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Wearable Technologies for Children with Chronic Illnesses: An Exploratory Approach

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Abstract

Objective

To determine the utility of wearable technologies in physical activity assessment in three paediatric diseases, namely, Niemann-Pick C (NP-C), Juvenile Idiopathic Arthritis (JIA) and Duchenne Muscular Dystrophy (DMD).

Design

Exploratory study

Setting and Patients

Thirty children were recruited across three UK hospitals (Royal Manchester’s Children Hospital, Great Ormond Street Children’s Hospital, and the Great North Children’s Hospital). Ten were diagnosed with NP-C, eight with DMD and twelve with JIA.

Intervention

All participants completed the 6-min walk test (6MWT) at enrolment. Patients were provided with disease-specific smartphone apps paired with a wearable device via Bluetooth. Ambulation was recorded in 30-min epochs measuring average daily maximum (ADM), average daily steps (ADS) and average daily steps per 30-min epoch (ASE).

Results

Median 6MWT results were 450 m, 325 m and 434.5 m for the NP-C, DMD and JIA cohorts, respectively. Wearable data capture was feasible in all three disease cohorts, although complete data capture was not sustained. A statistically significant between-cohort difference was identified for ADM, ADS and ASE. Statistically significant differences were found between DMD/JIA for ADM; NP-C/DMD for ADS and DMD/JIA for ASE.

Discussion

Wearable sensor technologies have the potential to provide additional information for our understanding of ambulation in chronic paediatric disease. The wearable devices were easy to use and popular with patients although key features need to be addressed to appropriately meet study objectives. As the technology continues to evolve at a rapid pace, opportunities to implement child friendly solutions are already available.

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References

  1. Perry B, Geoghegan C, Lin L, et al. Patient preferences for using mobile technologies in clinical trials. Contemp Clin Trials Commun. 2019;15:100399.

    Article  Google Scholar 

  2. Kristensen PL, Moeller NC, Korsholm L, et al. The association between aerobic fitness and physical activity in children and adolescents: the European youth heart study. Eur J Appl Physiol. 2010;110:267–75.

    Article  Google Scholar 

  3. Kashikar-Zuck S, Flowers SR, Verkamp E, et al. Actigraphy-based physical activity monitoring in adolescents with juvenile primary fibromyalgia syndrome. J Pain. 2010;11:885–93.

    Article  Google Scholar 

  4. Melo HN, Stoots SJ, Pool MA, et al. Objectively measured physical activity levels and sedentary time in children and adolescents with sickle cell anemia. PLoS ONE. 2018;13(12):e0208916.

    Article  Google Scholar 

  5. Klonoff DC, King F, Kerr D. New opportunities for digital health to thrive. J Diabetes Sci Technol. 2019;13(2):159–63.

    Article  Google Scholar 

  6. Sim I. Mobile devices and health. N Engl J Med. 2019;381(10):956–68.

    Article  Google Scholar 

  7. Haberkamp M, Moseley J, Athanasiou D, et al. European regulators’ views on a wearable-derived performance measurement of ambulation for Duchenne muscular dystrophy regulatory trials. Neuromuscular Disord. 2019;29(7):514–6.

    Article  Google Scholar 

  8. European Commission. Communication from the Commission to the European Parliament, The Council, The European Economic and Social Committee and the Committee of the Regions on enabling the digital transformation of health and care in the Digital Single Market; empowering citizens and building a healthier society. Brussels, 25.4.2018 COM. 2018; 233 final.

  9. Manners PJ, Bower C. Worldwide prevalence of juvenile arthritis—why does it vary so much? J Rheumatol. 2002;29:1520–30.

    PubMed  Google Scholar 

  10. Hemke R, Nusman CM, van der Heijde DMFM, et al. Frequency of joint involvement in juvenile idiopathic arthritis during a 5-year follow-up of newly diagnosed patients: implication for MR imaging as outcome measure. Rheumatol Int. 2015;35:351–7.

    Article  Google Scholar 

  11. Broström E, Haglun-Akerlind Y, Hagelbers S, et al. Gait in children with juvenile chronic arthritis. J Rheumatol. 2002;31:317–23.

    Google Scholar 

  12. Limenis E, Grosbein HA, Feldman BM. The relationship between physical activity levels and pain in children with juvenile idiopathic arthritis. J Rheumatol. 2014;41(2):345–51.

    Article  Google Scholar 

  13. Race DL, Sims-Gould J, Tucker LB, et al. “It might hurt, but you have to push through the pain”: perspectives on physical activity from children with juvenile idiopathic arthritis and their parents. J Child Health Care. 2016;20:428–36.

    Article  Google Scholar 

  14. Patterson MC, Mengel E, Wijburg FA, et al. Longitudinal data from the international registry for Niemann-Pick disease type C (NPC). Mol Genet Metab. 2014. https://doi.org/10.1016/j.ymgme.2013.12.203.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Patterson MC, Niemann-Pick Disease Type C. editors GeneReviews® [Internet] Seattle (WA): University of Washington, Seattle; 1993–2019 [Internet]. 2000 Aug 26; In: Adam MP, Ardinger HH, Pagon RA, et al. https://www.ncbi.nlm.nih.gov/books/NBK1296/

  16. Patterson MC, Mengel E, Wijburg FA, et al. Disease and patient characteristics in NP-C patients: findings from an international disease registry. Orphanet J Rare Dis. 2013;8(1):12.

    Article  Google Scholar 

  17. Mah JK, Korngut L, Dykeman J, et al. A systematic review and meta-analysis on the epidemiology of Duchenne and Becker muscular dystrophy. Neuromuscul Disord. 2014;24(6):482–91.

    Article  Google Scholar 

  18. Bushby K, Finkel R, Birnkrant DJ, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol. 2010;9(2):177–89.

    Article  CAS  Google Scholar 

  19. Ricotti V, Ridout DA, Scott E, et al. Long-term benefits and adverse effects of intermittent versus daily glucocorticoids in boys with Duchenne muscular dystrophy. J Neurol Neurosur Ps. 2013;84(6):698–705. https://doi.org/10.1136/jnnp-2012-303902.

    Article  Google Scholar 

  20. A. T. S. Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002; 166(1):111–7.

  21. Ulrich S, Hildenbrand F, Treder U, et al. Reference values for the 6-minute walk test in healthy children and adolescents in Switzerland. BMC Pulm Med. 2013;13:49.

    Article  Google Scholar 

  22. Tudor-Locke C, Craig CL, Beets MW, et al. How many steps/day are enough? For children and adolescents. Int J Behav Nutr Phys Act. 2011;8:78.

    Article  Google Scholar 

  23. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126–31.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Lundqvist S, Börjesson M, Larsson MEH, et al. Which patients benefit from physical activity on prescription (PAP)? A prospective observational analysis of factors that predict increased physical activity. BMC Public Health. 2019;19(1):482.

    Article  Google Scholar 

  25. Gualano B, Bonfa E, Pereira RMR, et al. Physical activity for paediatric rheumatic diseases: standing up against old paradigms. Nat Rev Rheumatol. 2017;13(6):368–79.

    Article  Google Scholar 

  26. Heutinck L, van Kampen N, Jansen M, et al. Physical activity in boys with duchenne muscular dystrophy is lower and less demanding compared to healthy boys. J Child Neurol. 2017;32(5):450–7.

    Article  Google Scholar 

  27. European Medicines Agency. Guideline on clinical investigation of medicinal products for the treatment of juvenile idiopathic arthritis. 17.

  28. Nijhof LN, van de Putte EM, Wulffraat NM, et al. Prevalence of severe fatigue among adolescents with pediatric rheumatic diseases. Arthritis Care Res. 2015;68(1):108–14.

    Article  Google Scholar 

  29. McErlane F, Foster HE, Carrasco R, et al. Trends in paediatric rheumatology referral times and disease activity indices over a ten-year period among children and young people with Juvenile Idiopathic Arthritis: results from the childhood arthritis prospective Study. Rheumatology (Oxford). 2016;55(7):1225–34.

    Article  Google Scholar 

  30. The Arthritis Foundation, Childhood Arthritis and Rheumatology Research Alliance. Externally-led juvenile idiopathic arthritis patient-focused drug development meeting report. JIA patient-focused drug development meeting. Washington, DC: 2018.

  31. Fowler EG, Staudt LA, Heberer KR, et al. Longitudinal community walking activity in Duchenne muscular dystrophy. Muscle Nerve. 2018;57(3):401–6.

    Article  Google Scholar 

  32. European Medicines Agency. Qualification opinion on stride velocity 95th centile as a secondary endpoint in Duchenne Muscular Dystrophy measured by a valid and suitable wearable device. 77.

  33. Rochester L, Mazzà C, Mueller A, et al. A roadmap to inform development, validation and approval of digital mobility outcomes: the mobilise-D approach. Digit Biomark. 2020;4(1):13–27.

    Article  Google Scholar 

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Acknowledgements

The authors would like to acknowledge Duchenne UK for their funding, Niemann-Pick Association UK and International Niemann-Pick Disease Alliance (INPDA) for their collaboration and Professor Paul Gissen for ongoing support. Acknowledge research nurses Claire Duong at Newcastle. Newcastle Physiotherapists: Jassi Sodhi, Dionne Moat, Robert Muni Lofra, Meredith James and Michelle McCallum. Part of this work was supported by Actelion Pharmaceuticals.

Funding

The authors received no funding for the writing of this manuscript.

Author information

Authors and Affiliations

  1. Paediatric Rheumatology, Great North Children’s Hospital, Newcastle Upon Tyne, UK

    Flora McErlane

  2. Institute of Cellular Medicine (Rheumatology), Medical School, Newcastle University, Newcastle Upon Tyne, UK

    Flora McErlane

  3. Aparito, UK

    Elin Haf Davies, Cecile Ollivier & Obuchinezia Anyanwu

  4. The John Walton Muscular Dystrophy Research Centre at Newcastle, Newcastle University, Newcastle Upon Tyne, UK

    Anna Mayhew

  5. Paediatric Rheumatology, Great North Children’s Hospital, Newcastle Upon Tyne, UK

    Victoria Harbottle

  6. Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK

    Victoria Harbottle

  7. Manchester Centre for Genomic Medicine, St Marys Hospital, Manchester, UK

    Aimee Donald

Authors
  1. Flora McErlane
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Contributions

EHD, AM, VH, FME and AD drafted the initial protocol; CO, EHD and OA drafted the initial paper; AM, VH, FME and AD revised the paper; and all the authors approved the final version.

Corresponding author

Correspondence to Cecile Ollivier.

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Conflict of inerest

Elin Haf Davies and Cecile Ollivier are employees of Aparito and hold shares.

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McErlane, F., Davies, E.H., Ollivier, C. et al. Wearable Technologies for Children with Chronic Illnesses: An Exploratory Approach. Ther Innov Regul Sci 55, 799–806 (2021). https://doi.org/10.1007/s43441-021-00278-9

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  • DOI: https://doi.org/10.1007/s43441-021-00278-9

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