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Summary Purpose We evaluated the effects of low-intensity and home-based pulmonary rehabilitation (PR) on physical activity (PA) and the feedback provided by a pedometer in stable elderly patients with chronic obstructive pulmonary disease (COPD). Methods We assessed PA using a newly developed triaxial accelerometer (A-MES™, Kumamoto, Japan), which measures the time spent walking, standing, sitting and lying down. Twenty-seven elderly patients with COPD (age 74 ± 8 yrs; %FEV 1 56.6 ± 18.7%) participated. They were randomly selected to undergo PR (pulmonary rehabilitation only) or PR + P (PR plus the feedback from using a pedometer). Their PA and pulmonary function, exercise capacity (6-min walking distance; 6MWD), quadriceps femoris muscle force (QF) were evaluated before the PR began (baseline) and at 1 year later. We compared the patients' changes in PA and other factors between the baseline values and those obtained 1 year later and analyzed the relationships between the changes in PA and other factors in the both groups. Results The increase in the time spent walking in the PR + P group (51.3 ± 63.7 min/day) was significantly greater than that of PR group (12.3 ± 25.5 min/day) after the PR. The improvement rate of daily walking time after PR was significantly correlated with that of the 6MWD and QF in all subjects. Conclusions These data suggest that low-intensity and home-based PR with the feedback from using pedometer was effective in improving PA, and the improvements of physiological factors were correlated with increased walking time in stable elderly patients with COPD.

Purpose: We investigated the validity of a triaxial accelerometer system for measuring the time spent lying down, sitting, standing, walking, and operating a wheelchair by control subjects and stroke patients in a convalescence ward. Methods: Physical activities were measured using a new triaxial accelerometer system (A-MES; Activity Monitoring and Evaluation System) that consists of two sensors, a station, and analytical software used with a personal computer. In Experiment 1, the times that the healthy subjects (n = 12) spent operating a wheelchair, lying down, sitting, standing, and walking were measured both by the A-MES and by videotaping (video time). In Experiment 2, the amounts of time spent by the stroke patients not able to walk without support (n = 30) as they were lying down, sitting, standing, walking, and operating a wheelchair were measured by the A-MES. Results: The time spent operating a wheelchair measured with the A-MES was significantly correlated with the video time in the healthy subjects. The stroke patients’ average times (minutes) of total, operating a wheelchair, lying down, sitting, standing, and walking were 601.0 ± 18.1, 57.1 ± 28.8, 265.0 ± 86.3, 263.3 ± 60.6, 7.8 ± 7.0, and 7.7 ± 6.0, respectively. Conclusions: The A-MES accurately evaluated the stroke patients’ time spent operating a wheelchair. The stroke patients’ mean time spent operating a wheelchair over the course of one day was 57.1 ± 28.8 min in a Center for Rehabilitation.

Miura S, Satake M, Tamura Y, Ikeda M, Kawagoshi A, Sugawara K, Takahashi H, Homma M, Sakata S, Shioya T. Evaluation of walking time according to walking speed using a triaxial accelerometer system. Jpn J Compr Rehabil Sci 2013; 4: 73−79. Purpose: The primary purpose of this study was to quantify the walking time in daily life as slow and fast walking times using a newly improved triaxial accelerometer system. The secondary purpose was to study the slow and fast walking times of healthy young and elderly adults and stable patients with chronic obstructive pulmonary disease (COPD) using this system. Methods: Twenty-six healthy young subjects, 15 healthy elderly adults, and 11 stable COPD patients participated in this study. The subjects’ time spent walking, standing, sitting, and lying down were assessed using an activity monitoring and evaluation system (A-MESTM). We evaluated the slow and fast walking times according to changes in the detection threshold in the system’s software. Results: The distinguishing speed was found to be 2 km/h, and thus we divided the subjects’ walking time into slow (

Atsuyoshi Kawagoshi,1,2 Noritaka Kiyokawa,2 Keiyu Sugawara,2 Hitomi Takahashi,2 Shunichi Sakata,3 Saori Miura,4 Sachie Sawamura,5 Masahiro Satake,1 Takanobu Shioya1 1Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, 2Department of Rehabilitation, Akita City Hospital, Akita, 3Kumamoto Technology and Industry Foundations, Kumamoto, 4Department of Rehabilitation, Saitama Medical University, Saitama, 5Department of Rehabilitation, Research Institute for Brain and Blood Vessels-Akita, Akita Prefecture Hospital Organization, Akita, Japan Background: The purpose of this study was to quantify the walking time and frequency of postural changes in daily life in patients with chronic obstructive pulmonary disease (COPD) using a new triaxial accelerometer system. Methods: Twenty-six elderly patients with stable COPD (age 76.8 ± 6.2 years; percent forced expiratory volume in one second [%FEV1] 52.9% ± 26.3%) and 20 age-matched elderly subjects (age 73.0 ± 4.2 years; %FEV1 124.0% ± 22.3%) participated in the study. The subjects’ time spent walking (slow, fast), standing, sitting, and lying down and the frequency of their postural changes (getting up, standing up) were assessed for 7 consecutive days using an Activity Monitoring And Evaluation System (A-MES™). We analyzed the relationships among walking times, frequency of postural changes, and physiologic factors in both COPD patients and controls. Results: The COPD patients’ total walking time, including slow (