title: Measuring Patient Mobility in the ICU Using a Novel Noninvasive Sensor.
abstract: OBJECTIVE
  To develop and validate a noninvasive mobility sensor to automatically and continuously detect and measure patient mobility in the ICU.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  Surgical ICU at an academic hospital.
  
  
  METHODS
  Three hundred sixty-two hours of sensor color and depth image data were recorded and curated into 109 segments, each containing 1,000 images, from eight patients.
  
  
  METHODS
  None.
  
  
  RESULTS
  Three Microsoft Kinect sensors (Microsoft, Beijing, China) were deployed in one ICU room to collect continuous patient mobility data. We developed software that automatically analyzes the sensor data to measure mobility and assign the highest level within a time period. To characterize the highest mobility level, a validated 11-point mobility scale was collapsed into four categories: nothing in bed, in-bed activity, out-of-bed activity, and walking. Of the 109 sensor segments, the noninvasive mobility sensor was developed using 26 of these from three ICU patients and validated on 83 remaining segments from five different patients. Three physicians annotated each segment for the highest mobility level. The weighted Kappa (κ) statistic for agreement between automated noninvasive mobility sensor output versus manual physician annotation was 0.86 (95% CI, 0.72-1.00). Disagreement primarily occurred in the "nothing in bed" versus "in-bed activity" categories because "the sensor assessed movement continuously," which was significantly more sensitive to motion than physician annotations using a discrete manual scale.
  
  
  CONCLUSIONS
  Noninvasive mobility sensor is a novel and feasible method for automating evaluation of ICU patient mobility.
authors.affiliation: 1Department of Computer Science, Johns Hopkins University, Baltimore, MD.2Department of Anesthesia and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.3Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD.4Johns Hopkins University School of Medicine, Baltimore, MD.5Outcomes after Critical Illness and Surgery Group, John Hopkins University School of Medicine, Baltimore, MD.6Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.7John Hopkins Hospital, Baltimore, MD.8Department of Physical Medicine and Rehabilitation, John Hopkins University School of Medicine, Baltimore, MD.9Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Andy J
authors.initials: AJ
authors.lastname: Ma
authors.forename: Nishi
authors.initials: N
authors.lastname: Rawat
authors.forename: Austin
authors.initials: A
authors.lastname: Reiter
authors.forename: Christine
authors.initials: C
authors.lastname: Shrock
authors.forename: Andong
authors.initials: A
authors.lastname: Zhan
authors.forename: Alex
authors.initials: A
authors.lastname: Stone
authors.forename: Anahita
authors.initials: A
authors.lastname: Rabiee
authors.forename: Stephanie
authors.initials: S
authors.lastname: Griffin
authors.forename: Dale M
authors.initials: DM
authors.lastname: Needham
authors.forename: Suchi
authors.initials: S
authors.lastname: Saria
mesh_terms: D000368:Aged; D000465:Algorithms; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D009068:Movement; D011446:Prospective Studies; D014741:Video Recording / Q000295:instrumentation; D016138:Walking