“Measurement of Fidgeting in Patients With Anorexia Nervosa Using a Novel Shoe-Based Monitor”, Lauren Belak, Loren Gianini, Diane A. Klein, Edward Sazonov, Kathryn Keegan, Esther Neustadt, B. Timothy Walsh, Evelyn Attia2017 (, )⁠:

Objective: To objectively assess seated non-exercise physical activity in patients with anorexia nervosa (AN) relative to healthy controls (HCs) and examine the associations between this physical activity, eating disorder pathology, and levels of anxiety and depression.

Method: 11 inpatients with AN and 10 HCs wore a shoe-based accelerometer (SmartShoe) at 3 time points: (1) while eating lunch, (2) filling out questionnaires, and (3) watching television for 1h.

Results: Across all 3 tasks, patients with AN were statistically-significantly more active than HCs, thereby engaging in a greater degree of restless or fidgeting behavior. Degree of physical activity was positively correlated with eating disorder psychopathology in the sample with AN, and a trend towards a positive association between physical activity and levels of depression and anxiety was also found in this sample. Among individuals with AN, physical activity was not statistically-significantly correlated with BMI, duration of illness, or number of days since hospital admission.

Discussion: Use of a minimally invasive, shoe-based monitor revealed patients with AN engaged in a greater degree of fidgeting relative to HCs during quiet, seated tasks and this heightened activity was related to measures of pathology. Non-exercise physical activity, including fidgeting, may warrant further clinical attention in this patient population.