• Kristin E Schwab, An Q To, Jennifer Chang, Bonnie Ronish, Dale M Needham, Jennifer L Martin, and Biren B Kamdar.
• Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, 8783University of California, Los Angeles, CA, USA.
• J Intensive Care Med. 2020 Nov 1; 35 (11): 1323-1331.

ObjectiveIn the intensive care unit (ICU), prolonged inactivity is common, increasing patients' risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions to minimize inactivity are gaining popularity, highlighting actigraphy, a measure of activity involving a wristwatch-like accelerometer, as a method to inform these efforts. Therefore, we performed a systematic review of studies that used actigraphy to measure patient activity in the ICU setting.Data SourcesWe searched PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest from inception until December 2016.Study SelectionTwo reviewers independently screened studies for inclusion. A study was eligible for inclusion if it was published in a peer-reviewed journal and used actigraphy to measure activity in ≥5 ICU patients.Data ExtractionTwo reviewers independently performed data abstraction and risk of bias assessment. Abstracted actigraphy-based activity data included total activity time and activity counts.ResultsOf 16 studies (607 ICU patients) identified, 14 (88%) were observational, 2 (12%) were randomized control trials, and 5 (31%) were published after 2009. Mean patient activity levels per 15 to 60 second epoch ranged from 25 to 37 daytime and 2 to 19 nighttime movements. Actigraphy was evaluated in the context of ICU and post-ICU outcomes in 11 (69%) and 5 (31%) studies, respectively, and demonstrated potential associations between actigraphy-based activity levels and delirium, sedation, pain, anxiety, time to extubation, and length of stay.ConclusionActigraphy has demonstrated that patients are profoundly inactive in the ICU with actigraphy-based activity levels potentially associated with important measures, such as delirium, sedation, and length of stay. Larger and more rigorous studies are needed to further evaluate these associations and the overall utility of actigraphy in the ICU setting.

11 keywords...

hide…