Wearables, Physical Activity, and Exercise Testing in Liver Disease

Dunn, Michael A.; Kappus, Matthew R.; Bloomer, Pamela M.; Duarte‐Rojo, Andrés; Josbeno, Deborah A.; Jakicic, John M.

doi:10.1055/s-0040-1716564

Cited by 14 publications

(23 citation statements)

References 42 publications

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“…An improvement in physical activity leads to an improvement in cardiorespiratory fitness, and this can be measured with cardiopulmonary exercise testing (CPET). CPET is found to be useful in identifying risks in transplant hepatology [ 74 ]. These wearables are not only useful for detecting and identifying liver diseases, but are also useful for keeping track of physical activities that have shown to be helpful for NAFLD and hepatocellular carcinoma (HCC) patients.…”

Section: Wearables As Digital Diagnosticsmentioning

confidence: 99%

Smart Consumer Wearables as Digital Diagnostic Tools: A Review

Chakrabarti¹,

Biswas²,

Jones³

et al. 2022

Diagnostics

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The increasing usage of smart wearable devices has made an impact not only on the lifestyle of the users, but also on biological research and personalized healthcare services. These devices, which carry different types of sensors, have emerged as personalized digital diagnostic tools. Data from such devices have enabled the prediction and detection of various physiological as well as psychological conditions and diseases. In this review, we have focused on the diagnostic applications of wrist-worn wearables to detect multiple diseases such as cardiovascular diseases, neurological disorders, fatty liver diseases, and metabolic disorders, including diabetes, sleep quality, and psychological illnesses. The fruitful usage of wearables requires fast and insightful data analysis, which is feasible through machine learning. In this review, we have also discussed various machine-learning applications and outcomes for wearable data analyses. Finally, we have discussed the current challenges with wearable usage and data, and the future perspectives of wearable devices as diagnostic tools for research and personalized healthcare domains.

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Section: Wearables As Digital Diagnosticsmentioning

confidence: 99%

Smart Consumer Wearables as Digital Diagnostic Tools: A Review

Chakrabarti¹,

Biswas²,

Jones³

et al. 2022

Diagnostics

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“…185 Regarding cardiorespiratory fitness, cardiopulmonary exercise testing is the reference standard to quantify physical function reserve, though it is rarely used in clinical practice for AdvCLD. 186 Instead, the 6-minute walk test has been widely used and proven to be a useful surrogate. Approximately 5 to 15% of patients with AdvCLD cannot walk 250 m or longer, and such poor fitness is associated with a two- to threefold risk of mortality.…”

Section: D—debilitymentioning

confidence: 99%

Mastering Core Recommendations during HEPAtology ROUNDS in Patients with Advanced Chronic Liver Disease

Garcia‐Saenz‐de‐Sicilia

Al-Obaid

Hughes

et al. 2022

Semin Liver Dis

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Efficient and thorough care of hospitalized patients with advanced chronic liver disease is of utter importance to improve outcomes and optimize quality of life. This requires understanding current evidence and best practices. In order to facilitate focus on up-to-date knowledge and a practical approach, we have created the HEPA-ROUNDS mnemonic while outlining a practical review of the literature with critical appraisal for the busy clinician. The HEPA-ROUNDS mnemonic provides a structured approach that incorporates critical concepts in terms of prevention, management and prognostication of most common complications frequently encountered in patients with advance chronic liver disease. In addition, implementing the HEPA-ROUNDS mnemonic can facilitate education for trainees and staff caring for patients with advanced chronic liver disease.

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“…Given healthcare access restrictions derived from the COVID-19 pandemic and their negative effects on our prehabilitation program, we recently incorporated to clinical care the use of personal activity trackers (PATs) and Exercise & Liver Fitness (EL-FIT) to facilitate prescribing and monitoring of physical activity. 5,13 To further leverage the use of recently adopted prehabilitation technology, we conceived the possibility of performing the 6MWT via telehealth. In an initial step to develop and validate such strategy, we explored a method to measure the 6MWT distance using a PAT considering the implications for a future telemedicine application as a frailty metric.…”

Section: Introductionmentioning

confidence: 99%

A Telemedicine Alternative to the 6-Minute Walk Test Using Personal Activity Trackers in Liver Transplant Candidates

Duarte‐Rojo

Brown

Bloomer

et al. 2022

Transplantation Direct

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Liver TransplantationBackground. The COVID-19 pandemic has limited liver transplant (LT) candidates access to clinics. Telehealth methods to assess frailty are needed. We developed a method to estimate the step length of LT candidates, which would permit remotely obtaining the 6-min walk test (6MWT) distance with a personal activity tracker (PAT). Methods. 6MWT was performed while candidates wore a PAT. On first 21 subjects (stride cohort), the step length was measured and compared with calculated one (6MWT-distance/6MWT steps). On a second cohort (PAT-6MWT; n = 116), we collected the 6MWT step count and used multivariable models to generate formulas estimating step length. We multiplied the estimated step length times 6MWT steps to estimate the distance and compared it to the measured distance. The liver frailty index (LFI) and 6MWT were used as frailty metrics. Results. Measured/calculated step length were highly correlated (ρ = 0.85; P < 0.001) in the stride cohort. In the PAT-6MWT cohort, LFI was the strongest variable associated with step length, along with height, albumin, and large-volume paracentesis (R 2 = 0.58). On a second model without LFI, age, height, albumin, hemoglobin, and large-volume paracentesis were strongly associated with step length (R 2 = 0.45). There was a robust correlation between observed 6MWT and PAT-6MWT utilizing step length equations with (ρ = 0.80; P < 0.001) or without LFI (ρ = 0.75; P < 0.001). Frailty by 6MWT <250 m did not change significantly using the observed (16%) or the with/without LFI-estimated (14%/12%) methods. Conclusions. We created a method to obtain 6MWT distance remotely with the use of a PAT. This novel approach opens the possibility of performing telemedicine PAT-6MWT to monitor LT candidates' frailty status.

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Wearables, Physical Activity, and Exercise Testing in Liver Disease

Cited by 14 publications

References 42 publications

Smart Consumer Wearables as Digital Diagnostic Tools: A Review

Smart Consumer Wearables as Digital Diagnostic Tools: A Review

Mastering Core Recommendations during HEPAtology ROUNDS in Patients with Advanced Chronic Liver Disease

A Telemedicine Alternative to the 6-Minute Walk Test Using Personal Activity Trackers in Liver Transplant Candidates

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