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How Reproducible Is Home-Based 24-Hour Ambulatory Monitoring of Motor Activity in Patients With Multiple Sclerosis?

  • Marc B. Rietberg
    Correspondence
    Correspondence to Marc B. Rietberg, MSc, Dept of Rehabilitation Medicine, Physical Therapy Section, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
    Affiliations
    Department of Rehabilitation Medicine, Amsterdam, The Netherlands

    Research Institute MOVE, Amsterdam, The Netherlands

    VU University Medical Center, Amsterdam, The Netherlands
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  • Erwin E. van Wegen
    Affiliations
    Department of Rehabilitation Medicine, Amsterdam, The Netherlands

    Research Institute MOVE, Amsterdam, The Netherlands

    VU University Medical Center, Amsterdam, The Netherlands
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  • Bernard M. Uitdehaag
    Affiliations
    Department of Neurology, Amsterdam, The Netherlands

    Department of Epidemiology and Biostatistics, Amsterdam, The Netherlands

    VU University Medical Center, Amsterdam, The Netherlands
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  • Henrica C. de Vet
    Affiliations
    Department of Epidemiology and Biostatistics, Amsterdam, The Netherlands

    EMGO Institute, Amsterdam, The Netherlands

    VU University Medical Center, Amsterdam, The Netherlands
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  • Gert Kwakkel
    Affiliations
    Department of Rehabilitation Medicine, Amsterdam, The Netherlands

    Research Institute MOVE, Amsterdam, The Netherlands

    VU University Medical Center, Amsterdam, The Netherlands
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      Abstract

      Rietberg MB, van Wegen EE, Uitdehaag BM, de Vet HC, Kwakkel G. How reproducible is home-based 24-hour ambulatory monitoring of motor activity in patients with multiple sclerosis?

      Objective

      To determine the reproducibility of 24-hour monitoring of motor activity in patients with multiple sclerosis (MS).

      Design

      Test-retest design; 6 research assistants visited the participants twice within 1 week in the home situation.

      Setting

      General community.

      Participants

      A convenience sample of ambulatory patients (N=43; mean age ± SD, 48.7±7.0y; 30 women; median Expanded Disability Status Scale scores, 3.5; interquartile range, 2.5) were recruited from the outpatient clinic of a university medical center.

      Interventions

      Not applicable.

      Main Outcome Measures

      Dynamic activity and static activity parameters were recorded by using a portable data logger and classified continuously for 24 hours. Reproducibility was determined by calculating intraclass correlation coefficients (ICCs) for test-retest reliability and by applying the Bland-Altman method for agreement between the 2 measurements. The smallest detectable change (SDC) was calculated based on the standard error of measurement.

      Results

      Test-retest reliability expressed by the ICCagreement was .72 for dynamic activity, .74 for transitions, .77 for walking, .71 for static activity, .67 for sitting, .62 for standing, and .55 for lying. Bland and Altman analysis indicated no systematic differences between the first and second assessment for dynamic and static activity. Measurement error expressed by the SDC was 1.23 for dynamic activity, 66 for transitions, .99 for walking, 1.52 for static activity, 4.68 for lying, 3.95 for sitting, and 3.34 for standing.

      Conclusions

      The current study shows that with 24-hour monitoring, a reproducible estimate of physical activity can be obtained in ambulatory patients with MS.

      Key Words

      List of Abbreviations:

      ADLs (activities of daily living), AM (activity monitor), EDSS (Expanded Disability Status Scale), ICC (intraclass correlation coefficient), IQR (interquartile range), LoA (limit of agreement), MS (multiple sclerosis), SDC (smallest detectable change), SEM (standard error of the mean)
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