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Aim: To evaluate the longitudinal association of sedentary behavior, light and moderate-to-vigorous physical activity (MVPA) participation with depressive symptoms and whether their possible association changed depending on the pandemic phase. Methods: This longitudinal study conducted secondary analysis from the Spanish cohort of the Remote Assessment of Disease and Relapse – Major Depressive Disorder (RADAR-MDD) study. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-8). Sedentary behavior and physical activity were estimated via wrist-worn devices. Linear mixed models evaluated the longitudinal associations of sedentary behavior and physical activity (light and moderate-to-vigorous intensities) with depressive symptoms. Results: In total, 95 participants (67.5% women, 53.0 [±10.5] years of age on average) were monitored pre-COVID-19 and included in the analyses. Pre-COVID-19, 73.7% of participants presented depression, and, on average, participated in 13.2 (±1.08) hours/day of sedentary behavior, 2.42 (±0.90) hours/day of light physical activity and 23.6 (±19.80) minutes/day of MVPA. Considering all the observations (from November 2019 to October 2020), an additional hour/day of sedentary behavior was longitudinally associated with higher depressive symptoms [ β std = 0.06, 95% confidence interval (CI) 0.10 to 0.47], whereas an additional hour/day in light physical activity was associated with lower depressive symptoms (β std = −0.06, 95% CI −0.59 to −0.15). Time in MVPA was not associated with depressive symptomatology. The association of sedentary behavior and light physical activity with depressive symptoms was significant only during pre-COVID-19 and COVID-19 relaxation periods, whereas during the strictest periods of the pandemic with regards to the restrictions (lockdown and de-escalation), the association was not observed. Conclusion: Sedentary behavior and light physical activity were longitudinally associated with depressive symptoms in participants with a history of MDD. The incorporation of light physical activity should be stimulated in adults with a history of MDD. Neither sedentary behavior nor light physical activity were associated with depressive symptoms during the most restrictive COVID-19 phases, whereas sedentary behavior (positively) and light physical activity (negatively) were associated with depressive symptoms in persons with MDD before and after the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Conventional care in Parkinson's disease (PD) faces limitations due to the significant time and location commitments needed for regular assessments, lacking quantitative measurements. Telemonitoring offers clinicians an opportunity to evaluate patient symptomatology throughout the day during activities of daily living. Methods: The progression of PD symptoms over a two-year period was investigated in patients undergoing traditional evaluation, supplemented by insights from ambulatory measurements. Physicians integrated a telemonitoring device, the PDMonitor®, into daily practice, using it for informed medication adjustments. Results: Statistical analyses examining intra-subject changes for 17 subjects revealed a significant relative decrease of -43.9% in the device-reported percentage of time spent in "OFF" state (from 36.2 to 20.3%). Following the 24-month period, the majority of the subjects improved or exhibited stable symptom manifestation. In addition to positively impacting motor symptom control, telemonitoring was found to enhance patient satisfaction about their condition, medication effectiveness, and communication with physicians. Discussion: Considering that motor function is significantly worsened over time in patients with PD, these findings suggest a positive impact of objective telemonitoring on symptoms control. Patient satisfaction regarding disease management through telemonitoring can potentially improve adherence to treatment plans. In conclusion, remote continuous monitoring paves the way for a paradigm shift in PD, focusing on actively managing and potentially improve symptoms control. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the association between changes in the autonomic control of cardiorespiratory system induced by walk tests and outcome measures in people with Multiple Sclerosis (pwMS). Methods: Electrocardiogram (ECG) recordings of 148 people with Relapsing- Remitting MS (RRMS) and 58 with Secondary Progressive MS (SPMS) were acquired using a wearable device before, during, and after walk test performance from a total of 386 periodical clinical visits. A subset of 90 participants repeated a walk test at home. Various MS-related symptoms, including fatigue, disability, and walking capacity were evaluated at each clinical visit, while heart rate variability (HRV) and ECG-derived respiration (EDR) were analyzed to assess autonomic nervous system (ANS) function. Statistical tests were conducted to assess differences in ANS control between pwMS grouped based on the phenotype or the severity of MS-related symptoms. Furthermore, correlation coefficients (r) were calculated to assess the association between the most significant ANS parameters and MS-outcome measures. Results: People with SPMS, compared to RRMS, reached higher mean heart rate (HRM) values during walk test, and larger sympathovagal balance after test performance. Furthermore, pwMS who were able to adjust their HRM and ventilatory values, such as respiratory rate and standard deviation of the ECG-derived respiration, were associated with better clinical outcomes. Correlation analyses showed weak associations between ANS parameters and clinical outcomes when the Multiple Sclerosis phenotype is not taken into account. Blunted autonomic response, in particular HRM reactivity, was related with worse walking capacity, yielding r = 0.36 r = 0.29 (RRMS) and r > 0.5 (SPMS). A positive strong correlation r > 0.7 r > 0.65 between cardiorespiratory parameters derived at hospital and at home was also found. Conclusion: Autonomic function, as measured by HRV, differs according to MS phenotype. Autonomic response to walk tests may be useful for assessing clinical outcomes, mainly in the progressive stage of MS. Participants with larger changes in HRM are able to walk longer distance, while reduced ventilatory function during and after walk test performance is associated with higher fatigue and disability severity scores. Monitoring of disorder severity could also be feasible using ECG-derived cardiac and respiratory parameters recorded with a wearable device at home. [ABSTRACT FROM AUTHOR]

Pulse photoplethysmography (PPG) is a simple and economical technique for obtaining cardiovascular information. In fact, PPG has become a very popular technology among wearable devices. However, the PPG signal is well-known to be very vulnerable to artifacts, and a good quality signal cannot be expected for most of the time in daily life. The percentage of time that a given measurement can be estimated (e.g., pulse rate) is denoted coverage (C), and it is highly dependent on the subject activity and on the configuration of the sensor, location, and stability of contact. This work aims to quantify the coverage of PPG sensors, using the simultaneously recorded electrocardiogram as a reference, with the PPG recorded at different places in the body and under different stress conditions. While many previous works analyzed the feasibility of PPG as a surrogate for heart rate variability analysis, there exists no previous work studying coverage to derive other cardiovascular indices. We report the coverage not only for estimating pulse rate (PR) but also for estimating pulse arrival time (PAT) and pulse amplitude variability (PAV). Three different datasets are analyzed for this purpose, consisting of a tilt-table test, an acute emotional stress test, and a heat stress test. The datasets include 19, 120, and 51 subjects, respectively, with PPG at the finger and at the forehead for the first two datasets and at the earlobe, in addition, for the latter. C ranges from 70% to 90% for estimating PR. Regarding the estimation of PAT, C ranges from 50% to 90%, and this is very dependent on the PPG sensor location, PPG quality, and the fiducial point (FP) chosen for the delineation of PPG. In fact, the delineation of the FP is critical in time for estimating derived series such as PAT due to the small dynamic range of these series. For the estimation of PAV, the C rates are between 70% and 90%. In general, lower C rates have been obtained for the PPG at the forehead. No difference in C has been observed between using PPG at the finger or at the earlobe. Then, the benefits of using either will depend on the application. However, different C rates are obtained using the same PPG signal, depending on the FP chosen for delineation. Lower C is reported when using the apex point of the PPG instead of the maximum flow velocity or the basal point, with a difference from 1% to even 10%. For further studies, each setup should first be analyzed and validated, taking the results and guidelines presented in this work into account, to study the feasibility of its recording devices with respect to each specific application. [ABSTRACT FROM AUTHOR]