Validity of six activity monitors in chronic obstructive pulmonary disease: a comparison with indirect calorimetry

Hans Van Remoortel, Yogini Raste, Zafeiris Louvaris, Santiago Giavedoni, Chris Burtin, Daniel Langer, Frederick Wilson, Roberto Rabinovich, Ioannis Vogiatzis, Nicholas S Hopkinson, Thierry Troosters, PROactive consortium, Caterina Brindicci, Tim Higenbottam, Thierry Troosters, Fabienne Dobbels, Margaret X Tabberer, Roberto A Rabinovich, William McNee, Ioannis Vogiatzis, Michael Polkey, Nick Hopkinson, Judith Garcia-Aymerich, Milo Puhan, Anja Frei, Thys van der Molen, Corina De Jong, Pim de Boer, Ian Jarrod, Paul McBride, Nadia Kamel, Katja Rudell, Frederick J Wilson, Nathalie Ivanoff, Karoly Kulich, Alistair Glendenning, Niklas X Karlsson, Solange Corriol-Rohou, Enkeleida Nikai, Damijen Erzen, Hans Van Remoortel, Yogini Raste, Zafeiris Louvaris, Santiago Giavedoni, Chris Burtin, Daniel Langer, Frederick Wilson, Roberto Rabinovich, Ioannis Vogiatzis, Nicholas S Hopkinson, Thierry Troosters, PROactive consortium, Caterina Brindicci, Tim Higenbottam, Thierry Troosters, Fabienne Dobbels, Margaret X Tabberer, Roberto A Rabinovich, William McNee, Ioannis Vogiatzis, Michael Polkey, Nick Hopkinson, Judith Garcia-Aymerich, Milo Puhan, Anja Frei, Thys van der Molen, Corina De Jong, Pim de Boer, Ian Jarrod, Paul McBride, Nadia Kamel, Katja Rudell, Frederick J Wilson, Nathalie Ivanoff, Karoly Kulich, Alistair Glendenning, Niklas X Karlsson, Solange Corriol-Rohou, Enkeleida Nikai, Damijen Erzen

Abstract

Reduced physical activity is an important feature of Chronic Obstructive Pulmonary Disease (COPD). Various activity monitors are available but their validity is poorly established. The aim was to evaluate the validity of six monitors in patients with COPD. We hypothesized triaxial monitors to be more valid compared to uniaxial monitors. Thirty-nine patients (age 68±7 years, FEV(1) 54±18%predicted) performed a one-hour standardized activity protocol. Patients wore 6 monitors (Kenz Lifecorder (Kenz), Actiwatch, RT3, Actigraph GT3X (Actigraph), Dynaport MiniMod (MiniMod), and SenseWear Armband (SenseWear)) as well as a portable metabolic system (Oxycon Mobile). Validity was evaluated by correlation analysis between indirect calorimetry (VO(2)) and the monitor outputs: Metabolic Equivalent of Task [METs] (SenseWear, MiniMod), activity counts (Actiwatch), vector magnitude units (Actigraph, RT3) and arbitrary units (Kenz) over the whole protocol and slow versus fast walking. Minute-by-minute correlations were highest for the MiniMod (r = 0.82), Actigraph (r = 0.79), SenseWear (r = 0.73) and RT3 (r = 0.73). Over the whole protocol, the mean correlations were best for the SenseWear (r = 0.76), Kenz (r = 0.52), Actigraph (r = 0.49) and MiniMod (r = 0.45). The MiniMod (r = 0.94) and Actigraph (r = 0.88) performed better in detecting different walking speeds. The Dynaport MiniMod, Actigraph GT3X and SenseWear Armband (all triaxial monitors) are the most valid monitors during standardized physical activities. The Dynaport MiniMod and Actigraph GT3X discriminate best between different walking speeds.

Conflict of interest statement

Competing Interests: Frederick Wilson is employed by Pfizer Ltd and holds share options in Pfizer Inc. There are no patents, products in development, or marketed products to declare. This does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials.

Figures

Figure 1. Location of attachment for the…
Figure 1. Location of attachment for the Oxycon Mobile and the six activity monitors.
Figure 2. Minute-by-minute correlations (R) between activity…
Figure 2. Minute-by-minute correlations (R) between activity monitor outputs and metabolic equivalents of task (METs) per patient (white dots).
MM; MiniMod, AG; Actigraph, SW; SenseWear, AW; Actiwatch, VMU; vector magnitude unit, AC, activity count, AU; arbitrary unit. Dotted line corresponds to a correlation of 0.7, defined a priori as supporting monitor validity. Median (interquartile range) correlation for each activity monitor is reflected by cross bars, *p<0.05.
Figure 3. Relation between the activity monitor…
Figure 3. Relation between the activity monitor outputs and indirect calorimetry (METs).
Data points represent mean values over the whole protocol. MM; MiniMod, AG; Actigraph, SW; SenseWear, AW; Actiwatch, VMU; vector magnitude unit, AC; activity count, AU; arbitrary unit.
Figure 4. METs (derived from indirect calorimetry…
Figure 4. METs (derived from indirect calorimetry (IC)) and different activity monitor outputs during flat and inclined walking on a treadmill (both at the same speed (85% of their fastest walking speed during 6 MWT).
MM; MiniMod, SW; SenseWear, AG; Actigraph, AW; Actiwatch. Symbols represent the mean, error bars the standard error of the mean.
Figure 5. Bland regression analysis between METs…
Figure 5. Bland regression analysis between METs derived from indirect calorimetry (IC) and different activity monitor outputs.
Solid lines represent regression lines, dotted lines represent 95% limits of prediction.

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