Where to record motor activity: an evaluation of commonly used sites of placement for activity monitors

doi:10.1016/0168-5597(93)90076-2

Electroencephalography and Clinical Neurophysiology/Evoked Potentials Section

Volume 89, Issue 5, October 1993, Pages 359-362

https://doi.org/10.1016/0168-5597(93)90076-2 Get rights and content

Abstract

The aim of this study was to evaluate the role of the site of attachment of activity monitors. We compared mean diurnal and nocturnal motor activity measures as well as the daily pattern of motor activity of dominant and non-dominant wrist recordings over 5 successive days of 10 healthy right-handed and 10 left-handed subjects. In a second study we evaluated the relationship between truncal motor activity and wrist motor activity. No differences emerged between the diurnal and nocturnal measures as well as the diurnal activity pattern of the dominant and the non-dominant wrist. Additionally, no differences were found in relation to handedness. Our results show that it is inaccurate to regard wrist motor activity measurements as representative of an invariable percentage of truncal motor activity; the relation between the measurements of these two recording sites varies across the daytime period. During the nocturnal period bilateral wrist motor activity occurred frequently in absence of truncal motor activity. The reverse situation, however, may occur sporadically. This finding most likely reflects that integrated generalized movements like postural shifts are measured at all recording sites, while the small movements that occur at the distal extremites are predominantly recorded by wrist-worn monitors.

In conclusion, it is apparent that for both diurnal and nocturnal studies on the assessment of motor activity, either wrist can be chosen as the recording site. Across the diurnal period the relation between motor activity recorded at the wrist and waist is subject to considerable variability. During the nocturnal period motor activity can best be recorded at the wrist because this recording site detects both integrated generalized movements and movements that occur at the distal extremities.

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Citation Excerpt :
The topic of motor asymmetry has long been investigated in adults using various methodologies, including actigraphy. Higher activity in the non-dominant hand during the first hours of sleep has been documented consistently (e.g., Lauerma, Kaartinen, Polo, Sallinen, & Lyytinen, 1994; Lauerma, Lehtinen, Lehtinen, & Korkeila, 1992; Lehnkering, Strauss, Wegner, & Siegmund, 2006; Natale, 2002; Natale, Lehnkering, & Siegmund, 2010; Natale, Martoni, Esposito, Fabbri, & Tonetti, 2007; Sadeh, Sharkey, & Carskadon, 1994; Van Hilten, Middelkoop, Kuiper, Kramer, & Roos, 1993; Violani, Casagrande, Cinelli, & Testa, 1992; Violani, Testa, & Casagrande, 1998). Jovanovic (1971) was among the first to show increased movement of the non-dominant hand over the dominant hand during sleep, through electromyographic recording, regardless of the phase of the REM/NREM cycle.
Motor asymmetry during the first hours of sleep documented in adults found higher activity in the non-dominant limb. The stage of development at which such asymmetries first appear is unknown. Twenty healthy infants were followed from 7 to 12 months of age, at 3-week intervals, comparing motor activity of the right and left legs during sleep using twin actigraphs (AMI). Hour-by-hour analysis of the first seven hours of nocturnal sleep found no consistent difference in activity levels between the right and left legs. Using the standard algorithm for infants, which provides an overall estimate of sleep quality, revealed discrepancies in night waking episodes (Right versus Left) in 33% of the nights. Results pertaining to leg movement suggest that motor asymmetry is not yet present during the first year of life. However, given the large discrepancies in the detection of night waking, further investigation of the developmental course of circadian motor asymmetry is warranted.
Mood and motor activity in euthymic bipolar disorder with sleep disturbance
2016, Journal of Affective Disorders
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Patients were instructed to wear the actigraph around the wrist of their choice for at least 7 days without taking it off. Which wrist was not noted, but previous studies have not found significant differences between the left and right wrist (Littner et al., 2003; Van Hilten et al., 1993). Activity counts were recorded for one minute intervals.
The aims of this observational study of patients with euthymic bipolar disorder and sleep disturbance were to 1) compare characteristics related to mood and sleep between two groups with stable and unstable rest-activity cycles and 2) detect between-group differences in motor activity patterns.
43 patients wore an actigraph for 6–8 days while reporting daily mood and sleep. Patients were defined as having an unstable rest-activity cycle if their diurnal active period duration presented variation above 2 h from the mean during one week: 22 patients had stable and 21 unstable rest-activity cycles. Mood variability was defined as at least moderate symptoms and a change across two levels on a 7-point mood scale during one week.
Patients with unstable rest-activity cycles were younger (37 vs. 48 years, p=0.01) and displayed more mood variability (p=0.02). Ten of 11 patients diagnosed with delayed sleep phase disorder were in the unstable group (p<0.01), and the unstable group had later and more variable get-up-times and bedtimes. In actigraphy recordings, the mean activity counts per minute did not differ between groups, but the minute-to-minute variability was elevated (p=0.04) and increased relative to the overall variability (p=0.03).
A relatively small study sample and a 1-week study period prevent exploration of long-term clinical implications of results.
A subgroup of euthymic patients with bipolar disorder displayed unstable rest-activity cycles combined with mood variability and motor activity patterns that resemble findings in affective episodes.
Laparoscopic skills and cognitive function are not affected in surgeons during a night shift
2014, Journal of Surgical Education
Citation Excerpt :
If the surgeons were to perform surgery, the actigraph was mounted above elbow level by the use of a string and was returned to their wrists after surgery. The placement of actigraphy for wake time activity, frequency, and intensity is of less importance; however, data collection during sleep can be more critical, which is why the actigraph must be returned to the wrist before sleep.22,23 The actigraphy output was obtained by zero-crossing mode, and the sleep analysis was performed by the Cole-Kripke algorithm.19
To monitor surgeons’ performance and cognition during night shifts.
Surgeons were monitored before call and on call (17-hour shift). Psychomotor performance was assessed by laparoscopic simulation and cognition by the d2 test of attention. The surgeons performed the laparoscopic simulation and the d2 test of attention at 8 a.m. before call and at 4 a.m. on call. Sleep was measured by wrist actigraphy and sleepiness by the Karolinska sleepiness scale.
Department of Surgery at Herlev Hospital, Denmark.
Overall, 30 interns, residents, and attending surgeons were included and completed the study. One participant was subsequently excluded owing to myxedema.
The surgeons slept significantly less on call than before call. There was increasing sleepiness on call; however, no significant differences were found in the precall laparoscopic simulation values compared with on-call values. The d2 test of attention showed significantly improved values on call compared with before call.
Sleep deprivation during a 17-hour night shift did not impair surgeons’ psychomotor or cognitive performance.
Comparison of actigraphy and polysomnography to assess effects of zolpidem in a clinical research unit
2012, Sleep Medicine
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aTST from the Armband was closer to the PSG-recorded TST, as would be expected if measurement of skin temperature was helpful, but neither aTST nor aWASO provided by the Armband were significantly affected by zolpidem. It is possible that the benefits of the skin temperature measurement were offset by the placement of the Armband on the upper arm to minimise effects of small movements, but these small movements may be important to detect facets of sleep [12]. Whatever the reason, addition of skin temperature measurement in the Armband did not significantly improve the ability of actigraphy to estimate PSG endpoints in the present study.
This study sought to compare devices that use actigraphy for measuring sleep endpoints in the clinical research unit (CRU) and home environment. The abilities of polysomnography (PSG) and actigraphy monitors to detect drug effects in a CRU were also investigated.
Eleven healthy subjects were recruited and monitored with PSG for four consecutive nights in a CRU after receiving no treatment (night 1, N1), and then placebo or 5 mg day⁻¹ or 10 mg day⁻¹ zolpidem in a randomised, cross-over design. Subjects wore two devices that use actigraphy (a Respironics® Actiwatch® on the wrist and a BodyMedia® Sensewear® Armband on the upper-arm) on the non-dominant arm for five nights at home and four nights in the CRU during PSG.
Wake after sleep onset (WASO) and total sleep time (TST) measured by PSG and estimates of WASO by the Actiwatch decreased significantly with 5 mg but not 10 mg of zolpidem versus placebo. Direct activity (counts/min) with the Actiwatch decreased in response to zolpidem (both 5 and 10 mg day⁻¹) versus placebo. Armband recordings of direct activity were similar to the Actiwatch but not significantly different versus placebo. Both actigraphy device estimates of TST were approximately 1 h longer in CRU versus home. Agreement between actigraphy estimates of TST and WASO and PSG values of TST and WASO were closer during nights with zolpidem treatment.
PSG can detect the effects of zolpidem on sleep in a CRU setting. Actigraphy can provide useful assessment of sleep, but direct activity endpoints may be more effective than estimates of TST and WASO.
Objective assessment of motor activity in a clinical sample of adults with attention-deficit/hyperactivity disorder and/or cyclothymic temperament
2022, BMC Psychiatry
Complexity of body movements during sleep in children with autism spectrum disorder
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Technical noteWhere to record motor activity: an evaluation of commonly used sites of placement for activity monitors

Abstract

Brain Dev.

Phys. Behav.

Sleep-wake cycles in multi-infarct dementia and dementia of the Alzheimer type

Neurology

A classification of hand preference by association analysis

Br. J. Psychol.

Actigraphy: a means of assessing circadian patterns in human activity

Chronobiol. Int.

Technical note
Where to record motor activity: an evaluation of commonly used sites of placement for activity monitors