Intelligent Intensive Care Unit

Motion Analysis of Delirium in Intensive Care Units (ICUs) Subtitle 1: ADAPT: Autonomous Delirium Monitoring and Adaptive Prevention

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT02465307

Acronym

ICU_Delirium

Enrollment

130

Registered

2015-06-08

Start date

2016-02-29

Completion date

2028-05-30

Last updated

2025-06-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Delirium, Confusion

Keywords

Consciousness, Alertness, Cognition, Activity level, Delirium, Hyperactive delirium, Hypoactive delirium, Facial expression, Posture, Intensive care unit

Brief summary

Delirium, as a common complication of hospitalization, poses significant health problems in hospitalized patients. Though about a third of delirium cases can benefit from intervention, detecting and predicting delirium is still very limited in practice. A common characterization of delirium is change in activity level, causing patients to become hyperactive or hypoactive which is manifested in facial expressions and total body movements. This pilot study is designed to test the feasibility of a delirium detection system using movement data obtained from 3-axis wearable accelerometers and commercially available camera with facial recognition video system in conjunction with electronics medical record (EMR) data to analyze the relation of whole-body movement and facial expressions with delirium.

Detailed description

The aim of the study is to assess the potential of using motion and facial expression data to detect delirium in ICU patients by comparing motion and facial expression patterns in delirium and control groups. In this study, the investigators will use ActiGraph accelerometers to record each subject's movement patterns. Also, a processed video using a commercially available camera interfaces with a specialized program to identify patient facial expressions and movement patterns. A total of 60 participants will be enrolled with delirium, and 30 patients without delirium will be used as control group. Motion profiles will be compared in the motorically defined subgroups (hyperactive, hypoactive, normal) based on accelerometer and facial recognition data. Then, differences in facial expression, number of changes in postures, and percentage of time spent moving will be compared between motorically defined subgroups and in delirium and control groups. EMR data will also be used to assess the feasibility of detecting delirium by including additional information on related risk factors.

Interventions

BEHAVIORALConfusion Assessment Method

Confusion Assessment Method (CAM) score

DEVICEAccelerometer

3 accelerometers (placed on upper arm, wrist and ankle) and 1 placed on wall as ambient light sensor

DEVICECommercially available camera

As part of facial recognition video system

DEVICEInternet Pod (iPod)

Monitors noise levels in the room

DIAGNOSTIC_TESTCortisol Swab

Cortisol level collected through self administered salivary swab

Study design

Observational model

CASE_CONTROL

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Yes

Inclusion criteria

(ICU Patients): * Intensive care unit patient * 18 years of age or older

Exclusion criteria

(ICU Patients): * Anticipated intensive care unit stay less than one day * Less than 18 years of age * Inability to wear a motion sensor watch (ActiGraph) Inclusion Criteria (Healthy Controls): * 18 years of age or older. * sleeps in home environment

Design outcomes

Primary

Measure	Time frame	Description
Freedman Sleep Scale	Changes from Baseline up to 7 Days	To determine sleep quality of patient for given day.
CAM/CAM-ICU	Changes from Baseline up to 7 Days	Confusion Assessment Method for detection of delirium
Memorial Delirium Assessment Scale (MDAS) will be used for changes from baseline up to 7 days between the groups.	Changes from Baseline up to 7 Days	MDAS denotes motor profile and defines motor subtyping. It has 10 items which assesses several areas of cognitive functioning (memory, attention, orientation and disturbances in thinking) and psychomotor activity. The items are rated on a four point scale (0-3) based on the current interaction with the patient or by assessment of behavior. A score of 13 shows the diagnosis of delirium.
Delirium Motor Subtyping Scale (DMSS-4) will be used for changes from baseline up to 7 days between the groups.	Changes from Baseline up to 7 Days	Scoring from DMSS-4 which has 5 hyperactive and 8 hypoactive symptoms requires at least two symptoms to be present from either the hyperactive or hypoactive list to meet subtype criteria. The higher the score the higher the delirium.

Secondary

Measure	Time frame	Description
Number of subjects who died	Baseline up to 7 Days	Death at any time during admission
Number of subjects on mechanical ventilation	greater than 48 hours	Number of subjects requiring mechanical ventilation greater than 48 hours.

Other

Measure	Time frame	Description
Facial amimia versus non-amimia expressions between the groups	Changes from Baseline up to 7 Days	Frequency of presence of facial amimia versus non-amimia expressions between the groups.
Dynamic activity versus static position	Changes from Baseline up to 7 Days	Percentage of time spent moving versus static position

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026