scholarly journals Inferring Physical Function From Wearable Activity Monitors: Analysis of Free-Living Activity Data From Patients With Knee Osteoarthritis

10.2196/11315 ◽  
2018 ◽  
Vol 6 (12) ◽  
pp. e11315 ◽  
Author(s):  
Vibhu Agarwal ◽  
Matthew Smuck ◽  
Christy Tomkins-Lane ◽  
Nigam H Shah
2018 ◽  
Author(s):  
Vibhu Agarwal ◽  
Matthew Smuck ◽  
Christy Tomkins-Lane ◽  
Nigam H Shah

BACKGROUND Clinical assessments for physical function do not objectively quantify routine daily activities. Wearable activity monitors (WAMs) enable objective measurement of daily activities, but it remains unclear how these map to clinically measured physical function measures. OBJECTIVE This study aims to derive a representation of physical function from daily measurements of free-living activity obtained through a WAM. In addition, we evaluate our derived measure against objectively measured function using an ordinal classification setup. METHODS We defined function profiles representing average time spent in a set of pattern classes over consecutive days. We constructed a function profile using minute-level activity data from a WAM available from the Osteoarthritis Initiative. Using the function profile as input, we trained statistical models that classified subjects into quartiles of objective measurements of physical function as measured through the 400-m walk test, 20-m walk test, and 5 times sit-stand test. Furthermore, we evaluated model performance on held-out data. RESULTS The function profile derived from minute-level activity data can accurately predict physical performance as measured through clinical assessments. Using held-out data, the Goodman-Kruskal Gamma statistic obtained in classifying performance values in the first quartile, interquartile range, and the fourth quartile was 0.62, 0.53, and 0.51 for the 400-m walk, 20-m walk, and 5 times sit-stand tests, respectively. CONCLUSIONS Function profiles accurately represent physical function, as demonstrated by the relationship between the profiles and clinically measured physical performance. The estimation of physical performance through function profiles derived from free-living activity data may enable remote functional monitoring of patients.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1744.1-1744
Author(s):  
J. P. Pelletier ◽  
J. P. Raynauld ◽  
M. Dorais ◽  
P. Paiement ◽  
J. Martel-Pelletier

Background:The DISSCO trial (6-month international, multicentre, double-blind, randomised study on the effect of diacerein vs celecoxib in symptomatic knee osteoarthritis [OA] patients) showed that diacerein had comparable efficacy to celecoxib at reducing the level of pain (WOMAC pain).Objectives:To assess the effect of age, body mass index (BMI), and gender on the efficacy/safety profile of diacerein following 6 months of treatment.Methods:Of the patients (n=380) that were randomised, 186 received treatment with 50 mg diacerein once daily for the first month and twice daily thereafter. This study was done on the intent-to-treat population (n=183). Efficacy outcome assessments which included absolute change in WOMAC pain (score 0-50) and function (score 0-170), and VAS (score 0-10) were analysed following stratification based on age (< 65 vs ≥ 65 years old) and BMI (< 30 vs ≥ 30 kg/m2) at time of randomisation. Treatment effects on continuous efficacy outcomes were performed using covariance analysis (ANCOVA). For gastrointestinal (GI) safety outcomes, the adverse events (AEs), including diarrhoea, soft faeces, abdominal pain and dyspepsia, and the time-to-onset from baseline were stratified according to age of patients at randomisation. Treatment-related GI AEs were also assessed according to the gender. The independent variables were treatment, stratification variable, interaction between both, and the outcome measure at baseline. Comparisons between groups were carried out using Chi-square.Results:No significant differences were found between the two age groups (<65 years old [n=105], ≥65 years old [n=78]) in the level of reduction in WOMAC pain (-10.3 ± 1.1, -8.6 ± 1.3, respectively; p=0.30), VAS (-2.3 ± 0.2, -2.2 ± 0.3, p=0.73) or improved physical function (-29.7 ± 3.7, -22.1 ± 4.2, p=0.18). The reported incidences of treatment-related GI AEs were also similar between the two age groups; more specifically for diarrhoea, incidence for patients <65 years old [n=12] 11.3% and for those ≥65 years old [n=7] 8.8% (p=0.63) with a mean time-to-onset (day 43 ± 49, 61 ±51, respectively; p=0.11). Moreover, gender had no influence on treatment-related GI AEs (p=0.42).In regard to treatment response of obese (n=101) vs. non-obese (n=82) patients in terms of pain reduction (WOMAC: -10.1 ± 1.2, -9.1 ± 1.1, respectively; p=0.58; VAS: -2.6 ± 0.3, -2.0 ± 0.3; p=0.15), or improved WOMAC physical function (-29.8 ± 4.2, -23.5 ± 3.8; p=0.26), there were also no significant differences.Conclusion:In symptomatic knee OA patients, the level of effectiveness and safety profile of treatment with diacerein were found not to be influenced by age, BMI or gender.Disclosure of Interests:Jean-Pierre Pelletier Shareholder of: ArthroLab Inc., Grant/research support from: TRB Chemedica, Speakers bureau: TRB Chemedica and Mylan, Jean-Pierre Raynauld Consultant of: ArthroLab Inc., Marc Dorais Consultant of: ArthroLab Inc., Patrice Paiement Employee of: ArthroLab Inc., Johanne Martel-Pelletier Shareholder of: ArthroLab Inc., Grant/research support from: TRB Chemedica


2021 ◽  
Author(s):  
Fatme Hoteit ◽  
Debbie Erhmann Feldman ◽  
Lisa C. Carlesso

Purpose: To explore factors associated with intermittent, constant, and mixed pain in people with knee osteoarthritis. Method: We conducted a secondary analysis of a cross-sectional multicenter study with adults ≥ 40 years with knee osteoarthritis. Participants completed questionnaires on personal (e.g., demographics, comorbidities), physical (e.g., physical function), psychological (e.g., depressive symptoms), pain (e.g., qualities), and tests for physical performance and nervous system sensitivity. We qualified patients’ pain as intermittent, constant, or mixed using the Modified painDETECT Questionnaire and assessed associations with the variables using multinomial logistic regression. Results: The 279 participants had an average age of 63.8 years (SD = 9.6), BMI of 31.5 kg/m2 (SD = 8.7), and 58.6% were female. Older age (odds ratio [OR] 0.95; 95% CI: 0.90, 1.00) and higher self-reported physical function ([OR] 0.94; 95% CI: 0.91, 0.98) were associated with a lower likelihood of mixed pain compared with intermittent pain. Higher pain intensity ([OR] 1.25; 95% CI: 1.07, 1.47) was related to a 25% higher likelihood of mixed pain compared with intermittent pain. Conclusions: This study provides initial data for associations of personal, pain, and physical function factors with different pain patterns. Awareness of these factors can help clinicians develop targeted strategies for managing patients’ pain.


2011 ◽  
Vol 25 (S1) ◽  
Author(s):  
Denise K Houston ◽  
Cralen Davis ◽  
Claudine Legault ◽  
Dorothy B Hausman ◽  
Barbara J Nicklas ◽  
...  

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