Energy expenditure estimation in beta-blocker-medicated cardiac patients by combining heart rate and body movement data.
Accurate assessment of energy expenditure provides an opportunity to monitor physical activity during cardiac rehabilitation. However, the available assessment methods, based on the combination of heart rate (HR) and body movement data, are not applicable for patients using beta-blocker medication. Therefore, we developed an energy expenditure prediction model for beta-blocker-medicated cardiac rehabilitation patients.



Sixteen male cardiac rehabilitation patients (age: 55.8 ± 7.3 years, weight: 93.1 ± 11.8 kg) underwent a physical activity protocol with 11 low- to moderate-intensity common daily life activities. Energy expenditure was assessed using a portable indirect calorimeter. HR and body movement data were recorded during the protocol using unobtrusive wearable devices. In addition, patients underwent a symptom-limited exercise test and resting metabolic rate assessment. Energy expenditure estimation models were developed using multivariate regression analyses based on HR and body movement data and/or patient characteristics. In addition, a HR-flex model was developed.



The model combining HR and body movement data and patient characteristics showed the highest correlation and lowest error (r2= 0.84, root mean squared error = 0.834 kcal/minute) with total energy expenditure. The method based on individual calibration data (HR-flex) showed lower accuracy (i2= 0.83, root mean squared error = 0.992 kcal/minute).



Our results show that combining HR and body movement data improves the accuracy of energy expenditure prediction models in cardiac patients, similar to methods that have been developed for healthy subjects. The proposed methodology does not require individual calibration and is based on the data that are available in clinical practice.
Department of Medical Informatics, Academic Medical Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands j.kraal@mmc.nl.
Jos J
JJ
Kraal
Personal Health department, Philips Research, Eindhoven, The Netherlands.
Francesco
F
Sartor
Personal Health department, Philips Research, Eindhoven, The Netherlands.
Gabriele
G
Papini
Personal Health department, Philips Research, Eindhoven, The Netherlands.
Wim
W
Stut
Health eResearch Centre, Farr Institute for Health Informatics Research, University of Manchester, Manchester, United Kingdom.
Niels
N
Peek
Department of Cardiology, Máxima Medical Center Veldhoven, Veldhoven, The Netherlands.
Hareld Mc
HM
Kemps
Personal Health department, Philips Research, Eindhoven, The Netherlands.
Alberto G
AG
Bonomi
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D002153:Calorimetry, Indirect; D000072038:Cardiac Rehabilitation / Q000379:methods*; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D009426:Netherlands / Q000453:epidemiology
D000319:Adrenergic beta-Antagonists
Accelerometry; beta-blockers; cardiac rehabilitation; energy expenditure; heart rate monitoring; physical activity