Actigraphy in the critically ill: correlation with activity, agitation, and sedation.
OBJECTIVE
To determine the feasibility of continuous measurement of limb movement via wrist and ankle actigraphy (an activity measure) in critically ill patients and to compare actigraphy measurements with observed activity, subjective scores on sedation-agitation scales, and heart rate and blood pressure of patients.


METHODS
In a prospective, descriptive, correlational study, all activity of 20 adult patients in medical and coronary care units in a university medical center were observed for 2 hours and documented. Wrist and ankle actigraphy, heart rate, and systolic and diastolic blood pressure data were collected every minute. The Comfort Scale and the Richmond Agitation-Sedation Scale were completed at the beginning of the observation period and 1 and 2 hours later.


RESULTS
Wrist actigraphy data correlated with scores on the Richmond Agitation-Sedation Scale (r = 0.58) and the Comfort Scale (r = 0.62) and with observed stimulation and activity events of patients (r = 0.45). Correlations with systolic, diastolic, and mean arterial pressures were weaker. Wrist and ankle actigraphy data were significantly correlated (r = 0.69; P < .001); however, their mean values (wrist, 418; ankle, 147) were significantly different (t = 5.77; P < .001).


CONCLUSIONS
Actigraphy provides a continuous recording of patients' limb movement. Actigraphy measurements correlate well with patients' observed activity and with subjective scores on agitation and sedation scales. Actigraphy may become particularly important as a continuous measurement of activity for use in behavioral research and may enhance early recognition and management of the excessive activity that characterizes agitation.
Grap
Mary Jo
MJ
Adult Health Department of the School of Nursing, Virginia Commonwealth University Health System, Richmond, VA, USA.
Borchers
C Todd
CT
Munro
Cindy L
CL
Elswick
R K
RK
Sessler
Curtis N
CN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D016292:Procedural Sedation; D016638:Critical Illness; D004562:Electrocardiography / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009043:Motor Activity / Q000502:physiology*; D017286:Polysomnography / Q000379:methods*; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000175:diagnosis* / Q000209:etiology; D013997:Time Factors; D014953:Wrist / Q000502:physiology