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The Actiheart USER MANUAL

1. 50 4 4 8 2 Sleeping Heart Rate cir REIHE PRESE AEE E E exe BE ESE PARTE exe Eee ERE VERSER ARE E APERTE Rene X er RE ERa ex ERE TRT RS 50 4 4 8 3 Maximum Heart Rate ETE B 50 EEGENEN 50 4 4 9 Analysing an Advanced Energy Expenditure Recording nananana a enenatis sss a nnns 51 4 4 10 Viewing a Specific POIDt 5 vete ec dee ee te e ce VU Eee a EYE gege ue CERE OE RR HUS 53 AAV The Display Lb cereos terere ce e demie eh eem E UM MUI MTS 53 44 12 The AEE TaD DEE 54 4 4 13 The Ou Le ENEE 54 4 4 14 The Comments EC E 54 2 4 15 the Utilities EE 54 4 4 16 Printing and Previewing Data 55 4A T7 Copying all EE 55 Be Ee MOS EE 56 ASNN EE 56 4 522 Seting UDa Step Test tui item cia dene dud cede cua De de vata dene Fe REGE id FERNER ER dene dud cede RER EEK ERRE ERa 56 4 5 3 Downloading Step Test Data from the Actheart nona aan aa nana ana aa aan a seti insana sre se aas 58 4 5 4 Viewing Details of a Step Test RECOrdINE ssri atm s Vihe Eege geed eege Eege dee dens 58 4 5 6 Analysing a step Test Recording o se rir enee ee dee ege ee Eesen 58 4 5 7 The Energy Regression Equations ccccccccccsssssesssseeececssseseseseeececessesaaeseeeeecesseseeaeeeeeescessesaaaeseeeesseeseaaeaeeeeeeeseeseaaeas 59 4 5 8 Setting Up Multiple Users ettet Eee aac ee RE e ammai On ASSEN de Deed o ga dun eta e assa Tele 60 4 5 9 Marking Bad HR data iter ete n kuv ee ce evt a ene ce eee
2. A message will be displayed stating that the tests have been successful If there is a problem then a warning message will be displayed In this case please contact the technical department at CamNtech for further help Actiheart User Manual 4 0 35 Jan 2010 13 2 1 2 Battery Test 2 1 3 Reader Test 2 1 4 Firmware Update It is possible to test the condition of the battery in the Actiheart unit Selecting the Battery test tab of the Test Actiheart screen will bring up the screen Selecting Run full battery test will then run a load test on the battery in the Actiheart The LED in the Actiheart will flash continuously and various voltages will be displayed If a user Suspects a problem with the battery of an Actiheart and contacts CamNtech for advice these voltages may be requested to aid diagnosis so they should be noted This function should only be used if requested by a CamNtech representative NOTE This section applies to Actiheart 4 only serial numbers beginning with 90 To ensure optimal performance via product enhancements it may be necessary to update the operating software contained within the Actiheart The latest operating software firmware file is distributed with the latest version of the Actiheart PC software and can also be provided upon request To update the firmware click on the firmware tab to view the firmware update screen At the bottom right of the screen the currently
3. 25 3 27 EGIting IBI KE E 26 3 2 8 Editing IBI Data with an external program 27 3 3 Long Term RECONCINB ec 29 Actiheart User Manual 4 0 35 Jan 2010 3 3 3 1 Setting up a Long Term Recording ccccesesssssececececessessaaececececessesaaaeeeeeceeeeeeaeaeeeeecesseseaseaeeeeeesseesaeaeseeeesseesesauaeseeess 29 3 3 2 Summary of Long Term Recording Times ccccccccccesssssssecececscessesneaeceeeceseesesaeaeeeeecssseseeaeaeeeeeceseeseaaeseesescussesauaeeesess 30 3 3 3 Setting Up a Recording Delayed Start 30 3 3 4 Downloading Long Term Data from the Actheart nennen nennen nannaa aa ana a nannaa aaaaaaean 30 3 3 5 Viewing Details of a Long Term Recording cesses enne nnne ne th nina siis essen nass assi nananana aaaaaanean 30 3 3 6 Database Export and File Export 30 3 4 Analysing Long Term Recording ect octets tre ena eat re haee ane ea odo aene eoo ox et tarte ue dne dead ceno tas 31 3 4 1 Long Term Tools Tabs amp Controls iit te eire hatte Edo edet ko oon e eade RE De dU ERE ND Ove cies 32 3 5 Previewing amp Printing Long Term Data 34 SiG AULO Be T dee 35 3 Estimate SleepIDp HB metet p teh desees ute tuere E MULA I aes 36 3 8 Select DAY C 36 3 9 Copying datato the clipboard certet tt SEENEN erede a eec dade 36 3 9 T CoOpy Re EE c R 36 3 9 2 Copy C
4. See Section 4 4 8 2 for more details e Measured RMR This is whichever value the user has opted for i e equation based or actually measured See Section 4 4 8 1 for more details e HR max This is whichever the user has opted i e equation based or user entered See Section 4 4 8 3 for more details e VO2 max See Section 4 4 8 4 for more details The table also contains individual Activity and Heart Rate calibration data obtained either from the built in Step Test or from an external calibration The Step Test data is generated automatically when a Step Test is saved see Section 4 5 for more details The data is contained in the fields labelled Energy 20 to Energy 280 The data is in Joules min Kg Heart Rate calibration data is contained in the fields Hree 20 to Hree 280 and Activity Calibration data is contained in the fields Act EE 50 to Act EE 6400 This data is entered by the user Please see Section 4 4 8 on individual calibration for more details This database has seven tables of which only two PAEE and Step PAI are key operational tables The PAEE table is shown overleaf This table contains information about e Group calibration equations e Branched Model Discriminants and Weighting factors See Appendix 2 for more details e Compensation factors for recovered Heart Rate data and for stress see Appendix 2 e Flags to enable individual calibration The group calibration equations shown in the table are the de
5. and the Activity by 10 However if the HR data within the epoch is Recovered data and the Recovered factor is set to 15 then the HR within that epoch will be weighted by 15 and the activity by 85 This allows the normal HR data weighting to be reduced where there is a raised HR in the absence of sufficient activity This compensation works in a similar way to the Recovery factor Again this stress factor overrides the default weighting The following criterion is used for deciding whether the raised HR in an epoch is likely to be due to stress If the activity in the previous three minutes of activity is lt 25 counts per minute then the stress correction factor is applied 25 is equal to the value of X in the Branched Model If an epoch where stress is detected has recovered data which has had a Recovery Factor applied to it then the stress factor will override the recovery factor The stress factor is set in the Settings database If the box is left empty then the stress compensation is disabled Actiheart User Manual 4 0 35 Jan 2010 89 Example In an epoch with good HR data which falls into Branch 1 the HR would normally be weighted by 90 and the Activity by 10 However if the stress factor is set to 0 1 then the HR Act weighting which is applied will be 10 90 In an epoch with recovered data which has a Recovery factor of 25 applied to it the HR would be weighted by 25 and the Activity by 75 However if that epo
6. cam tech The Actiheart USER MANUAL Document Reference 30071 Issue Version 4 0 35 Issue Date 07 01 2010 CE 0120 The Actiheart is a Class 2a Medical Device This manual is designed to be read in conjunction with The Actiheart Guide to Getting Started Actiheart User Manual 4 0 35 Jan 2010 Regulatory Information CE Notice European Union Actiheart Medical device information The Actiheart is a Class Ila Medical Device conforming to the essential safety amp health requirements and provisions of EC Council Directives 93 42 EEC Annex V and VII CamNtech Ltd has been assessed and certified as meeting the requirements of the above directive by SGS United Kingdom Ltd Notified body number 0120 Actiheart certificate number GB06 67703 Manufacturer CamNtech Ltd Tel 01480 831223 Upper Pendrill Court Fax 01480 831733 Papworth Everard Email technical camntech co uk Cambridgeshire Web www camntech co uk CB233UY UK Applicable Standards Standard Description EN60601 1 1990 Medical electrical equipment Part 1 General requirements for safety EN60601 1 2 2002 Medical electrical equipment Part 1 2 General requirements for safety Collateral standard Electromagnetic compatibility Requirements and tests Group 1 equipment Class B emissions only EN60601 1 2 2002 Medical electrical equipment Part 1 2 General requirements for safety Collateral standard Electromagnetic compatibili
7. or Individual HR Cal Actiheart User Manual 4 0 35 Jan 2010 41 then only the recordings that contain an individual calibration will be displayed The energy expenditure calculation will then be based on the selected variant In order to view the available models stored in the Settings database click on the Branched Model Parameters button within the Energy Model box the following screen will be displayed Branched Model parameters Activity Group Calibration Equation ActEE Other settings Step HR adults Individual HR cal Act EE 921 cpm 77 if male 0 cpm if male P recover 25 Ind HR ACT cal Grp Stress adults fo age 0 height 0 BMI 71 P Stress 0 Ind HR cal stress Step HR stress adults Heart Rate Group Calibration HREE Use Step test Cal HR EE 55 HRaS i2 HRaS if male 16 if male Use HR Cal r D age 0 height 0 BMI 3 Use Activity Cal D Group Children Branched combined model using activity and heart rate Branched model AEE Bicis 0 1 ActEE 09 Hee Transition HRas 0 54 SHR 54 3 Branched model AEE jos ActEE 05 HRee Activity Value Das ER cpm Branched model AEE Less Greater jos ActEE 05 HRee Flex HRas 0 05 SHR 21 2 Branched model AEE 09 ActEE p1 HRee Step Test Calibration E guation AEE 23 HRaS 11 HRaS Male 23 HRaS StepSlope 13 Steplntercept 40 Male 0 Recove
8. that you wish to apply to the analysis from the drop down list If you select one of the group calibration models then all recordings will be displayed However if you select an individual calibration model e g Step test HR or Individual HR Cal then only the recordings that contain an individual calibration will be displayed The energy expenditure calculation will then be based on the selected variant In order to view the available models stored in the Settings database click on the Branched Model Parameters button within the Energy Model box the following screen will be displayed Branched Model parameters SL MM eel Activity Group Calibration Equation ActEE Other settings e adults d Individual HR cal Act EE 021 cpm 77 ifmale 0 cpm ifmale P recover 25 Ind HR ACT cal Grp Stress adults 0 age 0 height 0 BMI 2 P Stress 0 Ind HR cal stress Step HR stress adults Heart Rate Group Calibration HREE Use Step test Cal Group Children HR EE 55 HRaS 12 HRaS if male 15 ifmale UseHRCa 0 age 0 height ig BMI 34 Use Activity Cal Branched combined model using activity and heart rate Branched model AEE Grese jor ActEE os HRee Transition HRas 054 SHR 54 3 Branched model AEE Less jos ActEE 05 HRee Activity Value BE 25 cpm Branched model AEE Less rts n5 ActEE 05 HRee Flex HRas n ue 0 05 SHR 2
9. 4 3 4 Individual Calibration ierit tei REENEN e d Eva sre TTA qu EE a En Tad E a s E Te a E a a P Taken 42 4 3 5 Analysing a recording RANNER REESEN EORR NR EEEa Se REE E A eaaa 42 4 3 6 Gaps imthie Data eee te m erm eee UR e ee e eee ades Me Ou ad ee varese eoe qa ee Essa de eue o aa dux seta n met die de dus 44 Lc The Distribution Of EE 44 4 3 8 Previewing amp Printing Dat i tei tr bn immet mei isi is h m tt ss Rim REA 44 4 3 9 COPYINE Data EE 45 E AE EI UE EE 45 4 4 Advanced Energy EXpenditure gege eegene AE EEN 46 4 4 1 Steps in Performing an Anahysls sn aan nenne entera a naa a aa nannaa aa ana a nananana aan aa eaa a nananana 46 4 4 2 Setting Uup a Recording cte orientado eee e eese v is si Tmta Tae ee 46 4 4 3 Setting up a Recording Delayed Start monon n aa aa aa nana ana eaa aa nannaa aa aan a aa nannaa dass assessing nan 47 4 4 4 Downloading an Advanced EE Recording sanana aan nana aa aa aa aa nana annan aa ana aa ana aa ae enaa aaaaen 47 Actiheart User Manual 4 0 35 Jan 2010 4 4 4 5 Viewing Details of an Advanced EE Recording annan aa eaa nnn nennen nina nana s sensns tasa aa aa aa eaa nananana 48 4 4 6 Database Export and File Export soassa sa amm adds maksaen cte a ETT eC de e aa da deeds Vase EE e Dac eque ATT EEN 48 4 4 7 Selecting an Energy Model tette a NIVA Ne teeks de Ce Reda maalaa ssa Lie Tase KAT e TNA 48 448 INGIVidUal e ee ele Vu E 49 448 1 Measured RMR e P
10. A 33199 votenb3 uoneigiea dog Mushy v 200zdvf E dnog SIIJIAUPIP J Japoy PIYDURIA 7 LiVdHeeyljoy 9IVAHEIUPY givduieeunov TIVdHeeYylpy ElVdHesylpy TIV AHEDSUIPDVY TZ CZ TA TA gieduH giedyH pieduH zledyH TIedyH owen 11 Actiheart User Manual 4 0 35 Jan 2010 2 Settings and Utilities Clicking on the Utilities button from the front screen will display the Actiheart settings and utilities screen as shown below Actiheart Settings and Utilities v n Recharge Actiheart Preferences Test amp Maintenance Enable Sleep Analysis H Read Actiheart Communications Settings Yerify Actiheart Setup Database selection IC Users Howard S mith amp ppD ata Actiheart datatActiheartdemo mdb New Users in this database Current Computer Login Computer Name HS SONY Login name Howard Smith There are a number of buttons and software settings which are described below 2 1 Test amp Maintenance Clicking the Test amp maintenance button brings up the following screen r Test amp Maintenance Terminal Y Reader Test 1 Test Battery Test Get Actiheart Information Firmware Revision H90 57 Serial Number 000133 Movement Calibration Factor 80 Battery Voltage 2 69 V H 1 Charge Manually Reboot Actiheart Powerdown Actiheart Waiting for Actiheart communications This screen shows information about the Actiheart In thi
11. Actiheart User Manual 4 0 35 Jan 2010 40 4 3 Daily Energy Expenditure 4 3 1 Steps in Performing an Analysis 4 3 2 Setting Up amp Downloading Reading a Recording 4 3 3 Selecting an Energy Model Selecting the Daily EE button from the main screen will bring up the Daily Energy Expenditure window as shown below Le AEE TEE Estimation Daily Energy Expenditure Recordings available to analyse Select an energy model to view compatible recordings Energy Model Actiheart monitor Branched Model Parameters E m v pan Set up and record as described in Section 4 3 2 Read and save data as described in Section 4 3 2 Choose the desired Energy Model see Section 4 3 3 Set Resting Energy Expenditure only possible from Advanced Energy Expenditure tab See Section 4 4 8 1 for more details Set Sleeping Heart Rate only possible from Advanced Energy Expenditure tab See Section 4 4 8 2 for more details Analyse as described below This is the same as the process previously described for other recording types Please see Section 7 of the Guide to Getting Started for more details Before you can view a recording and analyse it you first need to select the Energy Model that you wish to apply to the analysis from the drop down list If you select one of the group calibration models then all recordings will be displayed However if you select an individual calibration model e g Step test HR
12. Jan 2010 25 3 2 7 Editing IBI Data In some circumstances IBI data may be noisy or contain periods of missed beats To overcome this the IBI data can be edited to remove such erroneous data points There are two options for editing the data Automatic and Manual The automatic function applies a bespoke cleaning algorithm to detect and correct erroneous points The manual function allows the user to individually manipulate IBI data points or blocks of points To edit the IBI data first select the period of interest on the Activity and HR graph and click edit then edit IBI data from the menu The figure below shows the lower part of the screen and is a graph of IBI data for the entire selected analysis period Clicking the Auto clean button will apply the cleaning algorithm to all of the points in this graph Click on the graph to select a 75 second block for manual editing see section below 16 08 00 Click to automatically clean all of the IBI points in the analysis window Manual cleaning is performed by first selecting a 75 second period of data by clicking on the lower graph the region will be highlighted in blue The upper graph on the display will show the IBI points in this 75 second period see figure below Click Save and exit to store the modified IBI data Tools for marking a block Click to edit IBI s with an Click Cancel to close of data to be cleaned see external program see
13. applicable select the reguired recording for analysis from the list of available recordings double clicking on the recording or highlighting it and selecting Analyse brings up the following screen note you may see a message asking if you wish to auto fill data for unworn periods select yes or no Actiheart User Manual 4 0 35 Jan 2010 51 A f Activity Energy Expenditure File Print Preview Copy Data timated RMR Sleeping Heart Rate Display AEE Comment Utilities Marked data AEB k TEE 6 w Sex Female d 5 8 45 BMI MJ Day Remove Unmark Include 11 Nov 2004 16 10 Copy Trim Set Sleeping heart rate Run external HR EE cal 281 65 oules kg min Branch 2 The screen is divided up into six primary regions as follows A B Tools Tabs displays analysis information and provides analysis tools C D Activity and Heart rate data Shows the activity and heart rate data for a User details Information about the user to which the recording relates Day Selector Allows the analysis day to be guickly selected section of the recording The heart rate data is shown in red and the activity data in black Energy Expenditure Shows an epoch by epoch plot of either Activity Energy Expenditure AEE or Physical Activity Intensity PAI in the units chosen or the Total Intensity AEE REE REE in METS For the purpose of this calculation REE is based on the Schofield eguation
14. displayed as a blue line as shown on the screen below If the cleaned data is copied and pasted then a comment such as Recovered Interpolated or Lost is pasted alongside each epoch Note that the cleaning process may be reversed by selecting Restore Raw Data from the data menu Actiheart User Manual 4 0 35 Jan 2010 35 3 7 Estimate Sleeping HR 3 8 Select Day 3 9 Copying data to the clipboard 3 9 1 Copy all data 3 9 2 Copy Circadian Components This function may be used to automatically determine the sleeping heart rate for the wearer The software will determine the average sleeping heart rate for all nights of the analysis and then provide an overall average for all days It is possible to select de select which day averages are included in the overall average The sleeping heart rate may then be saved with the user data This option may be selected for the Data menu and provides a quick means for selecting the full day of data from midnight to midnight for analysis There are two copy functions available from the Copy menu This function provides an epoch by epoch export for all days of data and includes time stamped Activity ECG uV BPM and IBI min max information This function provides estimates of the 24 hour components in the heart rate and activity waveforms Note that the auto clean function as described above must be applied first to ensure that any unworn periods do not
15. gt 100 120 amp 160 BPM Min for a 1 min 30 sec amp 15 second epoch respectively STEP 2 Removing Spurious Signals from the Cleaned Data STEP 3 Replacing Removed Data The cleaned data is analysed minute by minute and if the cleaned HR at any data point is gt 1 75 Filtered HR then the cleaned HR is set to zero Filtered HR is the average of the HR over the 4 minutes preceding the data point being analysed Between 4 and 16 HR values will be averaged depending on the epoch a Recovery For each minute where the HR has been set to zero each stored IBI minimum and maximum there will be sixteen if the epoch is 15 sec is used to calculate a HR 60 000ms IBI which is then compared with the previous valid heart rate The calculated HR which is closest to the valid heart rate and within 30 BPM of it is used to replace the zero values This is termed Recovered Data If the difference is gt 30 BPM the calculated HR is not used to replace the zero value b Interpolation Following the recovery process any remaining zero value gaps of lt 5 minutes are filled by interpolation straight line join If the gap is greater than 5 minutes the value is left at zero After selecting Auto Clean the following message will be displayed This will clean interpolate and finally remove bad data points Do you really want to continue Selecting Yes will apply the criteria to the data and any cleaned data will be
16. 2 3 Reading Downloading a Sleep Analysis Recording 5 3 Analysing a Sleep Analysis Recording Please note that if Record EDR EDR ECG derived respiratory signal is ticked the maximum recording time is approximately halved Clicking Send sends all the parameters to the Actiheart and once setup is complete the following screen will appear Actiheart 4 ActiHeart verified amp ready Starting at 15 53 Please remove From reader charger The Actiheart MUST be removed IMMEDIATELY from the Reader Failure to do so may lead to the Actiheart being unable to record in which case the setup procedure would need to be repeated Once the Actiheart is removed from the Reader it can be placed on the user by clipping onto the previously attached pads For details on setting up a delayed start recording please see Section 3 1 3 Downloading a Sleep Analysis recording is the same as any other recording For further details please see Section 7 of the Guide to Getting Started The recorded data can be accessed from the listing on the main Sleep Analysis screen see Section 5 2 above The data can be used for A detailed statistical analysis of the IBI data Identifying the Sleep Stages Apnoea Screening Searching for occurrences of apnoeic events Calculating a Spectrogram of the heart rate signal Actiheart User Manual 4 0 35 Jan 2010 64 Highlighting a recording of interest and clicking on Analyse produces th
17. 5 seconds will be a vocal prompt five four three two one and then the software will start the test The user should step in time to the drum beats voice prompt This will be accompanied by colour prompts signifying that the user should step At the end of the test the software will count down a 2 minute rest period during which time the user should stand still with the Actiheart still fitted At the end of this 2 minute period a message will be displayed telling the user that the Actiheart is ready for reading If at any time the user feels uncomfortable with the test they should stop immediately and rest with the Actiheart on until the end of the test The test can be stopped at any time by pressing the stop key and the drum beat vocal prompt paused using the appropriate keys Pressing the Stop key twice will allow the unit to be read without waiting for the 2 minute count down period Actiheart User Manual 4 0 35 Jan 2010 57 4 5 3 Downloading Step Test Data from the Actiheart 4 5 4 Viewing Details of a Step Test Recording 4 5 6 Analysing a Step Test Recording Downloading a Step Test recording is the same as any other recording For further details please see Section 7 of the Guide to Getting Started This is the same as for other recordings please see Section 3 1 5 A recording is selected either by double clicking on it or highlighting it and selecting Analyse The following screen is then shown e S
18. Energy Expenditure 4 4 1 Steps in Performing an Analysis Set up and record as described in Section 4 4 2 Read and save data as described below in Section 4 4 4 Choose and apply the correct Energy Model see Section 4 4 7 Set RMR see Section 4 4 8 1 Set Sleeping Heart Rate see Section 4 4 8 2 Analyse as described below 4 4 2 Setting up a Recording Clicking the Advanced Energy Expenditure button on the main screen produces the following screen r Advanced Energy expenditure Energy Expenditure and Intensity Recordings available to analyse 22 4ug 2008 10 40 11 Jun 2008 14 56 11 Jun 2008 14 56 18 Sep 2007 14 33 18 Sep 2007 14 17 39901 rev48 05 Sep 2007 16 15 33301 rev48 05 Sep 2007 16 16 99901 05 Sep 2007 13 07 Stressed_free 28 Apr 2004 06 00 26 May 2004 06 00 29 May 2004 06 00 22 May 2004 06 00 08 May 2004 06 00 24 A4pr 2004 06 00 17 Mar 2004 06 00 20 Mar 2004 06 00 20 Mar 2004 06 00 Actiheart monitor 1 os Common Models Branched Model Parameters sg N n N The user can choose which types of recordings are available to view by selecting the relevant recording type on the left hand side of the screen A recording and user are set up in the same way as previously documented For further details please see Section 7 of the Guide to Getting Started When the user is set up and the parameters are ready to be sent to the Actiheart the screen on the following page is shown Ac
19. HR 60 000 ms which is then compared with the previous valid heart rate The calculated HR which is closest to the valid heart rate and within 30 BPM s of it is used to replace the zero values This is termed Recovered Data If the difference is gt 30 BPM the calculated HR is not used to replaced the zero value Actiheart User Manual 4 0 35 Jan 2010 39 b Interpolation Following the recovery process any remaining zero value gaps of lt 5 minutes are filled by interpolation straight line join If the gap is greater than 5 minutes the value is left at zero If there are gaps in the data see below due to the unit not being worn the cleaning is disabled in the gaps 4 2 8 Gaps in the Data Whenever a file is opened from the Advanced EE or Daily EE screen an attempt is made to identify gaps in the data in each day due to the unit not being worn and the user is offered the option of filling these gaps with an average of the day s AEE excluding the gaps If selected the Auto Fill is automatically applied to all the days in the recording Actiheart 4 It appears the Actiheart may not have been worn For some periods Would you like to auto fill these periods with the average energy expenditure for the rest of the day you can change this option later using File gt Autofill In order to decide whether the Actiheart has not been worn the software searches for continuous periods of 2 hours or more of zero Activity
20. NEESS EES 70 5 4 3 COPVINE Data EE 70 SAA EXPOrting Data E 70 5 5 Apnoea EE DIDIER EENS 71 5 5 1 Previewing D tar eneee e EEN EEN EE 72 5 5 2 Printing Data KEE 72 5 5 3 COPYING Ke EE 72 EE WE ee ie dl DI d EE 72 5 6 ADriOSd Search scere mercedes treat eee e tee uds es uL IE E E ULM eU E 73 ERC PREVIEWING Data EE 75 5 6 2 Printing Datalasscsccvcsicccesas See Eed EENS EE VEER EENS de 75 5 6 3 COPYING Data EE 75 56 4 EXporting Dat EE 75 Bis T SPO CELO RAIN 5 22 E TE E eege eege ee ee 76 5 7 1 PREVIEWING Hate 76 5 7 2 Printing KE EE 76 5 7 3 COPYING KC EE 76 57 A Exporting Data EE 77 6 0 Safety and Handling Information wissicosssncecececpiccncscecncpecepeccendasncnsneckccentasancbancctecendeenncsanestedeetdeancnnbanseeentenene 78 6 1 DECONTAMINATION EE 78 6 2 Ee dE 78 EC 78 6 4 Warnings BENE EE 78 6 5 RI le cf EE 78 Appendix 1 Technical Specifications of the Actiheart System annan 79 Accelerometer Specification siset oce irokeesien eeaeee aeaee an a a eree aeaa OaE Visma e Aa aD ea o E aaae tai 79 Acceleration measurement sirsarsiniidcnciisiasainodniisedr tdeo aan k nda an KAT SENIN A N Kea ARACA AEN adaa ida teas 79 EGG specification eelere Eeler 80 Heart Rate Measurement eere eret tener tenen Lope Ny en Sa revue ENEE exe e NSN oe e vua US este cuewaceveousbueleedeevereetesseleuerneeverteys 80 Actiheart Recording TH
21. Period 00 38 Removed data 00 00 Max Heart rate 100 Ave Heart rate 64 LA verage activity 53 Actiheart User Manual 4 0 35 Jan 2010 33 Information on the period selected is shown in the top left hand corner of the screen This shows the times of the marked period the average heart rate maximum heart rate and average activity levels o Copy Selecting the copy function will export the marked data to the clipboard from where it can be pasted into an external program e g Excel for further analysis Removed data is copied as zero in the Edited Activity and Edited BPM columns respectively and the comments column will say Removed If the data has been cleaned then the comments column will say either Interpolated or Recovered see Section 3 6 for a description of these terms Moreover if following cleaning the Edited BPM is zero the Comments column will say Lost and if the unit has not been worn a Not Worn comment will be shown If the data has not been cleaned the Comments column will say Uncleaned o Trim The trim function allows the user to remove all of the data after a given point Clicking on the point after which all data is to be removed gives the following message Actiheart 4 Do you want to trim the data to end at 09 Dec 2008 16 05 Press cancel to clear any trim already set Selecting Yes will remove all data after the date and time given Note this is rev
22. See Section 4 4 11 for details of the available measures and units The screen above displays METs and is colour coded according to the following intensity bands 1 3 METS 3 6 METS gt 6 METS Green Orange Red Comments Shows any comments recorded with the data see Section 3 4 1 Actiheart User Manual 4 0 35 Jan 2010 52 NOTE During periods where the unit is not worn the display will show only 1 MET based on AEE 0 4 4 10 Viewing a Specific Point It is possible to view the data at any given point on screen This is done by right mouse clicking on the data point of interest Right clicking on the Activity and HR graph results in the pop up as shown to the right This shows the time heart rate in beats per minute in red and activity level in counts in black Right clicking on the Energy Expenditure graph results in the pop up as shown to the right Activity Energy Expenditure is shown in this case in Joules kg min The lower figure shown is the branch of the branched model used to calculate AEE at that particular moment Further details of the branched model are given in Appendix 2 Right clicking the mouse and moving along the recording will display the data epoch by epoch To review individual high resolution epochs e g 15 seconds it will be necessary to reduce the display width to allow more epochs to be resolved on screen 4 4 11 The Display Tab The Display tab is used to select the m
23. The Step Test is a built in function of the Actiheart software enabling an individual HR calibration to be carried out easily without needing a laboratory or an oxygen analyser For details of how the calibration curve is derived please see Appendix 4 The data obtained by the Step Test is also used to provide an estimated figure for VO2 max for assessing a subject s level of aerobic fitness The test lasts for 8 minutes and the stepping speed ramps linearly from 15 step cycles 1 step cycle is up up down down per minute to begin with up to 33 beats per minute at the end The stepping speed is dictated either by a drum rhythm or by voice commands The user can select whether the vocal prompt or drum beat is used in a given test Clicking the Step Test button brings up the following screen r Step Test Actiheart Step Test Expenditure Step test setup Actiheart monitor WEN f Setup ailable to analyse mo saa 99901 Step test 2 05 Sep 2007 14 17 15 steps min 33339 Step test 22 Jun 2004 17 12 33314 Step test 03 Jun 2004 13 42 Then ramp to 39915 Step test 014Jun 2004 15 19 33 steps min 99949 Step test 28 May 2004 18 40 33334 Step test 25 May 2004 15 15 Gtart test at 99944 Step test 21 May 2004 15 28 as 39940 Step test O7 May 2004 14 17 99901 Step test 2 23 Apr 2004 15 46 IM Include rest test E Info PER A user is set up in the same way as previously documented For further details please see Section
24. and clicking on the white area produces the following result Estimated Sleep Stage Sleep Statistics Bed Time 20 14 Sleep Start 22 15 Sleep Latency 02 01 Light Sleep 03 47 Get Up 07 09 Sleep End 06 54 Time Awake IIRS Deep Sleep 0233 Time in Bed 10 55 Sleep Time 08 39 Sleep Efficiency 90 2 REM 01 48 Detailed Statistics The Estimated Sleep stage window now contains the sleep stages for the period with light sleep displayed in yellow deep sleep displayed in green and REM sleep in red The time spent awake during the night is shown in black The Sleep Statistics window now contains the selected bed and get up times as well as the following calculated sleep parameters e Time in Bed e Sleep Start e Sleep End e Sleep Time e Sleep Latency e Time Awake e Sleep Efficiency Actiheart User Manual 4 0 35 Jan 2010 69 5 4 1 Previewing Data There are two ways of previewing data a Previewing General Statistics This displays the window and beat to beat zoom data if selected as well as the histogram triangular index and RMSSD for the recording and is done by selecting first Preview and then General Statistics from the drop down menu b Previewing Sleep Staging This is done by first selecting Preview and then Sleep Staging from the drop down menu 5 4 2 Printing Data There are two options for printing data a Print General Statistics This prints out the window data
25. available firmware version will be displayed This will typically be shown as 84 nn where nn current version number To proceed with the update ensure that the Actiheart is correctly placed upon the reader and then click Load new firmware Accept the warning messages and wait for the update verification to complete WARNING The Actiheart must not be removed and the computer should not be used for other activities until the firmware update is complete If the update is interrupted the Actiheart may need to be returned to CamNtech for repair Upon successful completion of the update the following screen will be displayed Test amp Maintenance Ae i Information Test Battery Test N Terminal Establishing Actheart status ctheart reset and ready for communications ctiheart ready for erase ctiheart erased and ready for firmware upload Firmware Reader Test xxxxxxxx D I NOT REMOVE THE Achheart Firmware update address 1000 FIRMWARE LOADED OK Firmware verification OFFF FIRMWARE UPDATE VERIFIED OK OU MAY REMOVE THE Actiheart j Firmware available 84 62 The Actiheart may now be removed and used as normal Actiheart User Manual 4 0 35 Jan 2010 14 2 1 5 Terminal Window Allows direct communication with the Actiheart and is used for diagnostic purposes if the Actiheart cannot be read It is a check that the communications between th
26. individual HR PAI relationship in the field The Step Test also provides an estimate of VO2 max Please see Appendix 4 for more information about the Step Test Actiheart User Manual 4 0 35 Jan 2010 88 Customising the Equations and the Model Branched Model Adjustment in the Presence of Recovered Data Example Branched Model Adjustment in the Presence of Stress All of the calibration equations and the discriminants and the weighting factors of the Branched Model are held in an Access database and can be altered by a user Fora description of how to do this please refer to Chapter 1 of this manual Normally in the branched model the contribution to energy expenditure from activity and heart rate is weighted epoch by epoch according to certain activity and HR thresholds However since the recovered HR data is obviously less reliable than bona fide recorded data it may be desirable to override the branched model default weighting factors with another factor which reduces the HR contribution A Recovered factor of 25 means that wherever there is recovered data a 25 75 weighting will be applied to the HR Act respectively in preference to the default weighting for that epoch The Recovery factor must be set in the Settings database to a value between zero and 100 If no value is entered in the database the program will set a default value of 25 In an epoch which falls into Branch 1 the HR would normally be weighted by 90
27. no two Actiheart units will produce exactly the same output The Actiheart time is set by the PC clock and elapsed time is marked in each unit by means of a crystal oscillator Selecting a sampling epoch sends an instruction to wait a certain number of oscillations before storing the number of activity counts This system is also used when any delays in starting of recording are set The Actiheart is designed to be waterproof Please see The Guide to Getting Started for further details regarding use of the Actiheart in water Static discharges will not damage the unit and will not stop the unit functioning However repeated exposure to static discharge may cause the unit to reset and lose small amounts of data 1 4 sec The risk of static discharge can be minimised by grounding both the user and subject at regular intervals particularly immediately prior to attaching the units Actiheart User Manual 4 0 35 Jan 2010 81 Appendix 2 The Branched Model Calibration Equations and Other Equations Estimating Energy Expenditure EE from Activity and Heart Rate Techniques used for Estimating Energy Expenditure from Activity and Heart Rate Activity monitors use motion sensors accelerometers to provide an objective indicator of total body movement They can be used to assess the frequency intensity duration and EE of physical activity A well described limitation of activity monitors typically worn on the hip is the inability to as
28. the Copy button on the menu bar of the Short Term analysis screen Analysis IBI data This function takes the analysed raw data and places it on the clipboard The output provides a header containing information about the recording the device and the User Next is a listing of time stamped Heart Rate BPM and Activity counts This is then followed by a listing of IBI s ms for every beat in the analysis period Note that all of these data are for the selected analysis period only Analysis Results This function takes the information from the IBI statistics area and places it on the clipboard The output provides a header containing information about the recording the device and the User This is followed by a listing of time stamped IBI analysis results as displayed on screen Note that all of these data are for the selected analysis period only It is possible to export the time stamped IBI data as a text file by selecting the required region as described above and clicking first Export and then Time stamped IBI data from the menu Take note of any warning messages regarding offset IBI s then note the confirmation message which contains the file name and folder for the data The software uses the Actiheart data folder as the default folder and the file name has trhe following format IBI ddmmmyyyy hhmm txt Where ddmmmyyyy is the date of the export and hhmm is the time of the export Actiheart User Manual 4 0 35
29. the Daily Energy Expenditure applications see Sections 4 3 3 amp 4 4 7 4 2 2 Branched Model Adjustment in the Presence of Recovered Data See Appendix 2 4 2 3 Branched Model Adjustment in the Presence of Stress See Appendix 2 4 2 4 Individual Calibration Individual calibration data can be used in the calculation of AEE instead of a group calibration The individual calibration can be applied from either Daily Energy Expenditure or Advanced Energy Expenditure However the calibration data itself i e Activity HR PAI which is stored in the User Info table of the recordings database can only be viewed in the Advanced Energy Expenditure see Section 4 4 8 4 2 5 Resting Energy Expenditure REE This is required in order to calculate the TEE By default the program uses the REE estimated from the Schofield equations However it is possible to replace this value with a measured value of REE To do this the file needs to be opened using the Advanced Energy Expenditure part of the software For further details please see Section 4 4 8 1 on measured RMR Actiheart User Manual 4 0 35 Jan 2010 38 4 2 6 Sleeping Heart Rate SHR 4 2 7 Lost Heart Rate Data STEP 1 Cleaning STEP 2 Removing Spurious signals from the cleaned data STEP 3 Replacing Removed Data This is required in order to calculate AEE The program will use in the first instance the estimate of SHR if entered with the user details duri
30. this function will cause the area highlighted to be marked A comment associated with the marked area can be added There are some stored comments which can be accessed via the drop down menu or a user can enter a comment of choice Comments recorded will be displayed in the bottom section of the screen when the cursor is passed over the marked area of data Remove This function enables the user to remove a section of the heart rate and activity data Unmark include This is the opposite of the Mark and Remove function and unmarks or re includes previously marked or removed data Marked data is highlighted in grey whilst removed data is highlighted in blue Removing data does not alter the raw data A mask is applied to the data and a note to that effect is stored in the read info table of the recordings database For further information please see Section 1 The same screenshot with the data in the area from 9 am until 4 pm will be as shown below r Activity Heart Rate and IBI Variability O Print Preview Data Copy Sleeping HR EEI Removed Display Heart rate Comment Remove Mark data 08 Mar 2004 15 43 H 08 Mar 2004 16 51 H zu MI Mak Unmark Include 5 06 00 00 00 2000 Min Max IBI ms 1000 0 06 00 2 00 00 00 Lost data Info Selecting Info with an area of the data marked shows the information below set detak ee 29 May 2004 15 57 29 May 2004 16 35
31. window 3 2 2 Analysis of IBI Data Graphs It is possible to perform a detailed analysis of the IBI data recorded by highlighting the region of interest on the Activity and Heart rate graph as described above The figure below shows the IBI Analysis results area of the screen Adjust R R scale ms Graph of Activity Grey vs R R Select to view R R or HR scale BPM interval Blue or HR Red ms or HR BPM Analysjs Results Beatto Beat Zoorr F 5 1348 1350 ES 352 1353 13 54 KAN O RR ms SDNN J0 WER Histogram i i Em SDANN Jo LF 78 RMSSD 8 34 HEI Triangular index 3 Graph Zoom Controls IBI Analysis Panel The IBI analysis panel to the right hand side of the graph provides the following information for the IBI analysis Statistics Tab VLF Very low frequency component of the IBI derived using an FFT LF Low frequency component of the IBI derived using an FFT HF High frequency component of the IBI derived using an FFT RMSSD Root mean square of the successive differences of the IBI s Triangular index The integral of the density distribution divided by the maximum interval This is also shown on the histogram plot When the 5 minute analysis epoch is selected the following further information is also displayed SDNN The standard deviation of the normal to normal intervals SDANN The standard deviation of the 5 minute average NN intervals Histogram Tab The Histogram display shows a time
32. without saving changes details in section below details in section below 75 seconds of IBI data 2000ms 1750ms 1500ms 1250ms 1000ms ERU 500ms 250ms 16 05 00 16 06 00 Actiheart User Manual 4 0 35 Jan 2010 26 There are two options for manual editing of IBI s Block Edit and Individual Edit The block edit function is performed as follows Click on the graph to Click on the graph to Click the Fill button highlight the start highlight the end to clean the IBI s point then click the point then click the between the start Start button to mark End button to mark and end points this point this point This process may be repeated for as many regions of the graph as reguired before clicking Save and exit to store the edited IBI data in the database The Individual Edit function is performed as follows Right Click and drag Editing an individual to edit individual point will affect the points The ms value next point It may be is displayed at the necessary to edit cursor several points This process may be repeated for as many regions of the graph as required before clicking Save and exit to store the edited IBI data in the database 3 2 8 Editing IBI Data with an external program A user may wish to export the IBls to a proprietary program for more sophisticated editing The procedure below allows the IBls to be exported for this purpose and to be re imported once edited and s
33. 1 2 Less i model AEE ActEE 01 o1 HRee Step Test Calibration Equation AEE 23 HRaS 11 HRaS Male 23 HRaS StepSlope 13 Steplntercept 10 Male 0 RecoveryTau 0 HRaS RecoveryTau 0 Age 0 Height 75 0 BMI Actiheart User Manual 4 0 35 Jan 2010 48 The screen above allows the settings to be viewed The top left hand window contains a list of all the variants of the model furnished with the software as standard The components of each variant calibration coefficients and branch parameters can be viewed by highlighting that variant in the window 4 4 8 Individual Calibration This screen is accessed by clicking the View edit button on the Advanced Energy Expenditure screen r Individual Calibration Energy calibration methods Step test calibration Other HR calibration Activity calibration 20bpm Sobpm 1606pmf 2306pmf 30 bpm 100 bpm 170bpm 240bpm 40 bpm 110 bpm 180bpm tel 50 bpm 120 bpm 190bpm 280bpm 60 bpm 130 bpm 20bpm z0bpm 7 bpm 140bpm 2A0bpm 2806pmf 80 bpm 150 bpm 220 bpm Measured RMR entry User data EIB HR sleep J oules miniKg sae f Estimated value of E MJ day using Schofield The individual calibration screen serves the following purposes a It allows an individual calibration for a given user to be saved in the database from where it will be called by the e
34. 6 of the Guide to Getting Started Unless a measured value of HR Max is known for the user leave the HR Max field blank The application will then use the Tanaka eguation by default Although a range of step heights are provided please note that the Step Test results have only been validated for a height of 215mm Actiheart User Manual 4 0 35 Jan 2010 56 Once the parameters have been inserted and sent to the Actiheart the screen below will be shown WARNING If Step Test data for a particular user already exists then use a non identical User ID to avoid calibration data being overwritten Using the same User Id with a different Test Id is not sufficient if this is to be avoided m Step Test eax Actiheart Step Test Expenditure p Actiheart rr p size 05 Sep 2007 14 17 15 steps min H 22 Jun 2004 17 12 Step te 03 Jun 2004 13 42 nee un D14Jun 2004 15 19 33 steps min 28 May 2004 18 40 25 May 2004 15 15 Gtart test at i 21 May 2004 15 28 07 May 2004 14 17 23 Api 2004 15 45 7 BB Include rest test EI Info Analyse The software will count down from at least 90 seconds to allow time to put the Actiheart on the user After the Actiheart has been placed on the user they should stand still by the step until the test starts It is possible to select if the rhythm to step is to be a vocal prompt or drum beat This is done by ticking or un ticking the Use music box At the end of the countdown the last
35. Actiheart User Manual 4 0 35 Jan 2010 77 6 0 Safety and Handling Information 6 1 Decontamination e Devices used in the field must be considered to be contaminated e Returned devices must be cleaned with alcohol wipes to minimise any potential contamination The operator must use gloves to handle such devices before and during de contamination 6 2 Battery e The device is battery operated and operates at voltages below 3VDC there is hence no risk from electric shock equipment Type B e The battery is NOT user replaceable 6 3 Water Ingress e The device is tested to 3 BAR and is considered to be suitable for exposure to moisture in normal daily living and swimming for short durations 6 4 Warnings general e Device is NOT defibrillation proof 6 5 Disposal Waste Electrical and Electronic Eguipment Directive 2002 96 EC that manufacturers and or distributors of Electronic and or Electrical Eguipment mm Manage and pay for the collection and further handling of WEEE products as well as provide WEEE related information to their customers R Waste Electrical amp Electronic Equipment WEEE The EU requires under the CamNtech has taken the following approach to complying with this Directive e CamNtech has registered with an approved producer compliance scheme PCS in accordance with the requirements of the WEEE Directive e CamNtech will provide free recycling for all of its WEEE products when returned to CNT e
36. CamNtech WEEE products will be designed with recycling reuse and waste management as a consideration e CamNtech WEEE products will be labeled or stamped with the WEEE marking in accordance with European Standard EN 50419 Actiheart User Manual 4 0 35 Jan 2010 78 Appendix 1 Technical Specifications of the Actiheart System Accelerometer specification Acceleration measurement Range gt 2 5g Resolution 8 Bit 0 2m sec or 0 02g Freguency range 1Hz to 7Hz 3dB Sampling rate 32Hz Acceleration is measured in the following manner The Actiheart contains a piezo electric element which generates a transient charge when exposed to time varying acceleration This produces a voltage signal which is converted into a binary signal by sampling in an 8 bit A D converter resulting in 256 distinct levels of acceleration 128 levels of positive and 128 negative levels The binary signal is stored ina cache 32 times a second and summed up over a specified time period or epoch An epoch period of 1 min would thus comprise the sum of 1920 samples of the acceleration signal This represents the area under the curve below Acceleration 32 60 Samples 1 uw 7 1 Min At the end of the epoch period the sum is divided by 16 and then again by 2 N times until the number is below 32 The resulting integer and N are then stored in a single byte 5 bits for integer and 3 bits for N which is written to the non volatile memory and the
37. E These boxes display the values of AEE and TEE in the highlighted period If the monitor has not been worn for part of this period then the AEE 0 unless Auto fill has been selected The TEE value includes REE Set Sleeping Heart Rate It is possible from the Utilities tab to set the sleeping heart rate for a user This is done by selecting the tab Setting the sleeping heart rate When this is selected the following screen is displayed H i Select sleep heart rates e H o s EI a R Thu 11 Nov 2004 To calculate SHR the AH must be worn for at least one complete night The SHR is set at the highest value of the thirty lowest minute by minute HR readings during a 24 hr day If the epoch is 15 sec then 120 readings are used BHEHERHEHEHEHEEHES The Sleeping Heart rate can also be entered manually from the Individual Calibration screen see Section 4 4 8 Average sleeping HR 97 H uni EA Save Actiheart User Manual 4 0 35 Jan 2010 54 Run External HR EE Cal This utility allows recorded Activity and HR data to be exported to an external application where it can be combined in a file with Physical Activity Intensity PAI measured with a gas analyser and the data can then be re imported into the Actiheart application for use as an individual calibration The external application for combining the data is not provided by CNT The procedure for exporting and re imp
38. EE There are 4 possible viewing options for the analysis Mets HR info HR limits HR histogram To move between these they can either be selected from the drop down menu Analysis display at the top of the screen or they can be scrolled through by repeatedly right clicking on the required day in the bar graph An example of the HR displayed data is shown below Average distribution of AEE for all full days HR histogram 00 00 12 00 24 00 This example shows the average distribution of AEE for all full days together with the HR histogram option It is possible to preview and or print the data from the daily living screen There are two options for preview print which may be selected from the preview or print menus Preview Print Energy Summary This provides a hard copy of the on screen data with the addition of a graph showing the average distribution for all days This report also provides average daily times for MET levels Preview Print Activity amp Heart Rate Data This report provides graphs for all days showing the BPM red and Activity Black with daily HR statistics Actiheart User Manual 4 0 35 Jan 2010 44 4 3 9 Copying Data There are 5 possible options for copying data to the clipboard for importation and analysis into an external program such as Excel 1 Copy Summary Row Provides an export with header information of the average values for all full days in the report 2 Copy Daily Data Provide
39. Excel 1 Copy Detailed Data Provides an export with header information and an epoch by epoch time stamped listing of activity and Heart Rate data with IBI and HRV values 2 Copy Summary Row Provides a single row export of the results for the current analysis 4 5 11 Printing and Previewing It is possible to preview or print the step test report which contains a results summary and graphs of the activity and HR a graph of the ECG for the currently selected 15 second block a graph of the Activity for the currently selected 15 second block and a graph of the Heart rate and Activity Energy Expenditure Select preview to view the report on screen select print to send the report to the printer 4 5 12 Create Derived Short Term Recording This function re saves the step test data into the database in a format that may be opened with the Short term activity and heart rate analysis 4 5 13 Analyse All This is a batch processing function which places on the clipboard a summary row for all the step tests in the selected database This function also provides the option of saving the individual calibration of each user Actiheart User Manual 4 0 35 Jan 2010 60 4 5 14 Saving an Individual Calibration The results of the Step Test are not saved in the database unless the Save button in the right hand corner of the Step Test analysis screen is pressed Pressing this button produces the following screen Actiheart 4 Do yo
40. IMES EE 81 Sensor Calibration and R produ cibility iecit eter to t enne eo eee Tet deene 81 EH par c 81 Waterproof Ca S s forside essien D E m ET 81 The Actiheart and Static Electricity ii ec ree cedet rero etre dEr areneda PR e date rea bes eere dede Page 81 Appendix 2 The Branched Model Calibration Equations and Other Equations 82 Estimating Energy Expenditure EE from Activity and Heart Rate 82 Techniques used for Estimating Energy Expenditure from Activity and Heart Rate 82 The Branched Equation Model for Estimating AEE from Simultaneous Activity and HR 83 Default Parameter Values for the Branched Model 87 Activity Only or Heart Rate Only Mode cr ee e soe te ce V x a TEE von ea e vU EX SE EYES XE ERES 88 Individual Calibration ic E 88 Customising the Equations and the Model 89 Branched Model Adjustment in the Presence of Recovered Data 89 Actiheart User Manual 4 0 35 Jan 2010 6 Branched Model Adjustment in the Presence Of Stress 89 Appendix 3 The Schofield EguotlOns iisassssssssasismaan asa NK epe n tte abba kho tas tcu E ANKKKKKESNSNKUN NNK NPNKHNNANNNSONK NEN 91 Scholield EQuabioFis eec etaed ELM t E bee EN M eis 91 Appendix 4 The Step Test Calculations eeeeeeeeeeeeeeeeeeeeeeeee sense a a aan nananana nnn ananas 92 HR Calibration EE 92 Activity Calibra tiO ln EE 93 Appendix 5 Cal
41. IMin Minimum IBI in the epoch e IBI Max Maximum IBI in the epoch Time domain heart rate variability data e SD Standard Deviation of the IBI data e RMSSD The root mean square of the successive differences of the IBI s Clicking on Calculate LF HF calculates and displays the following frequency domain parameters Actiheart User Manual 4 0 35 Jan 2010 65 e LF The low frequency component of the IBI derived using an FFT HF The high frequency component of the IBI derived using an FFT e LF HF The ratio of the LF component to the HF component of the IBls To the right of the analysis results are the histogram window and some further general 3236 T 20 statistics The histogram shows a time domain frequency plot of the analysed IBls The No of statistics give the following data Ranin e Triangular index This is the integral of 0 the density distribution divided by the 0 1000ms 2000ms maximum interval This is also shown i 20 on the histogram plot Triangular Index e RMSSD This is the root mean square SDNN of the successive differences of the SDANN o Note All time domain and frequency domain parameters are based on the definitions contained in Heart Rate Variability Standards of Measurement Physiological Interpretation and Clinical Use Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology 5 3 1 Viewing a Specific Data Point It is possible to view the da
42. J Wareham Karsten Froburg Cross Validation of Intensity Prediction equations for treadmill walking and running The combined heart rate and motion sensor Actiheart Institute of Public Health University of Cambridge UK and 2 Institute of Sport Science amp Clinical Biomechanics University of Southern Denmark Odense DK Kirsten Corder Ulf Ekelund Seren Brage Nicholas J Wareham Cross Validation of Intensity Prediction equations for treadmill walking and running The combined heart rate and motion sensor Actiheart Medical Research Council Epidemiology Unit Cambridge UK Actiheart User Manual 4 0 35 Jan 2010 95
43. Significant components along the bottom of the scale may indicate the presence of sleep apnoea It is possible to preview the window and beat to beat zoom data for the recording This is done by selecting Preview from the drop down menu It is possible to print out the window data the histogram and the general statistics of the recording This is done by selecting print from the drop down menu at the top of the screen Data can be copied from the software for pasting into an external program of the user s choice The selected data is exported to the clipboard and can then be pasted from there into e g Microsoft Excel There are three options Actiheart User Manual 4 0 35 Jan 2010 76 a Copy raw data This takes the raw activity heart rate and IBI data and puts it on the clipboard This is done by selecting first Copy and then Raw Data from the drop down menu at the top of the screen b Copy Detailed Statistics This is done by selecting first Copy and then Detailed Statistics from the drop down menu at the top of the screen Provides a report with epoch by epoch time stamped data containing Activity BPM IBI Sleep stage and comments c Copy marker summary This is to copies areas of interest that may have been labelled in the beat to beat zoom window 5 7 4 Exporting Data It is possible to export data for further analysis in other programs Please refer to Section 5 3 6 for further details
44. Southern Denmark Odense DK Poster 6 Kirsten Corder Ulf Ekelund Seren Brage Nicholas J Wareham Cross Validation of Intensity Prediction equations for treadmill walking and running The combined heart rate and motion sensor Actiheart Medical Research Council Epidemiology Unit Cambridge UK 7 Seren Brage Niels Brage Paul Franks Ulf Ekelund Nicholas J Wareham Reliability and validity of the combined heart rate and movement sensor Actiheart Institute of Public Health University of Cambridge UK and 2 Institute of Sport Science amp Clinical Biomechanics University of Southern Denmark Odense DK European Journal of Clinical Nutrition 2005 Actiheart User Manual 4 0 35 Jan 2010 90 Appendix 3 The Schofield Equations Schofield Equations Children and Adolescents Age ale Female lt 3 0 167W 1517 4H 617 6 16 252W 1023 2H 413 5 3 10 19 59W 130 3H 414 9 16 969W 161 8H 371 2 10 18 16 25W 137 2H 515 5 8 36W 465H 200 Wt Kg H metres RMR kcal day Adults Male Female 18 30 0 063 x wt 2 896 0 062 x wt 2 036 30 60 0 048 x wt 3 653 0 034 x wt 3 538 Over 60 0 049 x wt 2 459 0 038 x wt 2 755 Wt Kg RMR MJ day To convert to kcal multiply by 238 846 Actiheart User Manual 4 0 35 Jan 2010 91 Appendix 4 The Step Test Calculations HR Calibration The built in step can be used to derive an individual HR calibration equation without needing access to a labora
45. The header will be of the same form as above but will not reflect the true date of the actual recording or its ID After the file is read and saved the header can be changed to the correct one for the recording from the recordings database see Section 1 1 for further information on the user data table Actiheart User Manual 4 0 35 Jan 2010 15 2 2 Recharge Actiheart 2 3 Read Actiheart 2 4 Communications Settings For full details on charging the Actiheart see Section 3 of the Guide to Getting Started This is a general Read function for reading all types of recording For full details of the Read function and how to read a recording please see Section 7 of the Guide to Getting Started Clicking the Communication Settings button will display the following window Single channel reader Multi channel reader charger Pot NPort9 C Poti C Port25 C Pot2 C Poti0 C Poti8 C Port 26 Device Description Actiheart reader charger C Pot3 Pott1 Pot19 C Por 27 Serial Number 00000000 C Pot4 Poti2 Pot20 Port28 Setup OK 15 14 27 C Pot5 Pot13 Port21 C Port 29 C Pot amp Poti4 C Pot22 Port 30 C Pot Poti5 Pot23 C Port 31 Pot8 C Pot16 C Pot24 Port 32 Find single channel reader Search Vv Multi channel reader charger Single channel reader charger Received character count 45 Transmitted character count 7724 Status information for the multi channel rea
46. Y value This is set to TransHRaS 5 Z value A value equal to FlexHRaS has been chosen as a starting point However Z is independent of FlexHRaS need not be equal to FlexHRaS a P1 value 0 9 b P2 value 0 5 c P3 value 0 5 d P4 value 0 1 Actiheart User Manual 4 0 35 Jan 2010 87 Activity Only or Heart Rate Only Mode This is a special case of the Branched Model where EE is estimated using either the Activity data or the HR data In this case the regression equations relating only to Act PAI Act or only to HR PAI HR are used The weighting P1 P2 P3 and P4 for the various modes is as follows P1 P2 P3 P4 Act 0 0 0 0 HR 1 100 1 1 1 Act HR 0 9 0 5 0 5 0 1 NB HR only mode is useful for any activity not just walking and running where the intensity is such that the HR is above the Flex HR Individual Calibration Group calibration is an approximation for a range of individual fitness levels Heart Rate above sleep HRaS based on individual sleeping HR is used to reduce error but individual calibration is more accurate Individual calibration eguations may be used in the Actiheart instead of the default group calibration ones The user may derive these values in the usual way by means of a treadmill test as described previously A typical calibration curve is shown below PAI AEE J min kg Sleeping HR For convenience the AH includes a built in step test protocol which can be used for deriving the
47. age is shown e File export exports a file in either Tab Delimited or Comma Delimited text format The default text file name and location are shown and clicking Save will export the data Alternatively clicking Save As allows an alternative file name folder location to be specified The export procedure is identical for all recording modes 3 2 Analysing a Short Term Recording The recording required for analysis can be selected by either double clicking on it or highlighting it and clicking on Analyse The Short Term analysis screen will be shown which is divided into 4 areas as shown below Actiheart Short Term Analysis Sex Print Preview Copy Export Edit rM User ID Sleeping HR DE ge WH NETUS MELDEN OO sv ENIN ug 2004 15 50 jji Analys s Results SDNN SDANN RMSSD Triangularindex A User and Recording Details This area shows the parameters of the chosen recording namely those for the user and those for the start and finish times of the recording Actiheart User Manual 4 0 35 Jan 2010 21 B Heart Rate amp Activity Graphs This area shows a graph of activity data in black and heart rate data in red for the duration of the recording Further details of the controls and functions are provided below C IBI Analysis When part of the Heart rate amp Activity Graph is highlighted left click and drag this area provides a detailed analysis of the be
48. as possible apnoeic events can be reviewed An example of the zoom window with possible apnoeic events marked in black underneath the heart rate and activity data is shown below Beat to Beat Zoom lole Actiheart User Manual 4 0 35 Jan 2010 74 5 6 1 Previewing Data It is possible to preview the window and beat to beat zoom data for the recording This is done by selecting Preview from the drop down menu 5 6 2 Printing Data It is possible to print out the window data the histogram and the general statistics of the recording This is done by selecting print from the drop down menu at the top of the screen 5 6 3 Copying Data Data can be copied from the software for pasting into an external program of the user s choice The selected data is exported to the clipboard and can then be pasted from there into e g Microsoft Excel There are three options a Copy raw data This takes the raw activity heart rate and IBI data and puts it on the clipboard This is done by selecting first Copy and then Raw Data from the drop down menu at the top of the screen b Copy Detailed Statistics This is done by selecting first Copy and then Detailed Statistics from the drop down menu at the top of the screen Provides a report with epoch by epoch time stamped data containing Activity BPM IBI Sleep stage and comments c Copy marker summary This is to copies areas of interest that may have been labe
49. at record and uses them to derive an empirical measure of sleep depth at 30 second intervals In the second stage this measure is combined with the movement record to produce an approximate estimate of sleep stage The empirical sleep depth measurement is calculated from Absolute heart rate a lower heart rate implies greater sleep depth Size of breathing peak in HRV spectrum larger implies greater sleep depth Total of all HRV smaller implies greater sleep depth The absolute heart rate refers to the average rate during the interval The breathing peak is a prominent peak in the HRV spectrum normally around 0 2 0 3Hz generated as a consequence of heart rate varying slightly with breathing Slowing and deepening of breathing will amplify the magnitude of the peak Faster and shallower breathing will have the opposite effect The total HRV measure includes a wide band of HRV in addition to the breathing peak Additional HRV outside the breathing peak tends to reduce during deep sleep After the sleep depth measure has been calculated for the whole night the movement record is used to identify periods of waking and a combination of thresholding and hysteresis is applied to identify the different sleep stages The two stage calculation is necessary because the thresholds vary from individual to individual as a consequence of normal heart rate and HRV variation and so must be derived from the night s data as a whole Cli
50. at to beat interval for the highlighted region This is discussed in more detail below D Statistical Listing When part of the Heart rate amp Activity Graph is highlighted left click and drag this area provides a detailed listing of statistical activity heart rate and IBI data for the highlighted region This is discussed in more detail below 3 2 1 Heart Rate amp Activity Graph Controls The Heart Rate amp Activity graph has a number of controls and functions as described below Adjust Heart Highlight the analysis Hold down right l E Rate Scale period by left clicking mouse button for Adjust Activity BPM dragging releasing epoch information Spale Cotinis Display a larger Change the Analysis Epoch Note This Fine adjust Analysis Period version of the graph analysis epoch is for post hoc analysis Start End or select all see below for purposes only as the data collection data Click Analyse after details epoch is fixed at 15 seconds making changes Clicking on the Zoom Window button produces a fully scaleable zoomable version of the graph as shown below Beat to Beat Zoom Click and drag with the left mouse button to scroll through the data Use the zoom in and out buttons to change the time scale Use the controls to the left and right of the Actiheart User Manual 4 0 35 Jan 2010 22 graph to change the vertical scale Resizing the entire window will change the graph size to fit the
51. ate resting energy expenditure REE from energy expended during physical activity AEE The flex point is required when HR alone is used to estimate EE This is commonly referred to as the Flex HR method and it has been thoroughly validated elsewhere The Flex HR was first defined as the average of the highest HR during rest and the lowest HR during incremental exercise in a treadmill test If HR is below an individual s Flex HR point AEE is normally assumed to be zero the only energy expended being resting energy expenditure REE For HR values above FlexHR EE is predicted using a regression line The AEE is set to zero in the classical HR only model to avoid overestimation of EE in daily living This does not apply to the model below due to the low weighting given to HR compared with activity in daily living Where HR and activity are combined the derivation of the regression line is the same is similar A multi linear regression MLR equation is derived and expressed in terms of both activity counts and HR Flex HR is normally not used in such an equation The above techniques rely heavily on individual calibration and have to date been shown to be effective for selected field based activities and for estimating AEE in free living Branched modelling proposed by Brage 4 uses movement data quantitatively and has the following aims a To achieve better estimates of AEE than those obtained using MLR b To interpret simultaneous HR and acc
52. aved with the Actiheart application Actiheart User Manual 4 0 35 Jan 2010 27 1 Ensure that the editing program is in the Program Files folder on the same PC as the Actiheart application Ensure that this program is named extedit exe 2 Load AH short term file and manually edit the IBls as necessary Click External Edit This exports the IBI data to a file called IBledit txt located in the root of the AH Program folder and it calls the external application Please note that the External Edit button is only visible if the editing application mentioned above is resident in the Program Files folder 3 Edit the file in the external application and close When the external program returns its value the new IBI txt file will appear in the AH edit screen When the AH edit screen is exited without cancelling the edited data is saved in the database 4 The new information does not overwrite the original data When the file is reopened from the AH application and edited data is available the user will be asked if they want to use it WARNING The Actiheart application must stay open throughout the editing The extedit exe program must not return until it is complete Windows programs such as notepad exe return as soon as they have finished loading and therefore cannot be used as editing programs Actiheart User Manual 4 0 35 Jan 2010 28 3 3 Long Term Recording 3 3 1 Setting up a Long Term Recording The lon
53. by the group calibration regression equations shown below for adults and children respectively These have been derived by walking and running on a treadmill in studies conducted with the Actiheart 5 6 7 and are included in the Actiheart EE analysis Actiheart User Manual 4 0 35 Jan 2010 84 The equations below the flex points are derived using the flex point itself and the regression line above it The HR is not set to zero at the Flex point as is normal for the reasons mentioned previously The movement flex point is a relatively new concept 4 which serves to interpolate the intensity curve of activity in the region between rest 0 0 and the slowest walking speed HRaS Heart rate above sleeping heart rate ADULTS Based on references 5 amp 7 PQ PAI 5 5 HRaS 94 16 male sex 1 2 HRaS male sex OP gradient 5 5 23 94 16 male sex 1 2 23 male sex 23 OP PAI OP gradient HRaS A y HRaS Flex Point HRaS PAI MN PAI 0 21 cpm 21 77 male sex OM gradient 0 21 133 21 77 male sex 133 N OM PAI OM gradient cpm M gt CPM Flex point 133 CPM Actiheart User Manual 4 0 35 Jan 2010 85 CHILDREN Based on reference 6 PAI PQ PAI 6 1 HRaS 73 1 20 7 male sex 1 4 HRaS male sex OP gradient 6 1 23 73 1 20 7 male sex 1 4 23 male sex 23 OP PAI OP gradient HRaS 11nn1111nnn gt HRS Flex Point HRaS Oo Above equation is based
54. cache is reset to zero The sum is restored to its original value when the data is read into the computer The accelerometer is designed to detect vertical movement with the person upright It is therefore important for maximum accuracy that the Actiheart be positioned on the chest so that the sensor is as horizontal as possible See the Guide to Getting Started for further details on positioning the Actiheart Actiheart User Manual 4 0 35 Jan 2010 79 ECG specification Sensitivity 250uV Range 30 BPM to 250 BPM Sampling frequency 128 Hz 8ms Input impedance 10MOhms R wave detection dv dt with variable threshold HR algorithm Average of the last 16 good IBls recorded IBI logging algorithm Interpolation is used with a resolution of 1 ms Heart Rate Measurement Heart rate is measured in the following manner The ECG signal is electronically amplified by a factor of 900 The amplifier has a frequency response of 10 to 35 Hz The resulting ECG signal is then sampled at 128 Hz The R wave negative edge is identified by using the Pan Tompkins real time QRS detection algorithm The average difference of ECG samples n and n 1 and ECG samples n and n 2 This average differential measurement removes most of the lower frequency components Detection for this differential value also compensates for variation in the signal level due to physiological changes and noise The Actiheart firmware applies a detection threshold w
55. ch is identified as a stress epoch and the stress factor is 2 then the weighting applied to HR Activity will be 20 80 REFERENCES 1 Rennie K Rowsell T Jebb SA H D and Wareham NJ A combined heart rate and movement sensor a proof of concept and preliminary testing study Eur J Clin Nutr 54 409 414 2000 2 Strath SJ Bassett DR Jr Swartz AM and Thompson DL Simultaneous heart rate motion sensor technigue to estimate energy expenditure Med Sci Sports Exerc 33 2118 2123 2001 3 Strath SJ Bassett DR Jr Thompson DL and Swartz AM Validity of the simultaneous heart rate motion sensor technigue for measuring energy expenditure Med Sci Sports Exerc 34 888 894 2002 4 Soren Brage Niels Brage Paul W Franks UIf Ekelund Man Yu Wong Lars Bo Andersen Karsten Froberg amp Nicholas J Wareham Branched eguation modelling of simultaneous accelerometry and heart rate monitoring improves estimate of directly measured physical activity energy expenditure J App Physiol 96 343 351 2004 First published September 12 2003 10 1152 japplphysiol 00703 2003 5 Seren Brage Niels Brage Paul Franks Ulf Ekelund Nicholas J Wareham Karsten Froburg Cross Validation of Intensity Prediction equations for treadmill walking and running The combined heart rate and motion sensor Actiheart Institute of Public Health University of Cambridge UK and 2 Institute of Sport Science amp Clinical Biomechanics University of
56. cking on the Sleep Staging tab at the bottom of the analysis screen produces the following screen Actiheart Sleep Analysis oc 0 a cie Print Previ Copy Export Sleeping HR Recording d Thu 17 Nov 2005 2222 Height ne jM 3 Beat to Beat Zoom Estimated Sleep Stage Drag the TO BED and GET UP marker to position and click her analyse Sleep Statistics Bed Time 23 29 Sleep Start Sleep Latency Light Sleep Get Up 08 26 Sleep End E Time Awake m Deep Sleep Time inBed Sleep Time Sleep Efficiency REM NNI Apnoea Screening Apnoea Search Spectrogram Detailed Statistics E Actiheart User Manual 4 0 35 Jan 2010 68 This screen is divided into four sections a Top section This shows the parameters of the chosen recording namely those for the user and those for the start and finish times of the recording b Second section This shows the activity data in black and the heart rate data in red for the duration of the recording The scale of these can be adjusted using the sliders to either side of this display c Third section The Estimated Sleep Stage window is used to display the sleep stages calculated from the sleep period of the recording d Fourth section The Sleep Statistics window is used to display sleep parameters derived from the sleep stage window Moving the To Bed and Get Up sliders to the respective bed times and get up times
57. ction 4 2 7 for details of this process Actiheart User Manual 4 0 35 Jan 2010 29 3 3 2 Summary of Long Term Recording Times Epoch Length With IBI Without IBI tick the disable HRV option 1 Minute 21 days 21 days 30 Seconds 21 days 21 days 15 Seconds 11 days 21 days 3 3 3 Setting Up a Recording Delayed Start For details on how to set up a delayed start recording please see Section 3 1 3 3 3 4 Downloading Long Term Data from the Actiheart Downloading a long term recording is the same as any other recording For further details please see Section 7 of the Guide to Getting Started The data is stored in the selected database for analysis 3 3 5 Viewing Details of a Long Term Recording For details on how to view a long term recording please see Section 3 1 5 3 3 6 Database Export and File Export Please see details in Section 3 1 6 Actiheart User Manual 4 0 35 Jan 2010 30 3 4 Analysing a Long Term Recording The recording required for analysis can be selected by either double clicking on it or highlighting it and then clicking on Analyse This will produce the following screen A Activity Heart Rate and IBI Variability Print Preview Data Copy Comment Thu 04 Mar 2004 Selected day Fri 05 Mar 2004 Sat 06 Mar 2004 Ave 39 Min 55 Max 245 All days Ave 78 Min 46 Max 245 06 00 Bus 4 See Hd Keel ESA E Sg IBI ms 1000 0 00 00 06 00 12 00 18 00 00 00 em e
58. culation of Energy Expenditure eeeeeeseeeeeeeeeeeeeeeeee nennen nennen nnn nnne nnana 94 Appendix 6 Validation Posters neos titre rr kao ERE p SEENEN DECKEN een 95 Actiheart User Manual 4 0 35 Jan 2010 7 1 Actiheart Databases 1 1 Recordings Database 1 1 1 Read Info Table Actiheart User Manual 4 0 35 Jan 2010 The Actiheart uses two Microsoft Access databases to store data and settings respectively Access is not required in order to record read and analyse data However Access is required if a user wishes to view the details of certain records which are not viewable through the user interface or if a user wishes to customise certain settings If Access is to be used then it should be version 2002 or later The database s which hold the recorded data are created and named by the user and by default are saved in C Documents and Settings Computer User Id Actiheart Data The software is shipped with a database actiheartdemo mdb which contains demonstration files The Settings database is also shipped with the software and is placed in the Actiheart Program File during installation This database holds recorded data and has five tables two of which Energy Calibration and Weights are not used The two key tables are Read Info and User Info This is probably one of the most important tables in that it contains all the raw data This database is populated every time that the Actiheart is r
59. curately derived to within one millisecond using an algorithm to remove noisy and spurious beats The actual data values in each 15 second epoch can be displayed by pressing and holding down the left mouse button whilst scrolling in the top graph All the data can be copied to the clipboard IMPORTANT The end point of the test which is important for the calculation of the recovery is occasionally set incorrectly by the software It is possible to set the end point manually to the nearest second in the following manner Right click in the bottom third of the screen until only the movement waveform is visible Then double click on the point where the activity ceases A vertical blue line will appear at that point and the following message will appear Actiheart 4 Do you want to use this as the end of the step test 4 5 7 The Energy Regression Equations The Step Test has a linearly increasing step rate from 15 to 33 step cycles per minute after the first minute As the weight and step height are constant the energy needed by the user is proportional to the step rate so the energy expended is also linear during the test A straight line can therefore be fitted to the data The resulting regression equations are shown at the bottom of the screen They are of the form BX A and these values are displayed along with the R value of the data An R value of 1 shows a completely straight line fit of the data For details of how the regression equatio
60. der charger will be displayed in the right hand part of the screen when the reader charger is correctly installed and connected There are no user settings for this device The older style single channel reader may require the selection of the correct COM port this is typically automatic when the software and drivers are installed If the reader is not detected click the search button to detect the reader and assign the correct port Note that it is not possible to manually change the port numbers If there are persistent problems with the reader please follow the appendix at the rear of the Actiheart Guide to Getting Started detailing the installation of USB drivers The latest drivers are also available for download from our website at www camntech com drivers htm Actiheart User Manual 4 0 35 Jan 2010 16 2 5 Verify Actiheart Setup This facility is provided in order to easily check the setup parameters of a recording Actiheart r Verify Actiheart Setup Current Actiheart setup UserlD 99901 R wave Start date Friday 29 4ug 2008 Logging type Waveform capture mode Data recorded 0 bytes 1513 Setup actiheart H90000133 for waveform99901 2 6 Database Management The lower part of the Actiheart Settings and Utilities windows provides information and tools for the management of the database Database selection W Users Howard Smith amp ppD ata Actiheart data Actiheartdemo mdb Current Comp
61. domain frequency plot of the analysed IBls FFT Tab The Fast Fourier Transform FFT display provides a frequency domain representation of the analysed IBIs The VLF LF and HF bands are shown Actiheart User Manual 4 0 35 Jan 2010 23 3 2 3 Analysis of IBI Data Statistics Statistical information about the IBI data is shown in the area below the Analysis Graph window The detail that is shown here is dependent on the analysis epoch selected Note that the analysis epoch is for post hoc analysis purposes only as the data collection epoch is fixed at 15 seconds The following data is shown for each analysis epoch e Activity The total number of counts in the analysis epoch e BPM The average heart rate in beats per minute for the analysis epoch e IBI Ave Average Inter beat Interval IBI for the analysis epoch e IBIMin Minimum IBI in the epoch e IBI Max Maximum IBI in the epoch e SD Standard Deviation of the IBI data e RMSSD The root mean square of the successive differences of the IBI s If either a 1 minute or a 5 minute post hoc analysis epoch is selected then the following further information is also available e LF The low frequency component of the IBI derived using an FFT e HF The high frequency component of the IBI derived using an FFT e LF HF The ratio of the LF component to the HF component of the IBIs Additionally in the case of the 5 minute epoch the VLF very low frequency component of the IBI is also visible No
62. e PC and the Actiheart are working properly and it is also a check that the recorded header date time ID Serial No has not become corrupted Clicking Test and Maintenance then the Terminal tab brings up the following screen with a three step routine Please note that the routine below will not cause any stored data to be lost FS L I Test amp Maintenance meom Information Test Battery Test Fmwse Terminal ReaderTest Communicating directly to Actiheart This can only work if battery is not discharged Press F1 to reset Actiheart Press F2 to show Actiheart setup Press F3 to reload Actiheart setup First press F1 The LED on the reader will flash This will reset the Actiheart If a gt prompt appears thereafter the communications are working normally If there is no gt prompt then there could be a fault with the Actiheart Press F1 again and if the gt prompt is still not displayed please contact CamNtech for assistance If communications are OK press F2 This will read the header information recorded in the Actiheart The format of this header information is as follows unless it has become corrupted If the latter has occurred proceed to step 3 below in order to recover the recorded data 12 Feb 2009 12 37 Mike Purday Step Test 030F100000 019057 H90000001 7E 02 0A 16 Pressing F3 will load a dummy header to enable the unit to be read
63. e following screen E DI Actiheart Sleep Analysis Print Preview Copy Export Sleeping HR Height 1 7 MI lulil li ul i B1 IBI ms Time Activity i 0 SD Rmssd Calculate LF HF 5236 TI 20 16 42 00 531 2000 40397 21018 16 42 30 761 1997 1119 16 43 00 740 1054 873 No of 16 43 30 783 2255 1233 Beats 16 44 00 774 1561 1070 15 44 30 761 1451 8 16 45 00 776 1923 d 16 45 30 752 14 16 5 1000ms 2000ms 16 46 00 747 17 53 16 46 30 842 50 78 Triangular Index 20 ka 16 47 00 764 35 95 16 47 30 666 1289 74 SDNN P 16 48 00 een 1041 5 16 48 30 781 51 21 16 SDANN P 16 43 00 792 4035 15 16 43 30 737 up 10 RMSSD 27 43 Sleep Staging Apnoea Screening Apnoea Search Spectrogram This screen is divided into three regions Top region This shows the parameters of the chosen recording namely those for the user and those for the start and finish times of the recording Second region This shows the activity data in black and the heart rate data in red for the duration of the recording The scale of these can be adjusted using the sliders to either side of this display Third region This section shows the analysis results for the complete recording in 30 sec analysis epochs e Activity The total number of counts in the analysis epoch e BPM The average heart rate in beats per minute for the analysis epoch e IBI Ave Average Interbeat Interval IBI for the analysis epoch e IB
64. ead The following information is stored along with the raw data e Computer Name e Computer User e Read Time e Start Time This is the time at which the recording started e Serial No e Bat Voltage This is the battery voltage when the data was read e User ld This is the User name which was used for the recording If a Test Id was also used then the User Id field will be displayed as User Id_ Test Id e g 99934 bike treadmill e Test type This is the recording mode e g IBI Variability Waveform see Section 8 of the Guide to Getting Started e Samples This is the file size e Step Size This is the step size at which a test was conducted and is very important reference information for the reasons given in Section 4 4 e Mask Comments Describes the type of mask applied to the data For a description of masks please see Section 3 4 1 on the Edit tab in long term recording 1 1 2 User Info Table 1 2 Settings Database Actiheart User Manual 4 0 35 Jan 2010 This table contains User details many of which affect the calculation of energy expenditure These are all entered from the AH application and they are e User ld e Height e Date of Birth e Weight This is used to calculate Resting Metabolic Rate RMR from the e Schofield equations see Appendix 3 It is also used to calculate Energy Expenditure from Energy Intensity The database field is called Start Weight e Resting Heart Rate Resting HR
65. ease refer to Section 5 3 6 for further details Actiheart User Manual 4 0 35 Jan 2010 70 5 5 Apnoea Screening Clicking on the Apnoea Screening tab automatically performs a frequency domain analysis of the cardiac inter beat interval increment of the recording as shown in the screen below DI Actiheart Sleep Analysis Print Preview Copy Export Sleeping HR M SECHE i WA ludi Whole period IBI increment analysis PSD 0 to 0 5 Hz A value of above 2 4 in an adult suggests they may suffer from Obstructive Sleep Apnoea AHI gt 10 0 01 0 05 Hz 0 01 0 5 Hz en Detailed Statistics Sleep Staging ET H Apnoea Search This analysis extracts the Very Low Frequency component of the IBI as shown in the results below Whole period IBI increment analysis PSD 0 to 0 5 Hz VLFI 45 A value of above 2 4 in an adult suggests they may suffer from Obstructive Sleep Apnoea AHI gt 10 0 01 0 05 Hz T2 0 01 0 5 Hz 493 Analysis carried out on 0 9 of data Detailed Statistics Sleep Staging Apnoea Screening The Apnoea screen is divided into three sections a Top section This shows the parameters of the chosen recording namely those for the user and those for the start and finish times of the recording b Second section This shows the activity data in black and the heart rate data in red for the duration of the recording The scale of these can be adjusted using the sl
66. easure and units of AEE The following options are available for AEE measure e kg min e min e kg e epoch e MET For AEE units Joules KJoules Calories KCalories It is also possible to alter the following parameters from the Display tab Heart rate scale Activity scale Display width Display centre Actiheart User Manual 4 0 35 Jan 2010 53 4 4 12 The AEE Tab 4 4 13 The Model Tab 4 4 14 The Comments Tab 4 4 15 The Utilities Tab The AEE tab shows the average and maximum AEE for each day of the study and the average for the whole study Epochs that have been removed are excluded from this calculation Not worn epochs are included provided Autofill has been selected In epochs with no HR the AEE is calculated using only activity It is also used to select whether the branches are visible as previously described This tab is used to select the model used in the AEE calculation It is possible to select the branched model or either just activity or just heart rate from this tab The selected energy model is also shown here The selection process is described in Section 4 4 7 This tab allows a comment to be stored with the recording This could be for example the type of pads used in the study or information about the type of activity or exercise being done This tab has a number of functions Remove Copy Unmark Include and Trim these are described in Section 3 4 1 AEE and TE
67. eat Interval IBI of the heart rate are recorded in this mode The epoch length for this mode is fixed at 15 seconds Selecting the Short Term Recording tab brings up the following screen r Short Term BPM Heart Rate and IBI Monitoring pv uw E wae Beat by Beat Short Term Monitoring Qe s LER n 23 0ct 2003 14 53 21 Nov 2005 22 35 17 Nov 2005 22 22 Apneal sleeptest 23 Mar 2004 22 00 IBledit 17 Nov 2004 00 58 Apnea Sleeptest 08 Mar 2004 20 00 39934 bike treadmill 11 Nov 2004 15 26 39940 bike treadmill 22 0ct 2004 13 28 39912 bike treadmill 21 0ct 2004 13 53 KE NUDE EE A Short Term recording is set up in the same way as a Signal Test recording by clicking on the set up button then following the set up wizard For further details please see Sections 6 amp 7 of the Guide to Getting Started Delayed Start allows the user time to set up an Actiheart or several Actihearts and for them to start recording at a time in the future This can be useful for example when setting up a group of subjects together The maximum start delay is 72 hours The Actiheart will not begin recording until the start time is reached All times are taken from the clock on the host PC The term HRV is a generic term used in this manual to indicate the variability of the cardiac Interbeat Interval The number of intervals available for analysis and the measure of variability used varies according to the application Actihea
68. eive cups aa E REENEN 60 4 5 10 Copying Data for a User 60 4 5 11 Printing and Previewing ccccccccsssssssecececeesesesseseceeeceseesesaeseeeeeceseeseaaeseeeeecesseseeaeseeeescussesaeaeseeeesseuesaeaeseseeesessenaeas 60 4 5 12 Create Derived Short Term Recording eene nennen enne nnns aan nana aan nass enaa setas sanas reser sinas 60 LECMENIIIe c Tat 60 BEE ESCH Maele Ke LTE e 61 5 0 Sleep Analysis Research Engen Seege 62 MEI UN VUN NSN 62 5 1 1 Choosing an Application for Making a Recording susanna aan aaau aa aan a aan aan KaRa Kaas 62 5 2 Sleep Anal EIE CIT MERE 63 5 2 1 Setting up a Sleep Recording ssa ERAN ante reco e codage Ye raa eee Re bee ecran de ea Ne ENEE 63 5 2 2 Setting up a Recording Delayed Start 64 5 2 3 Reading Downloading a Sleep Analysis Recording nennen eene enne enne ana a a nennen 64 5 3 Analysing a Sleep Analysis Recording ccccsessssccececeesesssaecececscessesaaaecececsseusesaeaeceeeceesesauaeaeeeeecuseesauaeaeesessessesanaeeesess 64 5 3 1 Viewing a Specific Data Point 66 E Te Ree Lu EE 66 53 3 Previewing Daer eege 67 5 3 4 Printing Data WEE 67 5 3 5 CODVING RE EE 67 5 3 6 Exporting RE EE 67 Actiheart User Manual 4 0 35 Jan 2010 5 E BE RTE 68 5 4 1 UHTIBAPEI M 70 5 4 2 Printing Datarcvssc2ecsidc cast Eed NEESS
69. elerometry data into minute by minute Physical Activity PAI c To minimize the need for individual calibration d To establish a framework that can be used for estimating more accurately AEE in free living Actiheart User Manual 4 0 35 Jan 2010 83 P4 HR PAI 1 Relationship P2 HR PAI 2 Relationship 1 P Act PAI P3 HR PAI 3 Relationship 1 P3 Act PAI Abovez P HR PAl 4 BPM Relationship 1 P Act PAI P1 P4 are weighting factors X is used to discriminate between activity and no activity Y and Z are used to apply HR thresholds in the presence and absence of activity respectively Y is used to discriminate between walking and running At running speeds HR is a very reliable measure of EE whereas activity as measured by vertical acceleration is less reliable since during running the latter does not increase linearly with speed This is reflected by the weighting in Box 1 where P1 is high At the other end of the spectrum HR is a poor measure of intensity whereas movement registration is more reliable and this is reflected by a relatively low weighting of the HR EE relationship i e P4 is low Z is used to discriminate between raised HR due to some true activity in the presence of no activity as set by X and raised HR due to other factors In boxes 2 and 3 movement and HR are equally weighted The HR PAI relationship and the Activity PAI relationships are given
70. ep Size in the Read Info table of the Recordings Database see Section 1 1 1 Actiheart User Manual 4 0 35 Jan 2010 61 5 0 Sleep Analysis Research Only 5 1 Overview 5 1 1 Choosing an Application for The Actiheart for Sleep software can be used for analyses to aid the detection of Obstructive Sleep Apnoea OSA and to identify the sleep stages Note that this is an optional software module for research purposes only It is not verified or guaranteed in any manner and all results should be treated with caution Two techniques are utilised in the Actiheart for OSA screening The first Section 5 5 relies solely on the use of Heart Rate Variability HRV analysis This technique does not attempt to identify specific apnoeic episodes The second technique Section 5 6 attempts to pinpoint individual apnoeic occurrences through the use of either HRV alone or HRV combined with ECG Derived Respiration EDR EDR is an indirect method of monitoring respiration It is not as accurate as direct methods that measure airflow directly ECGs recorded from the surface of the chest are influenced by the motion of the electrodes with respect to the heart due to expansion and contraction of the chest during breathing The ECG is also affected by changes in the electrical impedance of the thoracic cavity due to the filling and emptying of the lungs These physical influences result in amplitude variations in the ECG waveform which is inversely c
71. ersible by reselecting Trim and then selecting Cancel After a file has been trimmed the following message is displayed Actiheart 4 The data length has been manually trimmed This message is also shown when a trimmed file is first selected from the list of available recordings in the long term recording mode 3 5 Previewing amp Printing Long Term Data There are three printed report options that may previewed on the screen preview menu or printed as a hard copy print menu e Preview Print Days Provides an 8 day graphical report of Heart Rate and Activity data starting from the currently selected day e Preview Print Circadian Review Provides a 7 day report of double plotted heart rate graphs with an average SD graph for the period starting from the currently selected day e Preview Print Window Data Provides a detailed graphical report for the currently selected day Actiheart User Manual 4 0 35 Jan 2010 34 3 6 Auto Clean STEP 1 Cleaning The Auto Clean option may be accessed from the Data menu Lost or corrupt HR data can sometimes be recovered by applying a cleaning algorithm provided the recorded file is a Variability file and not a Normal file see Guide to Getting Started There are three steps in the cleaning process This involves setting suspect values to zero according to the following criteria i If HR lt 30 or ii If HR gt 30 and the rate of change of heart rate is
72. es The techniques used for estimating EE from either activity or heart rate alone involve establishing calibration curves of activity vs VO2 and HR vs VO2 This is done in a laboratory usually on a treadmill or a bike for lower body activity If using a treadmill subjects walk at a variety of incremental speeds and gradients and HR or activity counts are measured and plotted against oxygen consumption VO2 A curve is fitted to the data using linear regression and the resulting regression equation is used to predict VO2 and hence EE litre of Oxygen 4 8 kcal 20kJ EE is often expressed as an average intensity in terms of metabolic units or METS which represent multiples of resting metabolic rate 1 MET 3 5 ml kg min or 0 01 7Kcal kg min HR Calibration curves are unique to an individual due to physiological variations stroke volume haemoglobin content etc Actiheart User Manual 4 0 35 Jan 2010 82 The Branched Equation Model for Estimating AEE from Simultaneous Activity and HR Calibration curves of activity vary due to biomechanical factors and possibly to the activity mode too It is more economical in terms of participant and researcher workload to use a group regression equation although individualized regression equations are more accurate In the case of both activity counts and HR there is a point below which the linear relationship no longer holds This is referred to as the Flex Point and it has been used to demarc
73. fault ones supplied with the software but a user can specify his own The branched model discriminants can also be varied at will This information can be viewed directly from the application without having to open the database see Sections 4 3 3 and 4 4 7 1 2 1 Energy Models The Step PAI table contains the PAI HRaS regression equation obtained from the Step Test see Appendix 4 StepPAl WARNING When creating new equations or varying any of the branched model values do not replace any of the default values but create a new record in the database The different energy models available to analyse recordings are controlled by entries in the paee table of the settings database If you wish to experiment with a new model or combinations of existing models you may add new rows to this database You should do this with some caution and we can make no guarantee as to the energy expenditure results you will gain You must not alter the existing rows Each row added to the table will result in a new energy model being added to the list available within the software Most of the columns needed for each entry are shown in the diagram on the following page linked to the corresponding entries in the branched model parameters window The remaining columns are explained immediately below ViewOrder This number determines the order in which the models will be displayed within the software If adding a new model simply choose a higher number f
74. g min 20 2 HRaSmax HRmax SHR The maximum HR for an individual is predicted from age HR max 208 0 7 age and is based on a meta analysis done by Tanaka et al Tanaka H Monahan KD Seals DR Age predicted maximal heart rate revisited J Am Coll Cardiol 2001 37 1 153 56 If individual calibration is based not on Step Test data but on measured HR and VO2 data e g in a laboratory the external data can be imported into the AH Power J kg min Den 8 mins N Counts amp PStep at 1 Minute Counts Counts step 8 mins Slope B Count step J kg count Intercept o Count step J min Kg 93 Calculation of Energy Expenditure Appendix 5 seuo uijowun oj p ij d paloajas si spollad uJo Jo eDeJeAy WU ony ssejun pepnjoxe ase spoueg UI0mun Spoiled pepnjoxe UJOM JO 30 33V s VIVA GAAOWSY poned pepJooes 33H gy1 33v N33MHOS Q3ONVAGV 3JYNLION3AX3 A943INI Spoiled OM J04 FAV poised PSpiodsi 10j 394 Duip1o281 sponsa jo poued au OM JOJ ase Sje30 j 1801 FAV Jav Pue 338 SJH vc 334 N33HOS ONT AIYA seuo ujowun o p ij d spoued ulom jo eDeJleAv Spoiisd WOM JO 0 33V SJH vc 334 Spoiled UJOM jo 1101 33v SIH pZ 334 94 Actiheart User Manual 4 0 35 Jan 2010 Appendix 6 Validation Posters The following posters are to be found on the software CD S ren Brage Niels Brage Paul Franks Ulf Ekelund Nicholas
75. g term recording mode allows a recording of up to 21 days to be made Heart rate and activity data is recorded along with the option to record the IBI minimum and maximum intervals within an epoch The epoch length is user selectable and can be 15 seconds 30 seconds or 1 minute These epochs can either be without or with the IBI data The resulting file types are designated Normaf or Variability files respectively For more details of file types refer to Section 8 of the Guide to Getting Started Selecting the Long Term Recording button from the front screen brings up the following screen r Long Term BPM Heart Rate and Min Max Statistics fe LongTerm Monitoring Actiheart monitor Recordings available to analyse Stressed free 28 Apr 2004 06 00 26 May 2004 06 00 29 May 2004 06 00 22 May 2004 06 00 08 May 2004 06 00 24 Apr 2004 06 00 17 Mar 2004 06 00 20 Mar 2004 06 00 99905 free 20 Mar 2004 06 00 REH WER Em A recording is set up in the same way as a Signal Test recording For further details please see Section 7 of the Guide to Getting Started If the user is not yet set up in the database please refer to Section 6 of the Guide to Getting Started on setting up a new user WARNING If a file is recorded for Energy Expenditure Analysis purposes the Disable HRV box must not be ticked so that a Variability file is recorded The IBI data in the file is required for recovering lost HR data see Se
76. hose sensitivity changes with the amount of physical movement detected by the Actiheart At the end of each epoch the R R interval durations for the last 16 good heart beats are analyzed to get a representative value and remove noisy or missed beats The 16 values are initially averaged Any that are outside of 25 of this average are removed The remaining R R intervals are re averaged converted to beats per minute BPM and stored in the memory 3 J Pan and W J Tompkins A real time QRS detection algorithm IEEE Trans Biomed Eng BME 32 3 230 236 1985 v Actiheart User Manual 4 0 35 Jan 2010 80 Actiheart Recording Times Sensor Calibration and Reproducibility Time Keeping Waterproof Case The Actiheart and Static Electricity The table below summarises the recording durations refers to Actiheart 4 Epoch 15 sec 30 sec 1 min Recording time HR 21 days 21 days 21 days Activity Recording time HR 10 days 20 days 21 days Activity IBI Max Min Maximum 96 hrs at 76 BPM Recording IBI 440 000 depending on beats maximum signal guality All Actiheart units are calibrated thoroughly on a specially designed rig before they leave CNT The Actiheart incorporates a calibration factor to produce the same output for the same amount of motion in terms of g A standardised Actiheart mounting and positioning protocol is used during calibration In practice inherent variation in positioning of Actiheart units means that
77. ht Weight kg Height m o AE H D Sleep HR Max HR o aximum Heart Rate o Sleeping Heart Rate KS ms D O B When changes have been made click Save to store the information e Erase If a user s details are no longer required click on a user in the list then click the Erase button to permanently erase the details There are three controls available in the preferences section as described below Enable Sleep Analysis This allows the Sleep Analysis function to be accesses from the main screen See section 5 2 of this manual for more information Add components This allows the addition of optional software components where available Contact CamNtech to obtain a license and software key to enable components Change Language Allows the software to be localised for the required language This is achieved by means of a text file containing translations of English into the required language The software will only show languages with a valid translation file present Contact CamNtech Ltd for more information Actiheart User Manual 4 0 35 Jan 2010 18 3 0 Activity and Heart Rate 3 1 Short Term Recording 3 1 1 Overview 3 1 2 Setting Up a Short Term Recording 3 1 3 Delayed Start for Short Term Recording The short term recording mode is designed for recording up to 440 000 heartbeats This recording mode allows for detailed heart rate variability HRV analysis Heart rate activity and every Inter b
78. iders to either side of this display c Third section The Analysis Results window shows a power spectral analysis of the heart rate variability data with the Very Low Frequency component highlighted in red and the low and high frequency in light blue Actiheart User Manual 4 0 35 Jan 2010 71 The VLFI is the percentage of very low frequency power spectral density on the total power spectral spectral density which has been identified as a well suited variable for screening patients with obstructive sleep apnoea For further details see Frederic Roche et al Cardiac Interbeat Interval Increment for the Identification of Obstructive Sleep Apnoea Journal of Pacing and Clinical Electrophysiology Vol 25 No 8 August 2002 pp 1192 1199 5 5 1 Previewing Data It is possible to preview the window and beat to beat zoom data for the recording This is done by selecting Preview from the drop down menu 5 5 2 Printing Data It is possible to print out the window data the histogram and the general statistics of the recording This is done by selecting print from the drop down menu at the top of the screen 5 5 3 Copying Data Data can be copied from the software for pasting into an external program of the user s choice The selected data is exported to the clipboard and can then be pasted from there into e g Microsoft Excel There are three options a Copyraw data This takes the raw activity heart rate and IBI da
79. iiri a ja 9 ECG level The main screen is divided into 6 main regions as shown above A User details Information about the user to which the recording relates B Tools Tabs displays analysis information and provides analysis tools C Day Selector Allows the analysis day to be quickly selected D Activity and Heart rate data Shows the activity and heart rate data for a section of the recording The heart rate data is shown in red and the activity data in black E IBI Min and Max data if recorded Shows the IBI min and max data the average of the two lowest IBI figures and the two highest IBI figures per epoch respectively for the recording displayed epoch by epoch F Lost data and ECG level the level of ECG signal and the of lost signal per epoch Details of the controls tools and graphs are provided in the following sections Actiheart User Manual 4 0 35 Jan 2010 31 3 4 1 Long Term Tools Tabs amp Controls The tools tab control B contains 5 tabs with the following functions e The Display Tab Allows the user to adjust the following parameters Heart Rate scale Activity scale Min Max IBI scale Display width adjustable down to 1 hour Heart Rate cursor shown on the screen in yellow IBI cursor Shown on the screen in yellow Display centre e The Heart Rate Tab allows the user to view the following information o The average minimum and maximum heart rate for the selected day of the rec
80. input it directly see Section 4 4 15 4 4 8 3 Maximum Heart Rate An estimate of HR max may have been entered into the database when a user was created This screen allows one to alter the initial value or to use the Tanaka equation as an estimate This is 208 0 7 x n where n age of the subject Selecting the Tanaka option will allow the estimate to be generated separately for each recording using the subject s age at the time of the recording 4 4 8 4 VO2 Max This parameter is a measure of an individual s fitness It is calculated automatically when a Step Test is performed See Appendix 4 for details of how this is calculated VO2 max is calculated from the value of PAI when the heart rate is equal to HR max To calculate proceed as follows e Select the calibration curve i e Step Test or Other HR e Ensure that any calibration data extends to the end of the table If real data e is not available use the Fill function which will extrapolate in a linear manner e Ensure that the HR max field has a value e Double click on the VO2 max This brings up one of the following messages depending on which calibration was selected Tanaka H Monahan KD Seals DR Age predicted maximal heart rate revisited J Am Coll Cardiol 2001 37 1 153 56 Actiheart User Manual 4 0 35 Jan 2010 50 Actiheart 4 Do you want to calculate the VO2 max from the Step test calibration and HR max If the RMR used is based on Schofield i
81. ircadian Components oonan a aan nananana aa A karsaa aaa sss a aa nana annan aan a aan nananana 36 4 0 Energy Expenditure Analysis ert nina ana Kakun kikan HO tase mn kk ni Ka uu EN ERR xi n Ama NN a KA ENEE 37 A OVET VIEW Mo DELE 37 4 1 1 Choosing an Application for Making a Recording momon ana eene nennen ennemis nennen thin aan a aa sinn naaaeen 37 4 1 2 Choosing an Application for Analysis uma aasia ate a ee duced ed eege e Een ao EENS De e is 37 4 1 3 Differences between the two Applications eene aan aan aan na aa aa aa aa ana anna aan nana enaa nian nns 37 4 2 Factors Affecting the Calculation of Energy Expenditure nananana aan a nennen enne annua aan a na aaaean 38 4 21 The Branched Model Settings tc gedet Aaa SN eet Eegeregie ele gege Lae uunia aitaa 38 4 2 2 Branched Model Adjustment in the Presence of Recovered Data 38 4 2 3 Branched Model Adjustment in the Presence Of Stress naan eaa annan aa naan na aa aa aa sse aaaaan 38 4 2 4 Individual CalibratiOn RE 38 4 2 5 Resting Energy Expenditure BEE 38 4 2 6 Sleeping Heart Rate SHR etre pni eren EE dee EVERE ENEE ee Eee eau gods 39 4 2 7 Lost Heart Rate D at EE 39 ADB Gaps Ir the RE E EE 40 4 3 Daily Energy Ee dE 41 4 3 1 Steps irn Performing aN Analysis E 41 4 3 2 Setting Up amp Downloading Reading a Recording c cccsscccessccesscccesseecsececssecesseceseecesaeceeneeceseeccateccsaeceesaeesees 41 4 3 3 Selecting an Energy MOdel EE 41
82. lled in the beat to beat zoom window 5 6 4 Exporting Data It is possible to export data for further analysis in other programs Please refer to Section 5 3 6 for further details Actiheart User Manual 4 0 35 Jan 2010 75 5 7 Spectrogram 5 7 1 Previewing Data 5 7 2 Printing Data 5 7 3 Copying Data Clicking on the Spectrogram tab automatically performs a calculation of the frequency spectrum of the heart rate signal as shown below e Actiheart Sleep Analysis i Print Preview Copy Export Height il Colours Red amp Blue C Black amp White The Spectrogram lines up with the recording above it and shows how the frequency components of the heart rate signal vary overtime Red areas show increased activity at a given frequency and blue areas very little activity A trace near or slightly above the centre of the plot normally appears during steady breathing and disappears when the breathing is weaker or less regular Significant components very near the bottom of the frequency scale may denote the presence of a regular longer period repetition such as Obstructive Sleep Apnoea Syndrome Detailed Statistics Sleep Staging Apnoea Screening Apnoea Search The resulting spectrogram as shown in the screen below lines up with the heart rate recording above it and shows how the frequency components of the heart rate signal vary over time The red areas show increased activity in a given frequency band
83. nergy model and used as a basis for the calculation of energy expenditure instead of the group calibration There are three possible sources of calibration data i Step test calibration If a user has done a Step Test for more details see later section on the Step Test then the software will automatically fill this screen with the parameters generated by the Step Test ii Other HR calibration If a calibration has been performed by some other means the data generated by this can then be entered here Read the Important Information before doing this iil Activity calibration If a calibration has been performed by some other means the data generated by this then can be entered here b Itis also possible to enter other parameters in the individual calibration screen which have a bearing on the calculation of energy expenditure and are described below Actiheart User Manual 4 0 35 Jan 2010 49 4 4 8 1 Measured RMR As mentioned previously the RMR is normally estimated from the Schofield equations If however there is a measured RMR for the user this can be inserted here To revert to the Schofield value at any time double click in the Measured RMR box 4 4 8 2 Sleeping Heart Rate It is possible to enter a value for measured sleeping heart rate in this screen Once saved this will overwrite whatever value was entered for that user in the database when the user was created If required the software can calculate this and
84. ng setup This may be replaced with a measured value from an overnight recording or another value which is more accurate than the original value entered The SHR can be changed from one of two locations e From the Utilities tab select database then select a user and edit the SHR e Goto the Advanced Energy Expenditure Press View Edit to bring up the Individual Calibration screen see Section 4 4 8 Lost or corrupt HR data will affect the calculation of AEE Therefore whenever a file is viewed in either Advanced or Daily Energy Expenditure an attempt is made to recover any lost data In those epochs where recovery fails the AEE is solely based on Activity There are three steps in the cleaning process This involves setting suspect values to zero according to the following criteria e If HR 300r e f HR gt 30 and the rate of change of heart rate is gt 100 132 amp 160 BPM Min fora 1 min 30 sec amp 15 second epoch respectively The cleaned data is analysed minute by minute and if the cleaned HR at any data point is gt 1 75 Filtered HR then the cleaned HR is set to zero Filtered HR is the average of the HR over the 4 minutes preceding the data point being analysed Between 4 and 16 HR values will be averaged depending on the epoch a Recovery For each minute where the HR has been set to zero each stored IBI minimum and maximum there will be minimum of sixteen if the epoch is 15 sec is used to calculate a
85. ns are arrived at please see Appendix 4 The activity equation is provided solely for information It is not used to derive an individual calibration based on activity and therefore it has no effect on the calculation of energy expenditure The heart rate equation on the other hand forms the basis of the derivation of a PAI HR calibration equation which can be used in the branched model in lieu of the group equations Actiheart User Manual 4 0 35 Jan 2010 59 4 5 8 Setting Up Multiple Users It is possible set up more than one user to do the Step Test simultaneously This is achieved by setting up the required number of Actihearts individually and setting them all to a synchronous start time Multiple steps will be required 4 5 9 Marking Bad HR data When manually reviewing the R wave graph and regions of bad signal are found it is possible to manually mark a 15 second block as bad data if you do not wish it to be included in the analysis This may be achieved by using the Bad HR data checkbox below the R wave graph a large red X will appear on the graph to show it is marked as bad data A small X will also appear at the top of the upper graph It is possible to select de select each of these marked blocks by double clicking on the small red X on the upper graph 4 5 10 Copying Data for a User There are 2 possible options for copying data to the clipboard for importation and analysis into an external program such as
86. o suit all applications The Daily Energy Expenditure application will calculate and report Activity Energy Expenditure and Total Energy Expenditure day by day The Advanced Energy Expenditure application will calculate and report Activity Energy Expenditure and Energy Intensity on an epoch by epoch basis e The Daily Energy Expenditure application cannot analyse IBI Short Term files Individual calibration data can only be viewed and edited using Advanced Energy Expenditure Sleeping HR for a user can only be set using Advanced Energy Expenditure HR maxcan only be set using Advanced Energy Expenditure REE can only be set using Advanced Energy Expenditure Using Advanced Energy Expenditure the energy calculation mode is selectable i e Branched HR only Activity only for further details see Appendix 2 Actiheart User Manual 4 0 35 Jan 2010 37 4 2 Factors Affecting the Calculation of Energy Expenditure 4 2 1 The Branched Model Settings The calculation of AEE is done using the Branched Model which is described in Appendix 2 The software contains certain default settings group calibration coefficients and branch parameters based on validation data However it is possible to customise these settings in order to create other variants of the model These settings reside in the Settings database where they can be edited using Microsoft Access However they can be viewed and applied from either the Advanced Energy Expenditure or
87. on that in 6 but modified for use with Sleeping HR instead of Resting HR PAI MN PAI 0 22 cpm 144 3 29 3 male sex OM gradient 0 22 133 144 3 29 3 male sex 133 OM PAI OM gradient cpm M 4 CPM Flex point 133 CPM Actiheart User Manual 4 0 35 Jan 2010 86 Default Parameter Values for the Branched Model The values below have been validated for walking and running and are believed to be reasonably valid for free living conditions Formal validation of the values for the latter conditions is in progress Therefore the values below are subject to minor changes as the branched model evolves and is validated for other activities 1 Flex HRaS Flex HRaS is defined as the average above sleep of the highest HR during rest and the lowest HR during incremental exercise during the treadmill test In 5 RHRaS at is 10 BPM and the HRaS at 3 2 kph is 36 BPM Thus the Flex HR is set to 23 6bpm 2 Transition HRaS This is the average between the highest walking and slowest jogging HRaS See 5 i e 80 4 BPM 3 X value Since cycling intensity is best guantified by HR when using walking running calibration eguations the value of X is chosen so that observations end up in one of the two top boxes 1 or 2 So a value of X has been chosen which is exceeded in cycling but at the same time is high enough to ensure that no movement including noise will be guantified by the two lower boxes P3 or P4 4
88. ond section This shows the activity data in black and the heart rate data in red for the duration of the recording The scale of these can be adjusted using the sliders to either side of this display c Third section The Analysis Results window is used to display potential occurrences of sleep apnoea and some statistics Moving the Fell Asleep and Woke Up sliders to the respective times and clicking on the white area produces one of the following messages If Record EDR was ticked when the recording was set up the message below is shown Actiheart 4 Use EDR data for apnoea detection Actiheart User Manual 4 0 35 Jan 2010 73 If Record EDR remained unticked when the recording was set up the message below appears Actiheart 4 Applying apnoea detection algorithm without EDR Clicking Yes or OK respectively produces the following screen Actiheart Sleep Analysis Print Preview Copy Export e hu 06 Sep 2007 16 42 ri 07 Sep 2007 15 33 Beat to Beat Zoom Potential Apnoea Periods Apnoea Detection Statistics Total minutes scanned 1097 Apnoea detected in p Mean apnoea mins hour 15 2 Review the areas indicated in black for possible apnoea Detailed Statistics Sleep Staging Apnoea Screening Apnoea Search Spectrogram The black vertical bars are estimated apnoeic periods during the night By expanding the window with the beat to beat zoom the periods identified
89. or example starting from 100 ActiheartFlex This controls the flex point value of activity counts where the EE prediction switches between a linear projection from the origin to the Act EE equation HRflex This controls the flex point value of heart rate where the EE prediction switches between a linear projection from the origin to the HR EE equation Jap2007Activity This controls whether the piecewise linear activity to EE model from the JAP2007 paper will be used common This determines whether the model appears when Show Common Models is selected Actiheart User Manual 4 0 35 Jan 2010 10 Vd Ed Cd Td 6 edyH LiredyH giedyH cieduH Je21 ves 2IIHOS SE d io3ssaug 18465813 sep Le amoy 60 33v epou payoueig 39 212 HHS 500 L segH S i coun El amoy S0 eaa 33v epou pauouerig SO 3xov SO e epow payoueig el suns 100 seg GE esgH S0 3xv Lol 33v pow payouerg ap yeay pue date Duisn japow pauiquios payouerg t e uHs 0 ajewy yHs 0 ITWHx Da w 0 95e 0 e fys YH dnos jov pu PINI H E3uHesp eeu Sl oreup seuH Zi HH JH Ee ege 1231591 days asn 33YH uoneiqre dnoit aey uesH Sange d 12 ING 0 aybtay 0 5e 0 3 E dnoit PH SH ae udo 0 wy A e wdo 170 2331 y huh odii au Wall SESCH ZEN dei 00zdvf Ie dnog sues an 7
90. ording o The average minimum and maximum heart rate for all days of the recording e The IBI Tab This tab shows the average and distribution of IBI s for both the currently selected day and for all days of the study e The Comments Tab This tab allows a comment to be stored with the recording This could be for example the type of pads used in the study or information about the type of activity or exercise being done e The Edit Tab The user is able to mark remove unmark include trim and copy sections of the data To manipulate a section of the data the required section first has to be highlighted This is done by left mouse clicking at the start of the data and then dragging across until the desired end point is reached For fine adjustment of this period the sliders in the middle of the edit box can be used The screenshot below shows a highlighted area of data from 10 29 am until 13 25 pm on the selected day QOO OC 0 0 r Activity Heart Rate and IBI Variability EE Print Preview Data Copy Comment Remove Mark data 08 Mar 2004 1543 H 08 Mar 2004 16 51 Mark Unmark Include Remove pains adi lt kl ll Er S 06 00 00 00 2000 Min Max IBI ms 1000 00 00 06 00 00 00 T n Actiheart User Manual 4 0 35 Jan 2010 32 Having selected the required period the following functions may applied to the data o Mark Selecting
91. orrelated with respiration i e higher amplitude ECG corresponds to a lower EDR amplitude Sleep stage identification in the Actiheart employs HRV analysis based on the findings of Vaughn and others but also uses the movement data captured by the accelerometer in the Actiheart The algorithm used is described in more detail in Section 5 4 Making a Recording If the user is interested in conducting a sleep analysis then it is preferable to set up the Actiheart from the Sleep analysis screen since this provides the option of using EDR Short Term recordings made from the Activity and Heart Rate tab can also be analysed using Sleep analysis However these will not contain EDR data Otherwise in both of these modes the Actiheart can record up to 440 000 R R intervals The maximum recording duration in these modes is 96 hours and the recording resolution is fixed at 15 sec Note The recording duration is dependent on the average heart rate and the signal quality e g the average heart rate for a 24 hour recording is 76 bpm 1 See Frederic Roche et al Cardiac Interbeat Interval Increment for the Identification of Obstructive Sleep Apnoea Journal of Pacing and Clinical Electrophysiology Vol 25 No 8 August 2002 2 See Th Penzel et al Systematic comparison of different algorithms for apnoea detection based on electrocardiogram recordings Med Biol Eng Comp 40 2002 3 See George B Moody et al Derivation of Respirato
92. orting is as follows a Ensure that the external program is in Program Files on the same PC as the Actiheart application Ensure that this program is named exteecal exe b Load an Actiheart file into Advanced Energy Expenditure application Press Run External HR EE Cal This exports Time Activity and HR data to a file called exteecal exe located in the root of the AH Program folder and it calls the external application Please note that the Run External HR EE Cal button is only visible if the application mentioned above is resident in the Program Files folder c The external program must return a file of 27 values of PAI HR and 8 values of PAI Activity The returned file must be called ext ee factors txt d When the file is returned a message will pop up in the Advanced Energy Expenditure inviting the user to save in the database the calibration data contained in the file WARNING The Actiheart application must stay open throughout The exteecal exe program must not return until it is complete Windows programs such as notepad exe cannot be used because they return as soon as they have finished loading 4 4 16 Printing and Previewing Data This is covered in Section 3 5 4 4 17 Copying all Days The Copy option on the toolbar copies all of the recorded data to the clipboard Actiheart User Manual 4 0 35 Jan 2010 55 4 5 The Step Test 4 5 1 Overview 4 5 2 Setting Up a Step Test IMPORTANT
93. print from the drop down menu at the top of the screen 5 3 5 Copying Data Data can be copied from the software for pasting into an external program of the user s choice The selected data is exported to the clipboard and can then be pasted from there into e g Microsoft Excel There are three options 1 Copy raw data This takes the raw activity heart rate and IBI data and puts it on the clipboard 2 Copy Detailed Statistics Provides an export with header information and an epoch by epoch time stamped listing of activity and Heart Rate data with IBI SD and RMSSD data 3 Copy Marker Summary This is to copy areas of interest that may have been labelled in the beat to beat zoom window 5 3 6 Exporting Data It is possible to export data for further analysis in other programs There are two options 1 Export time stamped IBI data This is done by selecting Export and then Time stamped IBI data from the menu 2 Export HRV Analysis This is done by selecting Export and then HRV Analysis from the menu The following message will be produced showing the file path to which the data has been exported Actiheart 4 The marked data has been exported to C Documents and SettingsiTom Evans Actiheart Data IBI 09Feb2009 1553 txt Actiheart User Manual 4 0 35 Jan 2010 67 5 4 Sleep Staging The software performs a two stage analysis of the sleep record The first stage involves measuring various characteristics of the heart be
94. re marked in grey The top region of the screen provides the user details and allows the selection of display units in kCal or kJoules It is also possible to select just to view the AEE component of energy expenditure rather than viewing all of the components The lower section of the display shows the components of energy expenditure day by day These are shown graphically and numerically with both being colour coded Total Energy Expenditure TEE is derived by adding to the calculated AEE a component for Resting Energy Expenditure REE and a component for Diet Induced Thermogenesis DIT The physical activity level PAL is also shown and this is a ratio of daily TEE to REE The REE can either be estimated using the Schofield equations or can be specified by the user see Appendix 3 and Section 4 4 8 1 respectively For details of how the AEE and REE values are calculated during incomplete days and or when the monitor is not worn please see Appendix 5 Actiheart User Manual 4 0 35 Jan 2010 43 4 3 6 Gaps in the Data 4 3 7 The Distribution of AEE 4 3 8 Previewing amp Printing Data A PAL figure is only shown for complete days with the figures for an incomplete day being shown in grey Please see Section 4 2 8 It is possible by right clicking on the appropriate bar graph to view the distribution of the AEE component of energy expenditure for each day and for all days Other information can be viewed along with the A
95. rt User Manual 4 0 35 Jan 2010 19 3 1 4 Downloading Short Term Recording Data from the Actiheart 3 1 5 Viewing Details of a Short Term Recording Click on the Read button to download the short term data This process is the same as for any other recording for further details please see Section 7 of the Guide to Getting Started The data is stored in the selected database ready for analysis Once the recording has been stored in the database it is possible to view information about it Highlight the required recording from the Short term BPM screen and then click the Info button to produce the screen shown below r Recording Details Recording no ss Type Ex s D EG Cep 200 16 42 Gilels Zeep 2007 15 35 EE HEH 124071 Actiheart Cerel Ho 430000010 Ee Ge E Target C Users garyungless A4ppD ata Actiheart Database 3t port 234092008 mdb oc Is Actiheart User Manual 4 0 35 Jan 2010 20 3 1 6 Database Export and File Export It is possible to export a particular file or to export a user s data and experiment data from this field This is done by selecting either the File export or Database export tab from the bottom of this screen e Database export exports the full user details and experiment details to a target database which is selected by clicking on the yellow Open File icon Click OK to export the database when this is complete a confirmation mess
96. ry Signals from Multi lead ECGs Computers in Cardiology Vol 12 1985 4 See B V Vaughn et al Heart period variability in sleep Electroencephalography and Clinical Neurophysiology 94 1995 Actiheart User Manual 4 0 35 Jan 2010 62 5 2 Sleep Analysis 5 2 1 Setting up a Sleep Recording Clicking on the Sleep Analysis button on the main screen produces the screen below Sleep version 1 0 Sleep Analysis satt monitor 19 Mar 2008 09 52 4 05 Dec 2007 14 32 E 05 Dec 2007 1353 05 Dec 2007 13 53 p 2007 16 42 06 Sep 2007 16 42 05 Sep 2007 16 28 x 05 Sep 2007 16 28 99901 rev48 05 Sep 2007 15 51 7 ba En zsm From this window the user can set up a new recording read recorded data from an Actiheart or view a recording from the database This is the same as the process previously described for other recording types Please see Section 7 of the Guide to Getting Started for more details When the user is set up and the parameters are ready to be sent to the Actiheart the following screen is shown 7 ActiHeart Sleep Setup User 1D EONIA Test D IIN SGU Immediate start E Record EDR The Actiheart will record for about 23 hours at 80 BPM Actlheart monitor GOEN 481000530 Battery volts 2 74V D Actiheart detected and ready ENCCEN USB Communications p HEEL ee Receive Actiheart User Manual 4 0 35 Jan 2010 63 WARNING 5 2 2 Setting up a Recording Delayed Start 5
97. ryTau 0 HRaS RecoveryTau 0 Age 8 Height 75 0 BMI The screen above allows the settings to be viewed The top left hand window contains a list of all the variants of the model furnished with the software as standard The components of each variant calibration coefficients and branch parameters can be viewed by highlighting that variant in the window 4 3 4 Individual Calibration To view and select an individual calibration go to the Advanced Energy Expenditure application and proceed in the manner described in Section 4 4 8 4 3 5 Analysing a recording A recording is selected either by double clicking on it or highlighting it and selecting Analyse The screen shown below is then displayed Actiheart User Manual 4 0 35 Jan 2010 42 Actiheart 4 It appears the Actiheart may not have been worn for some periods Would you like to auto fill these periods with the average energy expenditure for the rest of the day you can change this option later using File gt Autofill Selecting Yes to auto fill or No will lead to the following screen r Activity Energy Expenditure using Heart rate and activity File Print Preview Copy Analysis display Display units ails O kCal kJoules 22 05 2004 23 05 2004 24 05 2004 25 05 2004 26 05 2004 21 05 2004 28 05 2004 29 05 2004 30 05 2004 31 05 2004 01 06 2004 02 06 2004 Average of full days Kai Incomplete days a
98. s an export with header information and detailed statistics for each individual day 3 Copy Activity amp HR Data Provides an export with header information and an epoch by epoch time stamped listing of activity and Heart Rate data 4 Copy MET Data Provides an export with header information and an epoch by epoch time stamped listing of activity and Heart Rate data with MET values 5 Copy Full Data and Analysis Provides an export with header information and an epoch by epoch time stamped listing of all data from the analysis Note that this is a very large export and may take some time to copy depending upon the speed of the computer 4 3 10 Analyse All This is a batch processing function which appears on the main Daily Energy Expenditure screen It will analyse all of the recordings in the database and place all of the analysed data onto the clipboard The following screen shows the available export option W Analyse All Options Biel This function will analyse all of the recordings in the database and export the results as a single table for use in excel or other data analysis software Export Type e C Daily data one row for each day in the data Autofill Autofill any gaps with average of that day s data C Don t autofill Leave gaps empty PAI 0 Analyse All Cancel In the Summary Data calculated values are the average of all full days Actiheart User Manual 4 0 35 Jan 2010 45 4 4 Advanced
99. s case the Actiheart is functioning correctly If there is no response from the Actiheart because for example it has been powered down it may be necessary to manually reboot the Actiheart using the Manually Reboot Actiheart button at the bottom of the screen If the Powerdown function has been used it will have destroyed any stored data Actiheart User Manual 4 0 35 Jan 2010 12 2 1 1 Testing Actiheart Operation It is also possible to test the internal memory and circuitry of the Actiheart This is done by selecting the Test tab This brings up the following screen r Test amp Maintenance Firmware Terminal Reader Test Information Test Battery Test Test results el fe a ECG offset volts av Activity offset volts Jay Perform tests Clicking on the Perform Tests button will run a series of inbuilt tests which check the functionality of the unit These tests may take up to a minute to complete WARNING Performing these tests will cause any data and settings stored in the Actiheart to be lost If the Actiheart is functioning correctly the following screen will be shown r Test amp Maintenance Firmware Terminal Reader Test Information Test Battery Test Test results r r CG ECG offset volts 0 88 V Activity offset volts D 50 V Perform tests 294492008 15 04 TEST ACTIHEART 000080 H3000013350 57
100. ses cccccccccssssssssssseececessesssaesecececsssesaeaeeececeseseesaaesececsssesauaeaeeeescessesauaeeeesessesseaaaeeesess 17 2 62 Managing User Information eee teorica dee ite eaae eo VA de ra ee esu ie e decadandeansaxec Pe aaa A oae aaeeio kariei favs 18 2 7 Software le 18 3 0 Activity and Heart Rate M 19 3 1 Short enn ege EE 19 D ae 19 3 1 2 Setting Up a Short Term Recording eniti rotate na San e e po ER Ce Fut ue Ec se ad RNC E Deve aded 19 3 1 3 Delayed Start for Short Tern Recording cet tator aces ta Rene ne ade Fea Done tado Ro D ceo ead RE Doe Red 19 3 1 4 Downloading Short Term Recording Data from the Actiheart esses enne nnne nennt nnne 20 3 1 5 Viewing Details of a Short Term Recording eese eaa aa aa aa aa nananana eaa nannaa aa aa aa nananana aaaaaaaeen 20 3 1 6 Database Export and File Export 21 3 2 Analysing a Short Term Recording naamaan aa a n aan aa eaa a aa aa aa naa aa annua nannaa ana a aa aa Kanianka neki 21 3 2 1 Heart Rate amp Activity Graph Controls souousuussoo ooo aan aa aan aa aa aan aa siis nannaa aan a an nannaa aaaaaaean 22 ERNEIEREN 23 3 2 3 Analysis f IBI Data Statisties 2 cert teet ette de tea te dades pedea dee eege devs 24 3 2 4 Printing a Short Term Report 25 3 2 5 Copying Short Term Data to the Clpboard seen nhnnnn aa a enaa aaa inanes sese nina nana en 25 3 2 6 Exporting Short Term Data
101. sess upper body activities such as throwing catching carrying or lifting and lower body activity such as cycling Moreover they are unable to differentiate between walking on the flat versus up or down hills or stairs Recent studies have documented that activity monitors significantly underestimate EE of common daily activities in adults for all of the above reasons Heart rate HR monitors provide an objective indicator of physiological effect of physical activity They too can be used to assess frequency intensity duration and EE of physical activity HR has been shown to be linearly related to VO2 and EE during physical activity However the relationship between HR and VO2 depends on the amount of upper body work that is taking place HR will be higher for any given VO2 during arm activity in comparison with leg activity or combined arm and leg activity This is primarily because of the smaller amount of muscle mass involved with arm only activity Therefore HR alone will lead to an overestimation of EE For reliable results the HR VO2 relationship needs to be derived for a specific individual Numerous other factors that influence HR under resting conditions e g stress contribute additional error when HR monitors are used for extended periods of monitoring of daily activities Studies 1 amp 2 and others before them have demonstrated that use of HR along with motion data can improve prediction of energy expenditure for lifestyle activiti
102. skew the data Actiheart User Manual 4 0 35 Jan 2010 36 4 0 Energy Expenditure Analysis 4 1 Overview 4 1 1 Choosing an Application for Making a Recording 4 1 2 Choosing an Application for Analysis 4 1 3 Differences between the two Applications The Actiheart system is designed to calculate Activity Energy Expenditure AEE using recorded heart rate and or activity levels Short or Long Term recordings as described in the previous chapters can be analysed using the first two applications below However these applications can also be used in their own right to instigate recordings for subsequent analysis The third application the Step Test serves a different purpose from the first two and is described fully in Section 4 5 If the user is interested in the energy expended in daily living over several days then the Daily Energy Expenditure application can be used The Actiheart can record in this mode for up to 11 days using a fixed 1 minute epoch If the emphasis is on high resolution analysis of the energy expended then the recording should be made with either 15 or 30 sec epochs using Advanced Energy Expenditure In this case the recording duration will be 2 5 days or 5 days respectively This application can also be used to make a recording with a 1 minute epoch which will be identical to the one made with the Daily Energy Expenditure application In conclusion therefore Advanced Energy Expenditure has recording capabilities t
103. t will be calculated on the subject s age at today s date The VO2 max may therefore be slightly different From any value previously calculated and stored at the time of the step test Proceed anyway Actiheart 4 Do you want to calculate the VO2 max from the HR calibration and HR max If the RMR used is based on Schofield it will be calculated on the subject s age at today s date The VO2 max may therefore be slightly different From any value previously calculated and stored at the time of a step test or other HR calibration Proceed anyway Selecting Yes will input a value into the VO2 box NOTE The VO2 max value is stored with the User Info in the database This is the last value calculated either from the Step Test or from the Individual Calibration Only one value can be accommodated If the following message appears use the Fill function as described above Actiheart 4 Some energy values go down with heart rate or activity rather than up This is unlikely to be correct and probably means you should use the Fill button to Fill in gaps between your measured data points The current data will not be saved Once all of the reguired parameters have been input into the individual calibration screen clicking on Save will save these parameters for that user into the database 4 4 9 Analysing an Advanced Energy Expenditure Recording Having selected the desired energy model and individual calibration data if
104. ta and puts it on the clipboard This is done by selecting first Copy and then Raw Data from the drop down menu at the top of the screen b Copy Detailed Statistics This is done by selecting first Copy and then Detailed Statistics from the drop down menu at the top of the screen Provides a report with epoch by epoch time stamped data containing Activity BPM IBI Sleep stage and comments c Copy marker summary This is to copies areas of interest that may have been labelled in the beat to beat zoom window 5 5 4 Exporting Data It is possible to export data for further analysis in other programs Please refer to Section 5 3 6 for further details Actiheart User Manual 4 0 35 Jan 2010 72 5 6 Apnoea Search Clicking on the Apnoea Search tab produces the following screen e DI Actiheart Sleep Analysis EI Print Preview Copy Export b Sleeping HR Age EM sex ER Weight ENIN Height EN WAR Potential Apnoea Periods Drag the FELL ASLEEP and WOKE UD markers to position and click here to analyse Apnoea Detection Statistics Total minutes scanned Apnoea detected in Mean apnoea mins hour Spectrogram Detailed Statistics Sleep Staging Apnoea Screening This screen is divided into three sections a Top section This shows the parameters of the chosen recording namely those for the user and those for the start and finish times of the recording b Sec
105. ta at any given point on screen This is done by right mouse clicking on the data at the point of interest The readout is shown on the screen below showing the time in black heart rate in red and activity counts in black 5 3 2 Beat to Beat Zoom Double clicking on a section of the recording highlights an area around the selected data point in blue and causes the beat to beat zoom window to appear as shown in the screen below Beat to Beat Zoom tere e Zoom Out uo 0123 0124 0125 DS m 0128 0128 01 30 m 01 32 01 37 DS 01 39 01 40 na mu 0143 07 44 01 45 01 46 01 47 01 48 By left clicking on the screen and dragging left or right it is possible to scroll through the recording The default functionality of the left mouse button can be changed by clicking on the Paints Marker radio button This will allow areas of interest to be labelled Actiheart User Manual 4 0 35 Jan 2010 66 5 3 3 Previewing Data It is possible to preview the window and beat to beat zoom data for the recording This is done by selecting Preview from the drop down menu This produces a report which contains a graph of the full analysis period showing Activity and HR a zoomed activity and HR graph and the histogram triangular index and RMSSD 5 3 4 Printing Data It is possible to print out the window data the histogram and the general statistics of the recording This is done by selecting
106. tandard step test Using JAP2007 equations Copy Print User details UserlD 39315 e Sex Female Sip a Height MEI Estimated RMR ER Test results 683 663 649 637 638 652 641 635 642 638 651 771 15 second Activity and R wave data Bad HR data Save Step test duration m Actiheart User Manual 4 0 35 Jan 2010 58 The display is divided into three regions The top region shows the user details such as ID age weight and sex of the individual Also shown is a value of Recovery Tau which is the time constant of the recovery of the heart rate and is measured for the first minute and assumes that the recovery is exponential down to the resting heart rate On the right are shown derived values of VO2 max The HR max is obtained from the P max which is the maximum power that can be produced by stepping The step size is shown just underneath these values The central region of the screen shows the activity data as 15 second black blocks derived from the Actiheart An additional display in red can either be the heart rate in BPM as shown above the Heart Rate Variability per 15 second interval is displayed either as max min or the Root Mean Square of the beat to beat interval Any 15 second segment of this data can be selected and viewed in the bottom region of the screen where R waves are shown along with activity waveform A segment is selected by using the scroll bar or by clicking on the upper graph The IBI is ac
107. te All time domain and frequency domain parameters are based on the definitions contained in Heart Rate Variability Standards of Measurement Physiological Interpretation and Clinical Use Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology Actiheart User Manual 4 0 35 Jan 2010 24 3 2 4 Printing a Short Term Report 3 2 5 Copying Short Term Data to the Clipboard 3 2 6 Exporting Short Term Data The Short Term analysis information may be printed to a local printer or network based printer to provide a hard copy output The report includes user and recording information a copy of the main Heart Rate amp Activity graph a copy of the currently selected IBI analysis graph a copy of the IBI histogram graph the triangular index SDNN SDANN and RMSSD values There are two tools available for printing Print Preview Select Preview from the menu bar of the Short Term analysis screen to view the report on screen without sending to the printer Print Select Print from the menu bar of the Short Term analysis screen to open the standard Windows dialogue box where you can select the printer and print the report Data can be copied from the software for pasting into an external program of the user s choice The selected data is exported to the clipboard and can then be pasted from there into for example Microsoft Excel There are two options accessed from
108. the beat to beat zoom if it has been selected the histogram and the general statistics of the recording and is done by selecting first Print and then General Statistics from the drop down menu at the top of the screen b Print Sleep Staging This prints out the window data the calculated estimated sleep stages a hypnogram of the sleep stages and the sleep statistics and is done by selecting first Print and then Sleep Staging from the drop down menu at the top of the screen 5 4 3 Copying Data Data can be copied from the software for pasting into an external program of the user s choice The selected data is exported to the clipboard and can then be pasted from there into e g Microsoft Excel There are three options a Copy raw data This takes the raw activity heart rate and IBI data and puts it on the clipboard This is done by selecting first Copy and then Raw Data from the drop down menu at the top of the screen b Copy Detailed Statistics This is done by selecting first Copy and then Detailed Statistics from the drop down menu at the top of the screen Provides a report with epoch by epoch time stamped data containing Activity BPM IBI Sleep stage and comments c Copy marker summary This is to copies areas of interest that may have been labelled in the beat to beat zoom window 5 4 4 Exporting Data It is possible to export data for further analysis in other programs Pl
109. tiheart User Manual 4 0 35 Jan 2010 46 4 4 3 Setting up a Recording Delayed Start 4 4 4 Downloading an Advanced EE Recording r ActiHeart energy expenditure setup user 10 LLLA TIS Seay Immediate start S Recording type G Short term recording With eve Actlheart monitor ST 490000133 WEE 2 60v Ma Actiheart detected and ready USB Communications p 10i IT Tuu 2220 Receive This screen allows the user to select the reguired recording type The total length of recording time depends on the mode selected and is as follows Recording Type Total Recording Time Short term recording with every IBI 440 000 beats Long term recording with 15 Second epoch and HRV 11 days Long term recording with 30 Second epoch and HRV 21 days Long term recording with 1 Minute epoch and HRV 21 days For details on setting up a delayed start recording please see Section 3 1 3 Downloading an Advanced EE recording is the same as any other recording For further details please see Section 7 of the Guide to Getting Started Actiheart User Manual 4 0 35 Jan 2010 47 4 4 5 Viewing Details of an Advanced EE Recording 4 4 6 Database Export and File Export 4 4 7 Selecting an Energy Model For details on how to view information on a long term recording please see Section For further details please see Section 3 1 6 Before you can view a recording and analyse it you first need to select the Energy Model
110. tory and an oxygen analyser Derivation of the Physical Activity Intensity PAI HR calibration equation is a 4 step process 1 The recovery HR t is measured 2 The power Psiep generated during stepping in Joules min kg is calculated as follows Joules kg min Vertical distance m x steps min 3 P step and HR step values are plotted and a straight line is fitted to the data Power J kg min P max step V LLLL Extrapolated HR amp Pss at 1 Minute HRaS HRaS step 8 mins HRaS max Slope B HRaS tepJ kg beat Intercept o HRaS step J min Kg 4 PAI vs HRaS is then established a function of HRaS t B HRaS step o HRaS step PAI 2 9HRaS 1 1 HRaS male sex 2 9 HRaS Bstep 1 3 astep 10 male sex zero t zero t HRaS zero age zero height 75 zero BMI Actiheart User Manual 4 0 35 Jan 2010 92 Activity Calibration Actiheart User Manual 4 0 35 Jan 2010 This equation is valid for adults and is referred to in Reference No 7 in Appendix 2 There zero multiplier terms in the equation are not being used so mean literally zero They were inserted into the software for future flexibility if those parameters are found to increase accuracy but are not currently used The resulting PAI HR line thus obtained for an individual is then extrapolated to the assumed HR max for the person s age The predicted VO max in litres kg min is then equal to PAI max in J k
111. ty Requirements and tests Non life supporting equipment immunity section only EN60601 1 4 1997 Medical electrical equipment Part 1 4 General requirements for safety Collateral standard General requirements for programmable electrical medical systems Safety Classification Information e A The Actiheart is INTERNALLY POWERED EQUIPMENT The Actiheart is a TYPE B APPLIED PART The Actiheart mode of operation is CONTINUOUS OPERATION For further safety and handling advice please refer to section 6 0 Actiheart User Manual 4 0 35 Jan 2010 Contents TT 8 1 1 Recordings Databdas6e RE du P Fin Te ER ss Ee EEE Ea EI VENERE SS ERRINEIERERSEREL TEE ERN EErEE EES 8 1 1 1 Read Info Tall E 8 1 12 BEST Io Coe TUERI 9 Re dE 9 12 LENS ee EE 10 2 Settings and Utilities sussa asec cited eee eee eee 12 2 1L Test amp Maintenant EE 12 2 1 1 Testing Actiheart Operation oce e e ia AeA PAASION Kai e A aa e ka on accade e etd un 13 2 1 2 Battery Test issuaassn 14 2 1 3 Reader RT L EL H 14 2 1 4 Firmware Update eI DRESD HUMUM IE 14 2 15 terminal TRIS le UE 15 2 2 Recharge Actilieart ertet eat eruat e boxe EE ee 16 2 3 Read ACNEE carena a ea E E R 16 2 4 gelueft te ERT dl TC 16 225 V rity Actili art SOLU e EE 17 2 6 Database Manage lies Eege Ee Ae eege Ae Ae dese geed 17 2 6 1 Adding or Changing Databa
112. u want to save values derived from this step test as this user s individual calibration Examples of these data points are 60 bpm gt 29 6 J Kg min 100 bpm gt 238 1 J Kg min 140 bpm gt 485 1 J Kg min 180 bpm gt 732 1 J Kg min This will be saved to your database Es and Settings Tom EvanstActiheart dataiTomdb mdb Clicking Yes will save the results of the test into the User Info table of the target database which can be viewed in Microsoft Access For further details please see Section 1 WARNING If any of the anthropomorphic variables such as HR max Sleeping Heart Rate and weight are altered for a completed test then the results will alter accordingly on screen and if Save is pressed the original Step Test calibration data held in the User Info database will be overwritten If a Step Test for a subject is performed at a later date or time and possibly with a different step height but with the same user ID as previously it will be logged as a separate test in the Read Info table of the Recordings database However when the results are saved the earlier calibration data held in the User Info table will be overwritten To avoid this a unique user ID should be used for each test on the same subject Changing the Test ID is not sufficient 4 5 15 Correcting the Step Height of a Completed Test If following completion of a test it is found that the entered height during set up was incorrect the value can be changed by editing the St
113. uter Login Computer Name IHS SONY Login name Howard Smith The currently selected database and its location are shown within the Database selection area A listing of all users contained within the current database is shown in the Users in this database area 2 6 1 Adding or Changing Databases To add a new blank database no users or records click on the New button A Windows file dialogue box will be displayed where you can supply the name and location of the new database before clicking Open to save the database Actiheart User Manual 4 0 35 Jan 2010 2 6 2 Managing User Information 2 7 Software Preferences To select a different existing database click on the folder button This will open a standard Windows folder dialogue where it is then possible to locate and select the required database It is possible to manage user information with the controls located in the Users in this database area Theses controls provide the following options e Add This will invoke the Add new user wizard as described in section 6 of the Actiheart Guide to Getting Started e View Click on any user in the list then click the View button to view details for that user e Edit Click on a user in the list then click the Edit button to show the following screen Edit User Info It is possible to change the following user details pas User ID from this screen EH Weig

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