title: Which indicators for measuring the daily physical activity? An overview on the challenges and technology limits for Telehealth applications.
abstract: BACKGROUND
  Obesity is one of the biggest drivers of preventable chronic diseases and healthcare costs in Worldwide. Different prevention activities are suggested. By monitoring daily energy expenditure (EE) could be possible make personalized diets and programming physical activity. In this, physical inactivity is one of the most important public health problems. Some studies refer the effort of the international community in promoting physical activities. Physical activity can be promoted only by increasing citizens' empowerment on taking care of their health, and it passes from the improving of individual information. Technology can offer solutions and metrics for monitoring and measuring daily activity by interacting with individuals, sharing information and feedbacks.
  
  
  OBJECTIVE
  In this study we review indicators of total energy expenditure and weaknesses of available devices in assessing these parameters.
  
  
  METHODS
  Literature review and technology testing EuNetHta core model.
  
  
  RESULTS
  For the clinical aspects, it is fundamental to take into account all the factor that can influence the personal energy expenditure as: heart rate, blood pressure and thermoregulation (influenced by the body temperature).
  
  
  CONCLUSIONS
  In this study we focused the attention on the importance of tools to encourage the physical activity. We made an analysis of the factor that can influence the right analysis of energy expenditure and at the same time the energy regime. A punctual monitoring of the exercise regime could be helpful in Telemedicine application as Telemonitorig. More study are needed to value the impact of physical activity tracker in Telemonitorig protocols.
  
  
  CONCLUSIONS
  On the assessment of the energy expenditure, critical issues are related to the physiological data acquisition. Sensors connected with mobile devices could be important tools for disease prevention and interventions affecting health behaviors. New devices applications are potential useful for telemedicine assistance, but security of data and the related communication protocol limits should be taking into account.
authors.affiliation: Scientific Direction, Research Area of Clinical-Healthcare and Management Innovations, Pediatric Hospital Bambino Gesù, Rome, Italy.|Department of Human Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Tagliente
authors.affiliation: Norwegian Centre for Integrated Care and Telemedicine, University hospital of North Norway, Tromsø, Norway.
authors.forename: Terje
authors.initials: T
authors.lastname: Solvoll
authors.affiliation: Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Trieste
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Carlo N
authors.initials: CN
authors.lastname: De Cecco
authors.affiliation: Scientific Direction, Research Area of Clinical-Healthcare and Management Innovations, Pediatric Hospital Bambino Gesù, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Murgia
authors.affiliation: Unit of Cystic Fibrosis, Department of Pediatric Medicine, Pediatric Hospital Bambino Gesù, Rome, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Bella
mesh_terms: D001794:Blood Pressure; D001833:Body Temperature Regulation; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D015438:Health Behavior; D006339:Heart Rate; D006801:Humans; D007031:Hypothalamus / Q000378:metabolism; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D017216:Telemedicine / Q000295:instrumentation*
keywords: Physical activity; Telehealth; energy expenditure; energy metabolisms; instruments and apparatus; mobile health; motor activities; psychomotor performance; telemedicine