An increase in world population along with a significant aging portion is forcing rapid rises in healthcare costs. The healthcare system is going through a transformation in which continuous monitoring of inhabitants is possible even without hospitalization. The advancement of sensing technologies, embedded systems, wireless communication technologies, nano technologies, and miniaturization makes it possible to develop smart systems to monitor activities of human beings continuously. Wearable sensors detect abnormal and/or unforeseen situations by monitoring physiological parameters along with other symptoms. Therefore, necessary help can be provided in times of dire need. This paper reviews the latest reported systems on activity monitoring of humans based on wearable sensors and issues to be addressed to tackle the challenges.

Wearable Sensors for Human Activity Monitoring: A Review

The deleterious health consequences of physical inactivity are vast, and they are of paramount clinical and research importance. Risk identification, benchmarks, efficacy, and evaluation of physical activity behavior change initiatives for clinicians and researchers all require a clear understanding of how to assess physical activity. In the present report, we have provided a clear rationale for the importance of assessing physical activity levels, and we have documented key concepts in understanding the different dimensions, domains, and terminology associated with physical activity measurement. The assessment methods presented allow for a greater understanding of the vast number of options available to clinicians and researchers when trying to assess physical activity levels in their patients or participants. The primary outcome desired is the main determining factor in the choice of physical activity assessment method. In combination with issues of feasibility/practicality, the availability of resources, and administration considerations, the desired outcome guides the choice of an appropriate assessment tool. The decision matrix, along with the accompanying tables, provides a mechanism for this selection that takes all of these factors into account. Clearly, the assessment method adopted and implemented will vary depending on circumstances, because there is no single best instrument appropriate for every situation. In summary, physical activity assessment should be considered a vital health measure that is tracked regularly over time. All other major modifiable cardiovascular risk factors (diabetes mellitus, hypertension, hypercholesterolemia, obesity, and smoking) are assessed routinely. Physical activity status should also be assessed regularly. Multiple physical activity assessment methods provide reasonably accurate outcome measures, with choices dependent on setting-specific resources and constraints. The present scientific statement provides a guide to allow professionals to make a goal-specific selection of a meaningful physical activity assessment method.

Guide to the Assessment of Physical Activity: Clinical and Research Applications A Scientific Statement From the American Heart Association

Background The dose–response relation between physical activity and all-cause mortality is not well defined at present. We conducted a systematic review and meta-analysis to determine the association with all-cause mortality of different domains of physical activity and of defined increases in physical activity and energy expenditure.

Methods MEDLINE, Embase and the Cochrane Library were searched up to September 2010 for cohort studies examining all-cause mortality across different domains and levels of physical activity in adult general populations. We estimated combined risk ratios (RRs) associated with defined increments and recommended levels, using random-effects meta-analysis and dose–response meta-regression models.

Results Data from 80 studies with 1 338 143 participants (118 121 deaths) were included. Combined RRs comparing highest with lowest activity levels were 0.65 [95% confidence interval (95% CI) 0.60–0.71] for total activity, 0.74 (95% CI 0.70–0.77) for leisure activity, 0.64 (95% CI 0.55–0.75) for activities of daily living and 0.83 (95% CI 0.71–0.97) for occupational activity. RRs per 1-h increment per week were 0.91 (95% CI 0.87–0.94) for vigorous exercise and 0.96 (95% CI 0.93–0.98) for moderate-intensity activities of daily living. RRs corresponding to 150 and 300 min/week of moderate to vigorous activity were 0.86 (95% CI 0.80–0.92) and 0.74 (95% CI 0.65–0.85), respectively. Mortality reductions were more pronounced in women.

Conclusion Higher levels of total and domain-specific physical activity were associated with reduced all-cause mortality. Risk reduction per unit of time increase was largest for vigorous exercise. Moderate-intensity activities of daily living were to a lesser extent beneficial in reducing mortality.

/pdf/domains-of-physical-activity-and-all-cause-mortality-4k8cdnsuyz.pdf

Domains of physical activity and all-cause mortality: systematic review and dose–response meta-analysis of cohort studies

Physical activity has a fundamental role in the prevention and treatment of chronic disease. The precise measurement of physical activity is key to many surveillance and epidemiological studies investigating trends and associations with disease. Public health initiatives aimed at increasing physical activity rely on the measurement of physical activity to monitor their effectiveness. Physical activity is multidimensional, and a complex behaviour to measure; its various domains are often misunderstood. Inappropriate or crude measures of physical activity have serious implications, and are likely to lead to misleading results and underestimate effect size. In this review, key definitions and theoretical aspects, which underpin the measurement of physical activity, are briefly discussed. Methodologies particularly suited for use in epidemiological research are reviewed, with particular reference to their validity, primary outcome measure and considerations when using each in the field. It is acknowledged that the choice of method may be a compromise between accuracy level and feasibility, but the ultimate choice of tool must suit the stated aim of the research. A framework is presented to guide researchers on the selection of the most suitable tool for use in a specific study.

Assessment of physical activity - a review of methodologies with reference to epidemiological research: a report of the exercise physiology section of the European Association of Cardiovascular Prevention and Rehabilitation.

Practical guide to measuring physical activity.

Accurate quantification of physical activity energy expenditure is a key part of the effort to understand disorders of energy metabolism. The Actiheart, a combined heart rate (HR) and movement sensor, is designed to assess physical activity in populations. Objective: To examine aspects of Actiheart reliability and validity in mechanical settings and during walking and running. Methods: In eight Actiheart units, technical reliability (coefficients of variation, CV) and validity for movement were assessed with sinusoid accelerations (0.1–20 m/s 2 ) and for HR by simulated R-wave impulses (25–250 bpm). Agreement between Actiheart and ECG was determined during rest and treadmill locomotion (3.2–12.1 km/h). Walking and running intensity (in J/ min/kg) was assessed with indirect calorimetry in 11 men and nine women (26–50 y, 20–29 kg/m 2 ) and modelled from movement, HR, and movement þ HR by multiple linear regression, adjusting for sex. Results: Median intrainstrument CV was 0.5 and 0.03% for movement and HR, respectively. Corresponding interinstrument CV values were 5.7 and 0.03% with some evidence of heteroscedasticity for movement. The linear relationship between movement and acceleration was strong (R 2 ¼ 0.99, Po0.001). Simulated R-waves were detected within 1 bpm from 30 to 250 bpm. The 95% limits of agreement between Actiheart and ECG were � 4.2 to 4.3 bpm. Correlations with intensity were generally high (R 2 40.84, Po0.001) but significantly highest when combining HR and movement (SEEo1 MET). Conclusions: The Actiheart is technically reliable and valid. Walking and running intensity may be estimated accurately but further studies are needed to assess validity in other activities and during free-living. Sponsorship: The study received financial support from the Wellcome Trust and SB was supported by a scholarship from

ORIGINAL COMMUNICATION Reliability and validity of the combined heart rate and movement sensor Actiheart

Physical activity and obesity prevention: a review of the current evidence. [Erratum: 2005 Nov., v. 64, no. 4, p. 581-584.]

PurposeThis study aimed to examine the associations between objectively measured physical activity (PA), sedentary time, and health-related fitness and to investigate the combined association of PA and sedentary time on health-related fitness in youths.MethodsPA and sedentary time were asses

Association between physical activity, sedentary time, and healthy fitness in youth.

Aims/hypothesis
The peroxisome proliferator-activated receptor gamma coactivator 1-alpha protein, encoded by the PPARGC1A gene, transcriptionally activates a complex pathway of lipid and glucose metabolism and is expressed primarily in tissues of high metabolic activity such as liver, heart and exercising oxidative skeletal muscle fibre. Ppargc1a-null mice develop systemic dyslipidaemia and hepatic steatosis. In humans, NEFAs downregulate PPARGC1A expression in skeletal muscle. Furthermore, a common non-synonymous coding variant at PPARGC1A (Gly482Ser, rs8192678) is associated with decreased PPARGC1A mRNA levels and increased type 2 diabetes risk.

/pdf/ppargc1a-coding-variation-may-initiate-impaired-nefa-2i49j09xme.pdf

PPARGC1A coding variation may initiate impaired NEFA clearance during glucose challenge

AIMS/HYPOTHESIS: The PPARGC1A gene coactivates multiple nuclear transcription factors involved in cellular energy metabolism and vascular stasis. In the present study, we genotyped 35 tagging polym ...

/pdf/ppargc1a-sequence-variation-and-cardiovascular-risk-factor-1odltmdugu.pdf

PPARGC1A sequence variation and cardiovascular risk-factor levels: a study of the main genetic effects and gene x environment interactions in children from the European Youth Heart Study.

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