Joint Distribution and Transitions of Pain and Activity in Critically Ill Patients

Pain and physical function are both essential indices of recovery in critically ill patients in the Intensive Care Units (ICU). Simultaneous monitoring of pain intensity and patient activity can be important for determining which analgesic interventions can optimize mobility and function, while minimizing opioid harm. Nonetheless, so far, our knowledge of the relation between pain and activity has been limited to manual and sporadic activity assessments. In recent years, wearable devices equipped with 3-axis accelerometers have been used in many domains to provide a continuous and automated measure of mobility and physical activity. In this study, we collected activity intensity data from 57 ICU patients, using the Actigraph GT3X device. We also collected relevant clinical information, including nurse assessments of pain intensity, recorded every 1-4 hours. Our results show the joint distribution and state transition of joint activity and pain states in critically ill patients.