Actigraphy to MEasuRe Intensive Care Unit Activity

Patients that meet inclusion criteria will have a wristwatch size, lightweight ActiGraph
GT3X+ placed at each of three body sites, the dominant-side wrist, right hip and
dominant-side ankle to objectively measure physical activity. Patients will wear the
ActiGraph devices during two 30-minute periods of direct observation. To compare activity
counts measured by the ActiGraph devices with directly observed purposeful physical
activity, we will record the time and type of physical activity performed by patients such
as sitting at the edge of the bed, sitting in a bedside chair, transferring to a chair,
standing and ambulating. The data acquired from this observational (AMERCIA) study will seek
to establish the feasibility of using accelerometers to measure activity in a diverse
population of patients with medical or surgical critical illness.

Inclusion Criteria:

Patients will be included if they are:

1. adult patients,

2. admitted to the medical or surgical ICU,

3. receiving or have received invasive or non-invasive mechanical ventilation for
respiratory failure or vasopressors for shock (i.e., cardiogenic, hemorrhagic, septic
or undifferentiated shock) within the last 48 hours, and

4. who are receiving routine physical and occupational therapy.

Exclusion Criteria:

Patients will be excluded if they meet any of the following criteria:

1. Those who have severe physical disability that prevented independent living prior to
their illness,

2. Those unable to speak and communicate in English,

3. Expected death within 24 hours of enrollment or lack of commitment to aggressive
treatment by the family or medical team (i.e., likely to withdraw life support
measures within 24 hours of screening),

4. Inability to obtain informed consent from authorized surrogate;