Wrist accelerometer cut-points for classifying sedentary behavior in children

Christiana M.T. van Loo; Anthony D. Okely; Marijka J. Batterham; Trina Hinkley; Ulf Ekelund; Søren Brage; John J. Reilly; Stewart G. Trost; Rachel A. Jones; Xanne Janssen; Dylan P. Cliff

Wrist accelerometer cut-points for classifying sedentary behavior in children

Christiana M.T. van Loo, Anthony D. Okely, Marijka J. Batterham, Trina Hinkley, Ulf Ekelund, Søren Brage, John J. Reilly, Stewart G. Trost, Rachel A. Jones, Xanne Janssen, Dylan P. Cliff

Physical Activity For Health

Research output: Contribution to journal › Article

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Abstract

Introduction: To examine the validity and accuracy of wrist accelerometers for classifying sedentary behavior (SB) in children. Methods: Fifty-seven children (5-8y and 9-12y) completed a ~170min protocol including 15 semi-structured activities and transitions. Nine ActiGraph (GT3X+) and two GENEActiv wrist cut-points were evaluated. Direct observation was the criterion measure. The accuracy of wrist cut-points was compared to that achieved by the ActiGraph hip cut-point (≤25 counts/15s) and the thigh-mounted activPAL3™. Analyses included equivalence testing, Bland-Altman procedures and area under the receiver operating curve (ROC-AUC). Results: The most accurate ActiGraph wrist cut-points (Kim, vector magnitude: ≤3958 counts/60s and vertical axis: ≤1756 counts/60s) demonstrated good classification accuracy (ROC-AUC = 0.85-0.86) and accurately estimated SB time in 5-8y (equivalence p=0.02; mean bias: 4.1%, limits of agreement [LoA]: -20.1-28.4%) and 9-12y (equivalence p<0.01; - 2.5%, -27.9-22.9%). Mean bias of SB time estimates from Kim were smaller than ActiGraph hip (5-8y: 15.8%, -5.7-37.2%; 9-12y: 17.8%, -3.9-39.5%) and similar to or smaller than activPAL3™ 36 (5-8y: 12.6%, -39.8-14.7%; 9-12y: -1.4%, -13.9-11.0%), although classification accuracy was similar to ActiGraph hip (ROC-AUC = 0.85) but lower than activPAL3™ (ROC-AUC = 0.92-0.97). Mean bias (5-8y: 6.5%, -16.1-29.1%; 9-12y: 10.5%, -13.6-34.6%) for the most accurate GENEActiv wrist cut-point (Schaefer: ≤0.19g) was smaller than ActiGraph hip, and activPAL3™ in 5-8y, but larger than activPAL3™ 40 in 9-12y. However, SB time estimates from Schaefer were not equivalent to direct observation (equivalence p>0.05) and classification accuracy (ROC-AUC = 0.79-0.80) was lower than for ActiGraph hip and activPAL3™. Conclusion: The most accurate SB ActiGraph (Kim) and GENEActiv (Schaefer) wrist cut-points can be applied in children with similar confidence as the ActiGraph hip cut-point (≤25 counts/15s), although activPAL3™ was generally more accurate.

Original language	English
Pages (from-to)	1-42
Number of pages	42
Journal	Medicine and Science in Sports and Exercise
Publication status	Accepted/In press - 19 Oct 2016

Keywords

activity monitor
youth
physical activity
objective measurement
sitting
sedentary behavior

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Van-Loo-etal-MSSE-2016-wrist-accelerometer-cut-points-for-classifying-sedentary-behavior-in-childrenAccepted author manuscript, 2.52 MB

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van Loo, C. M. T., Okely, A. D., Batterham, M. J., Hinkley, T., Ekelund, U., Brage, S., ... Cliff, D. P. (Accepted/In press). Wrist accelerometer cut-points for classifying sedentary behavior in children. Medicine and Science in Sports and Exercise, 1-42.

@article{c33a2cfca5f14d87a8407528995a6b90,

title = "Wrist accelerometer cut-points for classifying sedentary behavior in children",

abstract = "Introduction: To examine the validity and accuracy of wrist accelerometers for classifying sedentary behavior (SB) in children. Methods: Fifty-seven children (5-8y and 9-12y) completed a ~170min protocol including 15 semi-structured activities and transitions. Nine ActiGraph (GT3X+) and two GENEActiv wrist cut-points were evaluated. Direct observation was the criterion measure. The accuracy of wrist cut-points was compared to that achieved by the ActiGraph hip cut-point (≤25 counts/15s) and the thigh-mounted activPAL3™. Analyses included equivalence testing, Bland-Altman procedures and area under the receiver operating curve (ROC-AUC). Results: The most accurate ActiGraph wrist cut-points (Kim, vector magnitude: ≤3958 counts/60s and vertical axis: ≤1756 counts/60s) demonstrated good classification accuracy (ROC-AUC = 0.85-0.86) and accurately estimated SB time in 5-8y (equivalence p=0.02; mean bias: 4.1{\%}, limits of agreement [LoA]: -20.1-28.4{\%}) and 9-12y (equivalence p<0.01; - 2.5{\%}, -27.9-22.9{\%}). Mean bias of SB time estimates from Kim were smaller than ActiGraph hip (5-8y: 15.8{\%}, -5.7-37.2{\%}; 9-12y: 17.8{\%}, -3.9-39.5{\%}) and similar to or smaller than activPAL3™ 36 (5-8y: 12.6{\%}, -39.8-14.7{\%}; 9-12y: -1.4{\%}, -13.9-11.0{\%}), although classification accuracy was similar to ActiGraph hip (ROC-AUC = 0.85) but lower than activPAL3™ (ROC-AUC = 0.92-0.97). Mean bias (5-8y: 6.5{\%}, -16.1-29.1{\%}; 9-12y: 10.5{\%}, -13.6-34.6{\%}) for the most accurate GENEActiv wrist cut-point (Schaefer: ≤0.19g) was smaller than ActiGraph hip, and activPAL3™ in 5-8y, but larger than activPAL3™ 40 in 9-12y. However, SB time estimates from Schaefer were not equivalent to direct observation (equivalence p>0.05) and classification accuracy (ROC-AUC = 0.79-0.80) was lower than for ActiGraph hip and activPAL3™. Conclusion: The most accurate SB ActiGraph (Kim) and GENEActiv (Schaefer) wrist cut-points can be applied in children with similar confidence as the ActiGraph hip cut-point (≤25 counts/15s), although activPAL3™ was generally more accurate.",

keywords = "activity monitor, youth, physical activity, objective measurement, sitting, sedentary behavior",

author = "{van Loo}, {Christiana M.T.} and Okely, {Anthony D.} and Batterham, {Marijka J.} and Trina Hinkley and Ulf Ekelund and S{\o}ren Brage and Reilly, {John J.} and Trost, {Stewart G.} and Jones, {Rachel A.} and Xanne Janssen and Cliff, {Dylan P.}",

year = "2016",

month = "10",

day = "19",

language = "English",

pages = "1--42",

journal = "Medicine and Science in Sports and Exercise",

issn = "0195-9131",

}

Wrist accelerometer cut-points for classifying sedentary behavior in children. / van Loo, Christiana M.T.; Okely, Anthony D.; Batterham, Marijka J.; Hinkley, Trina; Ekelund, Ulf; Brage, Søren; Reilly, John J.; Trost, Stewart G.; Jones, Rachel A.; Janssen, Xanne; Cliff, Dylan P.

In: Medicine and Science in Sports and Exercise, 19.10.2016, p. 1-42.

Research output: Contribution to journal › Article

TY - JOUR

T1 - Wrist accelerometer cut-points for classifying sedentary behavior in children

AU - van Loo, Christiana M.T.

AU - Okely, Anthony D.

AU - Batterham, Marijka J.

AU - Hinkley, Trina

AU - Ekelund, Ulf

AU - Brage, Søren

AU - Reilly, John J.

AU - Trost, Stewart G.

AU - Jones, Rachel A.

AU - Janssen, Xanne

AU - Cliff, Dylan P.

PY - 2016/10/19

Y1 - 2016/10/19

N2 - Introduction: To examine the validity and accuracy of wrist accelerometers for classifying sedentary behavior (SB) in children. Methods: Fifty-seven children (5-8y and 9-12y) completed a ~170min protocol including 15 semi-structured activities and transitions. Nine ActiGraph (GT3X+) and two GENEActiv wrist cut-points were evaluated. Direct observation was the criterion measure. The accuracy of wrist cut-points was compared to that achieved by the ActiGraph hip cut-point (≤25 counts/15s) and the thigh-mounted activPAL3™. Analyses included equivalence testing, Bland-Altman procedures and area under the receiver operating curve (ROC-AUC). Results: The most accurate ActiGraph wrist cut-points (Kim, vector magnitude: ≤3958 counts/60s and vertical axis: ≤1756 counts/60s) demonstrated good classification accuracy (ROC-AUC = 0.85-0.86) and accurately estimated SB time in 5-8y (equivalence p=0.02; mean bias: 4.1%, limits of agreement [LoA]: -20.1-28.4%) and 9-12y (equivalence p<0.01; - 2.5%, -27.9-22.9%). Mean bias of SB time estimates from Kim were smaller than ActiGraph hip (5-8y: 15.8%, -5.7-37.2%; 9-12y: 17.8%, -3.9-39.5%) and similar to or smaller than activPAL3™ 36 (5-8y: 12.6%, -39.8-14.7%; 9-12y: -1.4%, -13.9-11.0%), although classification accuracy was similar to ActiGraph hip (ROC-AUC = 0.85) but lower than activPAL3™ (ROC-AUC = 0.92-0.97). Mean bias (5-8y: 6.5%, -16.1-29.1%; 9-12y: 10.5%, -13.6-34.6%) for the most accurate GENEActiv wrist cut-point (Schaefer: ≤0.19g) was smaller than ActiGraph hip, and activPAL3™ in 5-8y, but larger than activPAL3™ 40 in 9-12y. However, SB time estimates from Schaefer were not equivalent to direct observation (equivalence p>0.05) and classification accuracy (ROC-AUC = 0.79-0.80) was lower than for ActiGraph hip and activPAL3™. Conclusion: The most accurate SB ActiGraph (Kim) and GENEActiv (Schaefer) wrist cut-points can be applied in children with similar confidence as the ActiGraph hip cut-point (≤25 counts/15s), although activPAL3™ was generally more accurate.

AB - Introduction: To examine the validity and accuracy of wrist accelerometers for classifying sedentary behavior (SB) in children. Methods: Fifty-seven children (5-8y and 9-12y) completed a ~170min protocol including 15 semi-structured activities and transitions. Nine ActiGraph (GT3X+) and two GENEActiv wrist cut-points were evaluated. Direct observation was the criterion measure. The accuracy of wrist cut-points was compared to that achieved by the ActiGraph hip cut-point (≤25 counts/15s) and the thigh-mounted activPAL3™. Analyses included equivalence testing, Bland-Altman procedures and area under the receiver operating curve (ROC-AUC). Results: The most accurate ActiGraph wrist cut-points (Kim, vector magnitude: ≤3958 counts/60s and vertical axis: ≤1756 counts/60s) demonstrated good classification accuracy (ROC-AUC = 0.85-0.86) and accurately estimated SB time in 5-8y (equivalence p=0.02; mean bias: 4.1%, limits of agreement [LoA]: -20.1-28.4%) and 9-12y (equivalence p<0.01; - 2.5%, -27.9-22.9%). Mean bias of SB time estimates from Kim were smaller than ActiGraph hip (5-8y: 15.8%, -5.7-37.2%; 9-12y: 17.8%, -3.9-39.5%) and similar to or smaller than activPAL3™ 36 (5-8y: 12.6%, -39.8-14.7%; 9-12y: -1.4%, -13.9-11.0%), although classification accuracy was similar to ActiGraph hip (ROC-AUC = 0.85) but lower than activPAL3™ (ROC-AUC = 0.92-0.97). Mean bias (5-8y: 6.5%, -16.1-29.1%; 9-12y: 10.5%, -13.6-34.6%) for the most accurate GENEActiv wrist cut-point (Schaefer: ≤0.19g) was smaller than ActiGraph hip, and activPAL3™ in 5-8y, but larger than activPAL3™ 40 in 9-12y. However, SB time estimates from Schaefer were not equivalent to direct observation (equivalence p>0.05) and classification accuracy (ROC-AUC = 0.79-0.80) was lower than for ActiGraph hip and activPAL3™. Conclusion: The most accurate SB ActiGraph (Kim) and GENEActiv (Schaefer) wrist cut-points can be applied in children with similar confidence as the ActiGraph hip cut-point (≤25 counts/15s), although activPAL3™ was generally more accurate.

KW - activity monitor

KW - youth

KW - physical activity

KW - objective measurement

KW - sitting

KW - sedentary behavior

UR - http://journals.lww.com/acsm-msse

M3 - Article

SP - 1

EP - 42

JO - Medicine and Science in Sports and Exercise

JF - Medicine and Science in Sports and Exercise

SN - 0195-9131

ER -