Table 1.
Characteristics of Studies Utilizing Actigraphy to Measure Activity in Critically Ill Patients.
| Citation, Country | Population: Cohort, Sample Size, Gender, Age | Study Design | Activity Outcomesa | Key Findings |
|---|---|---|---|---|
| Redeker et al, United States25 | Surgical ICU; post-CABG (n = 25, 0% male, mean age 64 ± 10) | Observational; evaluation of sleep as related to recovery post- CABG | Mean activity | Positive association between length of activity period and recovery (as defined by length of stay and dysfunction) |
| Redeker et al, United States26 | Surgical ICU; post-CABG females (n = 13, 0% male, age 62 ± 11) | Observational; evaluation of changes in activity in post- CABG females | Mean activity, Activity amplitude, Circadian activity rhythm | Measured activity does not correlate with selfreported recovery, but can be feasible to measure daily patterns of activity and rest over a long-term period of recovery |
| Winkelman et al, United States27 | General ICU; MV, ICU LOS 5–15 days (n = 20, 40% male, mean age 60 ± 16) | Observational; direct observation vs actigraphy | Therapeutic activity | Actigraphy adequately measures activity duration and frequency, but not intensity |
| Grap et al, United States28 | Respiratory ICU, CCU (n = 20, 50% male, mean age 51 ± 16) | Observational; subjective assessment vs physiological status vs actigraphy in measuring activity | Mean activity, Median activity | Physical activity correlates with sedation, comfort levels, and physiologic parameters |
| Whetstone Foster et al, United States29 | General ICU; MV, intubated, on neuromuscular blockade (n = 31,71% male, mean age 35) | Observational; evaluation of neuromuscular blockade drugs | Mean activity | No significant association between regaining neuromuscular transmission and functional activity. |
| Paul et al, Germany30 | Surgical ICU; receiving analgosedation (n = 24, 50% male, mean age 44 ± 14) | Observational; evaluation of actigraphy recordings and physiological measurements | Spontaneous motor activity | Biological rhythms and cardiovascular function in ICU patients are disturbed |
| Winkelman et al, United States31 | Medical ICU, surgical ICU; MV, ICU LOS 5–15 days (n = 10, 20% male, mean age 62) | Observational; evaluation of cytokine levels | Therapeutic activity, Activity intensity | No significant association between duration and intensity of activity and serum cytokine levels |
| Taguchi et al, Japan32 | General ICU; extubated after esophageal cancer surgery (n = 11, 100% male, mean age 57) | RCT; bright light therapy (n = 6) vs normal light (n = 5), evaluating early ambulation and postoperative delirium | Circadian activity rhythm | Bright light therapy may promote early ambulation and reduce postoperative delirium |
| Mistraletti et al, Italy33 | Med-surgical ICU; MV (n = 13, 46% male, mean age 60 ± 16) | Observational; actigraphy vs nurse assessment to measure movements | Daytime activity, Nighttime activity | Limb movements correlate with markers of neurologic status during day and night |
| Osse et al, the Netherlands34 | Surgical ICU; post-cardio surgery, >65 years old (n = 70, 50% male, mean age 75 ± 5) | Observational; evaluating circadian activity patterns | Daytime activity, Nighttime activity, Immobility, Restlessness index, Circadian activity rhythm | Actigraphy may be a measure of motor activity as a marker of delirium |
| Osse et al, the Netherlands35 | Surgical ICU; post-cardio surgery, >65 years old (n = 79, 56% male, mean age 74 ± 5) | Observational; evaluating actigraphy in measuring motor activity | Daytime activity, Nighttime activity, Immobility, Restlessness index, Circadian activity rhythm | Actigraphy can be used for 24-hour rest-activity measurements after cardiac surgery |
| Winkelman, United States36 | Medical ICU; admitted for COPD (n = 17, 18% male, mean age 60 ± 9) | Observational; evaluation of cytokine levels | Baseline mobility and therapeutic mobility counts | Actigraphy can differentiate between levels of low intensity activity |
| Ono et al, Japan37 | Surgical ICU; postesophagectomy (n = 22, 100% male, mean age 64 ± 9) | RCT; bright light therapy (n = 12) vs. normal light (n = 10) | Nighttime activity, Circadian activity rhythm | Post-operative bright light therapy may improve 24-hour circadian rest- activity rhythms |
| Grap et al, United States38 | Surgical ICU, CCU, General ICU; intubated, MV (n = 169, 61% male, mean age 54 ± 14) | Observational; continuous physiological monitoring vs actigraph to study sedation | Activity level (as a surrogate for comfort) | Infrequent movements at all levels of sedation, but fewer movements with higher levels of sedation |
| Grap et al, United States39 | Surgical ICU, CCU, General ICU; intubated, MV (n = 67, 49% male, age 55 ± 15) | Observational; evaluating level of sedation after use of noxious stimuli | Activity level (as a surrogate for comfort) | Movement may be an appropriate parameter to measure the level of sedation and discomfort |
| Duclos et al, Canada40 | ICU; GCS<3 (n = 16,81% male, mean age 27 ± 11) | Observational; evaluating circadian rhythm disturbances | 24-hour activity, Rest- activity cycle consolidation | Actigraphy can be used to assess rest-activity cycles in the acute care setting |
Abbreviations: CABG, coronary artery bypass grafting; CCU, coronary care unit; COPD, Chronic Obstructive Pulmonary Disease; CPRU, Comprehensive Pulmonary Rehabilitation Unit; GCS, Glasgow Coma Scale; ICU, intensive care unit, MV, mechanically ventilated; RCT, randomized control trial.
a
As defined by study authors. “Mean activity,” “Median activity,” “Spontaneous motor activity,” “Daytime activity,” “Nighttime activity,” “Activity level” = activity count as defined by number of movements per epoch. “Activity amplitude” = half of the distance between the peak and trough of the rhythm. “Circadian activity rhythm” = activity rhythm over a 24-hour period. “Therapeutic activity” = time spent performing activities such as turning and range of motion. “Activity intensity” = acceleration over baseline, reported as proportional integrating measure. Restlessness index = composite score of both activity and immobility. Immobility = number of minutes immobile. “24-hour activity” = minutes scored as “moving” over a 24-hour period. “Rest-activity cycle consolidation” = if Daytime activity/24-hour activity > 0.8).