Identification and Quantification of Activities Common to Intensive Care Patients; Development and Validation of a Dual-Accelerometer-Based Algorithm

Abstract

The aim of this study was to develop and validate an algorithm that can identify the type, frequency, and duration of activities common to intensive care (IC) patients. Ten healthy participants wore two accelerometers on their chest and leg while performing 14 activities clustered into four protocols (i.e., natural, strict, healthcare provider, and bed cycling). A video served as the reference standard, with two raters classifying the type and duration of all activities. This classification was reliable as intraclass correlations were all above 0.76 except for walking in the healthcare provider protocol, (0.29). The data of four participants were used to develop and optimize the algorithm by adjusting body-segment angles and rest-activity-threshold values based on percentage agreement (%Agr) with the reference. The validity of the algorithm was subsequently assessed using the data from the remaining six participants. %Agr of the algorithm versus the reference standard regarding lying, sitting activities, and transitions was 95%, 74%, and 80%, respectively, for all protocols except transitions with the help of a healthcare provider, which was 14–18%. For bed cycling, %Agr was 57–76%. This study demonstrated that the developed algorithm is suitable for identifying and quantifying activities common for intensive care patients. Knowledge on the (in)activity of these patients and their impact will optimize mobilization.

Keywords

• accelerometer
• ICU
• mobilization
• rehabilitation
• validity
• algorithm