Decreases in 24-hour activity variability, changes in resting activity measures, and total sleep transitions were associated with changes in pain symptoms, pain tolerance, sleep patterns, and depression symptoms after a study collected biomarker data. rehabilitation and exposure to traumatic stress with wrist-worn technology.
The results of these new studies have been published JAMA Psychiatryas the authors noted, “We found and confirmed cross-sectional and longitudinal associations between 24-hour activity patterns and post-traumatic neuropsychiatric sequelae (APNS) symptoms at 8 weeks post-injury, a time when individuals are at high risk for transitioning symptoms.” restore or sustain. To our knowledge, this study is the first to investigate such an association.”
Their study was a subanalysis of data from the AURORA study of patients presenting to 27 emergency departments (EDs) after exposure to traumatic stress. A total of 3,040 people aged 18-65, who could speak and read English, and who presented to the ER within 72 hours of being hit by a car, physically assaulted, sexually assaulted, or fell, met the initial criteria for inclusion in the study. More than 10 feet, multiple accidents – 2021 patients provided device data and underwent 8 weeks of evaluation and analysis; Their mean (SD) age was 35.8 (13.0) years, and the most common annual income was less than $35,000. In addition, the majority of patients were female (62.2%), black (50.2%), had no college education (79.3%), and presented to the ED for a motor vehicle collision (75.2%).
Eight biomarkers assessing post-traumatic neuropsychiatric outcomes were pain (24-hour activity variability and 24-hour percent awake time), somatic symptoms (24-hour percent awake time and total sleep shifts), depressive symptoms, and hyperactivity. arousal, and nightmares (time awake in 24 hours, percentage of total sleep transitions). Of these, reduced 24-h activity variability was associated with increased pain (r = –0.14; 95% CI, –0.20–0.07).
In addition, changes in 6 measures of resting activity were associated with changes in pain over time, and changes in the number of transitions between sleep and wakefulness over time were associated with changes in pain, sleep, and anxiety. Furthermore, these device biomarkers identified individuals with better pain recovery (positive predictive model). [PPV], 0.85; 95% CI, 0.82–0.88), sleep (PPV, 0.83; 95% CI, 0.59–0.67), and anxiety (PPV, 0.76; 95% CI, 0.72–0.80).
Overall, the researchers found that reduced activity variability was a biomarker of increased pain, as well as 9 other resting activity biomarkers that changed with APNS symptoms.
Six activity-related biomarkers were associated with changes in pain, and 1 sleep-related biomarker was associated with changes in pain, sleep, and anxiety symptoms. Participants with increased pain showed an increased number of transitions between wakefulness and sleep.
The researchers acknowledged that there were limitations to this study, in that the generalizability of the findings to patients who did not visit the ER was unclear, and that missing or misreported data may not have accounted for their findings. The researchers suggest that future studies should examine patients wearing wrist braces over a longer period of time, not just 8 weeks post-injury.
Despite some limitations and uncertainties, the researchers believe that the wrist-worn device can help collect data on potential biomarkers that can identify adverse changes in pain, sleep, and anxiety symptoms in patients after injury.
“In the future, such biomarkers may be useful in identifying adverse outcomes of trauma, particularly in vulnerable populations that require further evaluation of trauma survivors,” the researchers wrote. “Such biomarkers may help clinicians and patients assess response to therapeutic interventions related to pain, sleep, and anxiety, and help patients understand how their activity, rest, and sleep affect their health.”
Straus LD, An X, Ji Y, et al. A wrist-worn data instrument for assessing pain, sleep, and anxiety outcomes following exposure to traumatic stress. JAMA Psychiatry. Published online on January 11, 2023. doi:10.1001/jamapsychiatry.2022.4533