Oura Ring Gen 4 sensor data, not clinical measurementsN=1 case study, not validated for clinical decisionsHEV diagnosed Mar 18; Day 109 post-ruxolitinibMore
Consumer wearable data can support exploratory review only. The HEV diagnosis, temporally confounded with treatment start, remains a material confounder.

Activity-Recovery Coupling

Module 4: Comparative Activity-Recovery Analysis
P1 COUPLING r
Absent
-0.043
Steps vs HRV (lag 1, n=87)
P2 COUPLING r
Absent
-0.092
Steps vs HRV (lag 1, n=518)
DIFFERENCE (FISHER z)
Not significant
0.679
p-value for coupling difference
P1 RECOVERY
Watch
Decoupled
negligible absent
P2 RECOVERY
Watch
Decoupled
negligible absent
EXECUTIVE SUMMARY

Executive Summary

This report examines whether physical activity on day N predicts sleep quality and autonomic recovery on day N+1 for both patients. Patient 1 (post-HSCT, ~2700 steps/day, HRV ~9ms) shows absent coupling (r=-0.043). Patient 2 (post-stroke, ~10000 steps/day, HRV ~43ms) shows absent coupling (r=-0.092).

Both patients show absent activity-recovery coupling.

SCATTER PLOTS

Activity vs Next-Day Recovery

CROSS CORRELATION

Cross-Correlation Functions

Positive lags = activity leads recovery (causal direction). Negative lags = recovery leads activity (reverse check). * indicates p < 0.10.

DOSE RESPONSE

Dose-Response: Activity Bins vs Next-Day HRV

PatientN pairsBinsKruskal Hp-valueSig (p<0.10)
Patient 1 (post-HSCT)8740.59p=0.898No
Patient 2 (post-Stroke)51849.03p=0.029Yes
Patient 3 (Healthy Control)2232.17p=0.338No
HEATMAPS

Full Correlation Matrices (Lag 1)

Each cell shows Spearman r for activity[N] vs recovery[N+1]. * indicates p < 0.10. Colorscale: blue=positive, red=negative.

LAGGED HEATMAP

Steps vs Recovery Across Lags

CLINICAL INTERPRETATION

Clinical Interpretation

Patient 1 (post-HSCT)

Coupling: absent (negligible) — r=-0.043, p=p=0.689, n=87
Recovery capacity: Decoupled
Activity and next-day recovery are effectively uncoupled. Other factors may dominate recovery dynamics.

Patient 2 (post-Stroke)

Coupling: absent (negligible) — r=-0.092, p=p=0.036, n=518
Recovery capacity: Decoupled
Activity and next-day recovery are effectively uncoupled. Other factors may dominate recovery dynamics.

Cross-Patient Comparison

Both patients show absent activity-recovery coupling.

Fisher r-to-z test p-value: p=0.679

Caveats

  • Patient 1 has only ~87 usable lag-1 pairs. With small N, many true correlations will not reach statistical significance. Effect sizes (r values) are more informative than p-values.
  • Relaxed significance threshold (p < 0.10) used throughout to balance Type I and Type II error with limited data.
  • Observational design: correlations do not establish causation. Confounders (illness severity, medication, stress) are not controlled.
  • P1's extremely low activity level (~2700 steps, ~6 min active) provides limited variance to detect dose-response relationships.
  • Oura readiness 'resting_heart_rate' is a 0-100 score, NOT bpm. Heart rate values come from sleep_periods only.