TBI) collected using mobile health (mHealth) technology. Setting: Community. Participants: Adults with lifetime history of TBI (n = 52) and adults with no history of brain injury (n = 12). Design: Two-week prospective ecological momentary assessment study. Main Measures: Behavioral Assessment Screening Tool (BASTmHealth) subscales (Negative Affect, Fatigue, Executive Dysfunction, Substance Abuse, and Impulsivity) measured frequency of neurobehavioral symptoms via a RedCap link sent by text message. Resting HRV (root mean square of successive R-R interval differences) was measured for 5 minutes every morning upon waking using a commercially available heart rate monitor (Polar H10, paired with Elite HRV app). Results: Data for n = 48 (n = 38 with TBI; n = 10 without TBI) participants were included in covariance analyses, with average cross-correlation coefficients (0-day lag) varying greatly across participants. We found that the presence and direction of the relationship between HRV and neurobehavioral symptoms varied from person to person. Cross-correlation coefficients r ≤ −0.30, observed in 27.1% to 29.2% of participants for Negative Affect, Executive Dysfunction, and Fatigue, 22.9% of participants for Impulsivity, and only 10.4% of participants for Substance Abuse, supported our hypothesis that lower HRV would covary with more frequent symptoms. However, we also found 2.0% to 20.8% of participants had positive cross-correlations (r ≥ 0.30) across all subscales, indicating that higher HRV may sometimes correlate with more neurobehavioral symptoms, and 54.2% to 87.5% had no significant cross-correlations. Conclusions: It is generally feasible for community-dwelling adults with and without TBI to use a commercially available wearable device to capture daily HRV measures and to complete a short, electronic self-reported neurobehavioral symptom measure for a 2-week period. The covariance of HRV and neurobehavioral symptoms over time suggests that HRV could be used as a relevant physiological biomarker of neurobehavioral symptoms, though how it would be interpreted and used in practice would vary on a person-by-person and symptom domain basis and requires further study.

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confidence: 99%

Neurobehavioral Symptoms and Heart Rate Variability: Feasibility of Remote Collection Using Mobile Health Technology

Nabasny¹,

Rabinowitz²,

Wright³

et al. 2022

Journal of Head Trauma Rehabilitation

Self Cite

View full text Add to dashboard Cite

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“…Of the 40 articles retrieved, the plurality ( n = 15) were reported or deemed to be descriptive in design, 19 , 41–54 and included small, non-randomized pilot studies and secondary analyses of data, or in two studies, were conducted in or described the retrospective analysis of a quality improvement initiative format. 52 , 53 Citations with an observational design formed the second most common type ( n = 10), 10 , 55–63 encompassing prospective 55 , 56 , 58 and retrospective 10 cohort studies and cross-sectional studies. 57 , 60 , 61 Research of experimental (n = 9) 64–72 and quasi-experimental ( n = 6) 73–78 design was similar in frequency.…”

Section: Resultsmentioning

confidence: 99%

“…Experimental designs included single-center 66 , 68–71 and international multi-center 65 , 67 randomized trial designs, among non-randomized, open-label trials. 64 , 72 Results of these studies were published primarily as original research articles ( n = 31), 10 , 19 , 41–44 , 48–53 , 55 , 56 , 59 , 61–75 , 78 with a lesser number as conference abstracts or research posters ( n = 8), 45–47 , 57 , 58 , 60 , 76 , 77 and research summary letters ( n = 1). 54 …”

Section: Resultsmentioning

confidence: 99%

“…With respect to TBI severity, FUTs were most frequently implemented in cohorts of patients with TBI of undefined severity ( n = 14) 10 , 44 , 45 , 49 , 52 , 53 , 55 , 58 , 62 , 65 , 67 , 70 , 71 , 77 —in some of these cases, patient cohorts were pooled with other diagnoses (trauma, spinal cord injury, stroke, orthopedic, acquired brain injury, among other neurological conditions). Where TBI severity was defined, seven studies ( n = 7) explored the implementation of FUTs in all-severity TBI patient cohorts.…”

Section: Resultsmentioning

confidence: 99%

“…The second technology most frequently used in the remote collection of outcome data were mobile applications, or “apps,” installed on Apple and Android devices such as smartphones and tablets ( Table 3 ) ( n = 9). 51 , 54 , 58 , 61 , 67 , 72 , 73 , 77 , 78 Such implementations of mobile applications ranged from gamified symptom journals and social networking 72 to delivering questionnaires for EMA. 51 , 58 , 73 Three studies described the further use of the device's onboard sensors and additional functionality in the delivery and collection of data, including native “push notifications” to prompt patients to input data, 78 the GPS tracking function in the collection of activity and community participation data, 61 or in one study, the Apple iPod Touch's in-built accelerometer to capture objective measurements of physical activity.…”

Section: Resultsmentioning

confidence: 99%

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Remote Follow-Up Technologies in Traumatic Brain Injury: A Scoping Review

Smith

Tumpa

Mantle

et al. 2022

Journal of Neurotrauma

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Traumatic brain injury (TBI) remains a leading cause of death and disability worldwide. Motivations for outcome data collection in TBI are threefold: to improve patient outcomes, to facilitate research, and to provide the means and methods for wider injury surveillance. Such data play a pivotal role in population health, and ways to increase the reliability of data collection following TBI should be pursued. As a result, technology-aided follow-up of patients with neurotrauma is on the rise; there is, therefore, a need to describe how such technologies have been used. A scoping review was conducted and reported using the PRISMA extension (PRISMA-ScR). Five electronic databases (Embase, MEDLINE, Global Health, PsycInfo, and Scopus) were searched systematically using keywords derived from the concepts of “telemedicine,” “TBI,” “outcome assessment,” and “patient-generated health data.” Forty studies described follow-up technologies (FUTs) utilizing telephones (52.5%, n = 21), short message service (SMS; 10%, n = 4), smartphones (22.5%, n = 9), videoconferencing (10%, n = 4), digital assistants (2.5%, n = 1), and custom devices (2.5%, n = 1) among cohorts of patients with TBI of varying injury severity. Where reported, clinical facilitators, remote follow-up timing and intervals between sessions, synchronicity of follow-up instances, proxy involvement, outcome measures utilized, and technology evaluation efforts are described. FUTs can aid more temporally sensitive assessments and capture fluctuating sequelae, a benefit of particular relevance to TBI cohorts. However, the evidence base surrounding FUTs remains in its infancy, particularly with respect to large samples, low- and middle-income patient cohorts, and the validation of outcome measures for deployment via such remote technology.

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TBI Rehabilomics Research: an Exemplar of a Biomarker-Based Approach to Precision Care for Populations with Disability

Wagner

2017

Curr Neurol Neurosci Rep

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To date, nearly every area of medicine uses biomarkers in some capacity to aid in understanding how personal biology informs clinical care. "-Omics"-based approaches use high throughput genomics, proteomics, and transcriptomics assay platforms to tailor and personalize treatments for subgroups of similar individuals based on these results. The recent Precision Medicine Initiative (PMI), sponsored by the National Institutes of Health (NIH), has propelled biomarker-based and genomics research to the forefront of many translational research and care programs addressing a variety of medical populations. Yet, the literature is sparse on precision medicine approaches for those with neurologically related and other disability. We demonstrate how the Rehabilomics Research model represents a translational framework for programs of precision rehabilitation research and care focused on linking personal biology to the biopsychosocial constructs that represent the WHO-ICF model and multidimensional outcome. We provide multiple exemplars from our own research program involving individuals with moderate-to-severe traumatic brain injury (TBI) to demonstrate how genomics and other biomarkers can be identified and assessed for their capacity to assist with personalized (precision) neurorehabilitation care and management.

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Variability in Emotional Symptoms and Fatigue Measured via Mobile Ecological Momentary Assessment after TBI

Cited by 6 publications

References 0 publications

Neurobehavioral Symptoms and Heart Rate Variability: Feasibility of Remote Collection Using Mobile Health Technology

Neurobehavioral Symptoms and Heart Rate Variability: Feasibility of Remote Collection Using Mobile Health Technology

Remote Follow-Up Technologies in Traumatic Brain Injury: A Scoping Review

TBI Rehabilomics Research: an Exemplar of a Biomarker-Based Approach to Precision Care for Populations with Disability

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