Query: Wearable COPD

title: Wearable Finger Pulse Oximetry for Continuous Oxygen Saturation Measurements During Daily Home Routines of Patients With Chronic Obstructive Pulmonary Disease (COPD) Over One Week: Observational Study
abstract: Chronic obstructive pulmonary disease (COPD) patients can suffer from low blood oxygen concentrations. Peripheral blood oxygen saturation (SpO2) as assessed by pulse oximetry, is commonly measured during the day using a spot check, or continuously during one or two nights to estimate nocturnal desaturation. Sampling at this frequency may overlook natural fluctuations in SpO2.  This study used wearable finger pulse oximeters to continuously measure SpO2 during daily home routines of COPD patients and assess natural SpO2 fluctuations.  A total of 20 COPD patients wore a WristOx2 pulse oximeter for 1 week to collect continuous SpO2 measurements. A SenseWear Armband simultaneously collected actigraphy measurements to provide contextual information. SpO2 time series were preprocessed and data quality was assessed afterward. Mean SpO2, SpO2 SD, and cumulative time spent with SpO2 below 90% (CT90) were calculated for every (1) day, (2) day in rest, and (3) night to assess SpO2 fluctuations.  A high percentage of valid SpO2 data (daytime: 93.27% nocturnal: 99.31% could be obtained during a 7 day monitoring period, except during moderate to vigorous physical activity (MVPA) (67.86% Mean nocturnal SpO2 (89.9% SD 3.4) was lower than mean daytime SpO2 in rest (92.1% SD 2.9; P<.001) On average, SpO2 in rest ranged over 10.8% (SD 4.4) within one day. Highly varying CT90 values between different nights led to 50% (10/20) of the included patients changing categories between desaturator and nondesaturator over the course of 1 week.  Continuous SpO2 measurements with wearable finger pulse oximeters identified significant SpO2 fluctuations between and within multiple days and nights of patients with COPD. Continuous SpO2 measurements during daily home routines of patients with COPD generally had high amounts of valid data, except for motion artifacts during MVPA. The identified fluctuations can have implications for telemonitoring applications that are based on daily SpO2 spot checks. CT90 values can vary greatly from night to night in patients with a nocturnal mean SpO2 around 90% indicating that these patients cannot be consistently categorized as desaturators or nondesaturators. We recommend using wearable sensors for continuous SpO2 measurements over longer time periods to determine the clinical relevance of the identified SpO2 fluctuations.

title: The use of wearable technology to monitor physical activity in patients with COPD: a literature review
abstract: Physical activity is an important predictor for survival in patients with COPD. Wearable technology, such as pedometer or accelerometer, may offer an opportunity to quantify physical activity and evaluate related health benefits in these patients.  To assess the performance of wearable technology in monitoring and improving physical activity in COPD patients from published studies.  Literature search of Medline, Cochrane, Dare, Embase and PubMed databases was made to find relevant articles that used wearable technology to monitor physical activity in COPD patients.  We identified 13 studies that used wearable technology, a pedometer or an accelerator, to monitor physical activity in COPD patients. Of these, six studies were randomized controlled trials (RCTs) which used the monitors as part of the intervention. Two studies reported the same outcomes and comparable units. They had measured the difference that the intervention makes on the number of steps taken daily by the patients. The results were highly heterogeneous with I2=92% The random effects model gave an effect outcome on the number of steps taken daily of 1,821.01 282.71; 3,924.74] in favor of the wearable technology. Four of the 13 studies have reported technical issues with the use of the wearable technology, including high signal to noise ratio, memory storage problems and inaccuracy of counts. While other studies did not mention any technical issues, it is not clear whether these did not experience them or chose not to report them.  Our literature search has shown that data on the use of wearable technology to monitor physical activity in COPD patients are limited by the small number of studies and their heterogeneous study design. Further research and better designed RCTs are needed to provide reliable results before physical activity monitors can be implemented routinely for COPD patients.

title: Findings of the Chronic Obstructive Pulmonary Disease Sitting and Exacerbations Trial (COPD SEAT) in Reducing Sedentary Time Using Wearable and Mobile Technologies With Educational Support: Randomized Controlled Feasibility Trial
abstract: Targeting sedentary time post exacerbation may be more relevant than targeting structured exercise for individuals with chronic obstructive pulmonary disease. Focusing interventions on sitting less and moving more after an exacerbation may act as a stepping stone to increase uptake to pulmonary rehabilitation.  The aim of this paper was to conduct a randomized trial examining trial feasibility and the acceptability of an education and self monitoring intervention using wearable technology to reduce sedentary behavior for individuals with chronic obstructive pulmonary disease admitted to hospital for an acute exacerbation.  Participants were recruited and randomized in hospital into 3 groups, with the intervention lasting 2 weeks post discharge. The Education group received verbal and written information about reducing their time in sedentary behavior, sitting face to face with a study researcher. The Education+Feedback group received the same education component along with real time feedback on their sitting time, stand ups, and steps at home through a waist worn inclinometer linked to an app. Patients were shown how to use the technology by the same study researcher. The inclinometer also provided vibration prompts to encourage movement at patient defined intervals of time. Patients and health care professionals involved in chronic obstructive pulmonary disease exacerbation care were interviewed to investigate trial feasibility and acceptability of trial design and methods. Main quantitative outcomes of trial feasibility were eligibility, uptake, and retention, and for acceptability, were behavioral responses to the vibration prompts.  In total, 111 patients were approached with 33 patients recruited (11 Control, 10 Education, and 12 Education+Feedback) Retention at 2 week follow up was 52% (17/33; n=6 for Control, n=3 for Education, and n=8 for Education+Feedback) No study related adverse events occurred. Collectively, patients responded to 106 out of 325 vibration prompts from the waist worn inclinometer (32.62% Within 5 min of the prompt, 41% of responses occurred, with patients standing for a mean 1.4 (SD 0.8) min and walking for 0.4 (SD 0.3) min (21, SD 11, steps) Interviews indicated that being unwell and overwhelmed after an exacerbation was the main reason for not engaging with the intervention. Health care staff considered reducing sedentary behavior potentially attractive for patients but suggested starting the intervention as an inpatient.  Although the data support that it was feasible to conduct the trial, modifications are needed to improve participant retention. The intervention was acceptable to most patients and health care professionals.

title: Wearable COPD pulmonary rehabilitation device and methods
abstract: To design a wearable rehabilitation device suitable for home and society COPD treatment aiming at the deficiency in the COPD pulmonary rehabilitation in China.  Physical activity therapy and pulmonary physical therapy methods which play very important role in the COPD pulmonary rehabilitation were studied. Physiological parameters of the COPD patient were acquired non intrusively with wearable technique. Biofeedback technology was used in the respiratory rehabilitation therapy. Target heart rate and SPO2 were used as parameters for the activity intensity assessment.  Wearable COPD pulmonary rehabilitation device based on breathing biofeedback was fabricated.  This device is a favorable rehabilitation tool for COPD patients to do self training at home or community.

title: Clinical Evaluation of Respiratory Rate Measurements on COPD (Male) Patients Using Wearable Inkjet Printed Sensor
abstract: Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease that causes long term breathing problems. The reliable monitoring of respiratory rate (RR) is very important for the treatment and management of COPD. Based on inkjet printing technology, we have developed a stretchable and wearable sensor that can accurately measure RR on normal subjects. Currently, there is a lack of comprehensive evaluation of stretchable sensors in the monitoring of RR on COPD patients. We aimed to investigate the measurement accuracy of our sensor on COPD patients.  Thirty five patients (Mean SD of age: 55.25 13.76 years) in different stages of COPD were recruited. The measurement accuracy of our inkjet printed (IJPT) sensor was evaluated at different body postures (i.e. standing, sitting at 90deg, and lying at 45deg) on COPD patients. The RR recorded by the IJPT sensor was compared with that recorded by the reference e Health sensor using paired T test and Wilcoxon signed rank test. Analysis of variation (ANOVA) was performed to investigate if there was any significant effect of individual difference or posture on the measurement error. Statistical significance was defined as p value less than 0.05.  There was no significant difference between the RR measurements collected by the IJPT sensor and the e Health reference sensor overall and in three postures (p 0.05 in paired T tests and Wilcoxon signed rank tests) The sitting posture had the least measurement error of 0.0542 1.451 bpm. There was no significant effect of posture or individual difference on the measurement error or relative measurement error (p 0.05 in ANOVA)  The IJPT sensor can accurately measure the RR of COPD patients at different body postures, which provides the possibility for reliable monitoring of RR on COPD patients.

title: P48 Bioplausible insights captured from COPD patients: aligning biometric data with exacerbation events and therapy changes using a commercial wearable device
abstract: Physical activity is a predictor of survival in COPD. Patients undertaking some level of regular exercise have a lower rate of COPD related admissions and mortality. Increases in daily physical activity have been noted following exacerbations and optimisation of COPD management. There has been a steady uptake in ownership of consumer based fitness trackers which can capture continuous physiology data over prolonged periods. With advancements in cloud computing, there is now the potential to integrate data from these wearable devices with electronic health record systems. Data can be reviewed by clinicians to monitor physical activity and physiology in patients with COPD, but value add and clinician capacity are uncertain. Application of machine learning analyses could generate predictive actionable insights, allowing clinician data review requirements to be focused.  Explore the potential insights to be gained from capturing continuous physiological measurements in COPD patients using commercially available wearable technology.  As part of the RECEIVER digital innovation study (NCT04240353) high risk COPD patients were given Fitbit Charge 3 devices linked to a co designed web app which also captures daily patient reported outcomes and exacerbation events. Exacerbation events, hospital admissions and treatment changes were plotted with daily step counts and daily average heart rate to evaluate potential patterns which would justify more extensive analyses.  Data from 32 patients with sustained FitBit recordings were reviewed as part of planned 6 month interim analyses. Average days of available data 58 (8 147) We identified notable trends in daily step count and heart rate around exacerbation events (figure 1) Increased daily step counts and reduction in heart rate were observed following commencement of home NIV.  Notable bio plausible insights are present, with correlation between Fitbit data, exacerbations and treatment interventions. Further evaluations of the capability of commercially available wearable sensors to track and predict COPD events are indicated. Results from this evaluation have directed the further analyses of the RECEIVER trial data. This includes expansion of the digital connectivity to incorporate intra day wearable data, integration with patient reported outcome and clinical summary data, and application of machine learning algorithms targeting a risk of exacerbation decision support prediction model.

title: Monitoring Physical Activity with a Wearable Sensor in Patients with COPD during In Hospital Pulmonary Rehabilitation Program: A Pilot Study
abstract: Accelerometers have become a standard method of monitoring physical activity in everyday life by measuring acceleration in one, two, or three axes. These devices provide reliable and objective measurements of the duration and intensity of physical activity. We aimed to investigate whether patients undertake physical activity during non supervised days during stationary rehabilitation and whether patients adhere to the rigor of 24 h monitoring. The second objective was to analyze the strengths and weaknesses of such kinds of sensors. The research enrolled 13 randomly selected patients, qualified for in patient, 3 week, high intensity, 5 times a week pulmonary rehabilitation. The SenseWear armband was used for the assessment of physical activity. Participants wore the device 24 h a day for the next 4 days (Friday Monday) The analysis of the number of steps per day, the time spent lying as well as undertaking moderate or vigorous physical activity >3 metabolic equivalents of task (METs) and the energy expenditure expressed in kcal showed no statistically significant difference between the training days and the days off. It seems beneficial to use available physical activity sensors in patients with chronic obstructive pulmonary disease (COPD) measurable parameters provide feedback that may increase the patient's motivation to be active to achieve health benefits.

title: Combined dual bronchodilator and wearable headset based exercise training enhance daily activity monitored by wearable watch in COPD>

title: Identification of COPD Patients' Health Status Using an Intelligent System in the CHRONIOUS Wearable Platform
abstract: The CHRONIOUS system offers an integrated platform aiming at the effective management and real time assessment of the health status of the patient suffering from chronic obstructive pulmonary disease (COPD) An intelligent system is developed for the analysis and the real time evaluation of patient's condition. A hybrid classifier has been implemented on a personal digital assistant, combining a support vector machine, a random forest, and a rule based system to provide a more advanced categorization scheme for the early and in real time characterization of a COPD episode. This is followed by a severity estimation algorithm which classifies the identified pathological situation in different levels and triggers an alerting mechanism to provide an informative and instructive message/advice to the patient and the clinical supervisor. The system has been validated using data collected from 30 patients that have been annotated by experts indicating 1) the severity level of the current patient's health status, and 2) the COPD disease level of the recruited patients according to the GOLD guidelines. The achieved characterization accuracy has been found 94%

title: WELCOME Innovative integrated care platform using wearable sensing and smart cloud computing for COPD patients with Comorbidities
abstract: We propose WELCOME, an innovative integrated care platform using wearable sensors and smart cloud computing for Chronic Obstructive Pulmonary Disease (COPD) patients with co morbidities. WELCOME aims to bring about a change in the reactive nature of the management of chronic diseases and its comorbidities, in particular through the development of a patient centred and proactive approach to COPD management. The aim of WELCOME is to support healthcare services to give early detection of complications (potentially reducing hospitalisations) and the prevention and mitigation of comorbidities (Heart Failure, Diabetes, Anxiety and Depression) The system incorporates patient hub, where it interacts with the patient via a light vest including a large number of non invasive chest sensors for monitoring various relevant parameters. In addition, interactive applications to monitor and manage diabetes, anxiety and lifestyle issues will be provided to the patient. Informal carers will also be supported in dealing with their patients. On the other hand, welcome smart cloud platform is the heart of the proposed system where all the medical records and the monitoring data are managed and processed via the decision support system. Healthcare professionals will be able to securely access the WELCOME applications to monitor and manage the patient's conditions and respond to alerts on personalized level.