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Erratum. Semiautomatic Training Load Determination in Endurance Athletes

Journal for the Measurement of Physical Behaviour

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Systematic Review of Accelerometer Responsiveness to Change for Measuring Physical Activity, Sedentary Behavior, or Sleep

Kimberly A. Clevenger and Alexander H.K. Montoye

Measurement of 24-hr movement behaviors is important for assessing adherence to guidelines, participation trends over time, group differences, and whether health-promoting interventions are successful. For a measurement tool to be useful, it must be valid, reliable, and able to detect change, the latter being a measurement property called responsiveness, sensitivity to change, or longitudinal validity. We systematically reviewed literature on the responsiveness of accelerometers to detect change in 24-hr movement behaviors. Databases (PubMed, Scopus, and EBSCOHost) were searched for peer-reviewed papers published in English between 1998 and 2023. Quality/risk of bias was assessed using a customized tool. This study is registered at Twenty-six papers met the inclusion/exclusion criteria with an overall sample of 1,939 participants. Narrative synthesis was used. Most studies focused on adults (n = 21), and almost half (n = 12) included individuals with specific medical conditions. Studies primarily took place in free-living settings (n = 21) and used research-grade accelerometers (n = 24) worn on the hip (n = 18), thigh (n = 7), or wrist (n = 9). Outcomes included physical activity (n = 19), sedentary time/behavior (n = 12), or sleep (n = 2) and were calculated using proprietary formulas (e.g., Fitbit algorithm), cut points, and/or count-based methods. Most studies calculated responsiveness by comparing before versus after an intervention (n = 16). Six studies included a criterion measure to confirm that changes occurred. Limited research is available on the responsiveness of accelerometers for detecting change in 24-hr movement behaviors, particularly in youth populations, for sleep outcomes, and for commercial and thigh- or wrist-worn devices. Lack of a criterion measure precludes conclusions about the responsiveness even in more frequently studied outcomes/populations.

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Context Matters: The Importance of Physical Activity Domains for Public Health

Tyler D. Quinn and Bethany Barone Gibbs

Physical activity can be performed across several domains, including leisure, occupation, household, and transportation, but physical activity research, measurement, and surveillance have historically been focused on leisure-time physical activity. Emerging evidence suggests differential health effects across these domains. In particular, occupational physical activity may be associated with adverse health outcomes. We argue that to adequately consider and evaluate such impacts, physical activity researchers and public health practitioners engaging in measurement, surveillance, and guideline creation should measure and consider all relevant physical activity domains where possible. We describe why physical activity science is often limited to the leisure-time domain and provide a rationale for expanding research and public health efforts to include all physical activity domains.

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Evaluation of Physical Activity Assessment Using a Triaxial Activity Monitor in Community-Dwelling Older Japanese Adults With and Without Lifestyle-Related Diseases

Sho Nagayoshi, Harukaze Yatsugi, Xin Liu, Takafumi Saito, Koji Yamatsu, and Hiro Kishimoto

Background: Several previous studies investigated physical activity of older adults using wearable devices, but more studies need to develop normative values for chronic disease conditions. This study aimed to investigate physical activity using a triaxial activity monitor in community-dwelling older Japanese adults with and without lifestyle-related diseases. Methods: Data from a total of 732 community-dwelling older Japanese men and women were collected and analyzed in a cross-sectional study. The participants’ physical activity was assessed for seven consecutive days by a triaxial accelerometer. Physical activity was assessed by number of lifestyle-related diseases and six lifestyle-related diseases categories by gender. Physical activity was assessed separately for total, locomotive, and nonlocomotive physical activity. Results: Participants with multiple (two or more) diseases had significantly lower total light-intensity physical activity (LPA; 278.5 ± 8.4 min/day) and nonlocomotive LPA (226.4 ± 7.0 min/day) versus without diseases in men. Compared in each disease category, total LPA and nonlocomotive LPA was significantly lower in men with hypertension and diabetes. Total sedentary time was significantly higher in men with hypertension, diabetes, and heart disease. Locomotive LPA was significantly lower in men with diabetes. In women, locomotive moderate- to vigorous-intensity physical activity was significantly higher in women with diabetes, and nonlocomotive moderate- to vigorous-intensity physical activity was significantly lower in women with heart disease. Conclusion: This study demonstrated that older Japanese men with multiple lifestyle-related diseases had lower physical activity. In each disease category, hypertension, diabetes, and heart disease affected lower physical activity, especially in men.

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Volume 6 (2023): Issue 3 (Sep 2023)

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Semiautomatic Training Load Determination in Endurance Athletes

Christophe Dausin, Sergio Ruiz-Carmona, Ruben De Bosscher, Kristel Janssens, Lieven Herbots, Hein Heidbuchel, Peter Hespel, Véronique Cornelissen, Rik Willems, André La Gerche, Guido Claessen, and on behalf of the Pro@Heart Consortium*

Background: Despite endurance athletes recording their training data electronically, researchers in sports cardiology rely on questionnaires to quantify training load. This is due to the complexity of quantifying large numbers of training files. We aimed to develop a semiautomatic postprocessing tool to quantify training load in clinical studies. Methods: Training data were collected from two prospective athlete’s heart studies (Master Athlete’s Heart study and Prospective Athlete Heart study). Using in-house developed software, maximal heart rate (MaxHR) and training load were calculated from heart rate monitored during cumulative training sessions. The MaxHR in the lab was compared with the MaxHR in the field. Lucia training impulse score, based on individually based exercise intensity zones, and Edwards training impulse, based on MaxHR in the field, were compared. A questionnaire was used to determine the number of training sessions and training hours per week. Results: Forty-three athletes recorded their training sessions using a chest-worn heart rate monitor and were selected for this analysis. MaxHR in the lab was significantly lower compared with MaxHR in the field (183 ± 12 bpm vs. 188 ± 13 bpm, p < .01), but correlated strongly (r = .81, p < .01) with acceptable limits of agreement (±15.4 bpm). An excellent correlation was found between Lucia training impulse score and Edwards training impulse (r = .92, p < .0001). The quantified number of training sessions and training hours did not correlate with the number of training sessions (r = .20) and training hours (r = −.12) reported by questionnaires. Conclusion: Semiautomatic measurement of training load is feasible in a wide age group. Standard exercise questionnaires are insufficiently accurate in comparison to objective training load quantification.

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Convergent Validity of Time in Bed Estimates From activPAL and Actiwatch in Free-Living Youth and Adults

Paul R. Hibbing, Jordan A. Carlson, Stacey L. Simon, Edward L. Melanson, and Seth A. Creasy

Actiwatch devices are often used to estimate time in bed (TIB) but recently became commercially unavailable. Thigh-worn activPAL devices could be a viable alternative. We tested convergent validity between activPAL (CREA algorithm) and Actiwatch devices. Data were from free-living samples comprising 47 youth (3–16 valid nights/participant) and 42 adults (6–26 valid nights/participant) who wore both devices concurrently. On average, activPAL predicted earlier bedtimes and later risetimes compared with Actiwatch, resulting in longer overnight intervals (by 1.49 hr/night for youth and 0.67 hr/night for adults; both p < .001). TIB interruptions were predicted less commonly by activPAL (mean <2 interruptions/night for both youth and adults) than Actiwatch (mean of 24–26 interruptions/night in both groups; both p < .001). Overnight intervals for both devices tended to overlap for lengthy periods (mean of 7.38 hr/night for youth and 7.69 hr/night for adults). Within these overlapping periods, the devices gave matching epoch-level TIB predictions an average of 87.9% of the time for youth and 84.3% of the time for adults. Most remaining epochs (11.8% and 15.1%, respectively) were classified as TIB by activPAL, but not Actiwatch. Overall, the devices had fair agreement during the overlapping periods but limited agreement when predicting interruptions, bedtime, or risetime. Future work should assess the criterion validity of activPAL devices to understand implications for health research. The present findings demonstrate that activPAL is not interchangeable with Actiwatch, which is consistent with their differing foundations (thigh inclination for activPAL vs. wrist movement for Actiwatch).

Open access

Daily Activity of Individuals With an Amputation Above the Knee as Recorded From the Nonamputated Limb and the Prosthetic Limb

Kerstin Hagberg, Roland Zügner, Peter Thomsen, and Roy Tranberg

Introduction: Mobility restriction following limb loss might lead to a sedentary lifestyle, impacting health. Daily activity monitoring of amputees has focused on prosthetic steps, neglecting overall activity. Purpose: To assess daily activity in individuals with an established amputation and to explore the amount of activity recorded from the prosthesis as compared to the overall activity. Methods: Individuals with a unilateral transfemoral amputation or knee disarticulation who had used a prosthesis in daily life for >1 year and could walk 100 m (unsupported or single aided) were recruited. Descriptive information and prosthetic mobility were collected. Two activPAL™ accelerometers were attached to the nonamputated thigh and the prosthesis, respectively. The mean daily activity over 7 days was compared between the nonamputated limb and the prosthesis. Results: Thirty-nine participants (22 men/17 women; mean age 54 [14.5] years) with amputation mainly due to trauma (59%) or tumor (28%) were included. Overall, participants took 6,125 steps and spent 10.2 hr sedentary, 5.0 hr upright, and 8.7 hr laying per day. Compared to recordings from the nonamputated limb, 85% of sit-to-stand transitions (32/38), 73% of steps (4,449/6,125), and 68% of walking time (1.0/1.5 hr) were recorded from the prosthesis. Recordings seemed to be less adequate for incidental prosthetic steps than for walks. Conclusions: Sedentary behavior accounted for most of the day demonstrating the importance to encourage physical activity among established prosthetic users. The prosthesis is used for daily activity to a great extent. However, noted pitfalls in the recordings call for further refinement of the measurements.

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Evaluation of Within- and Between-Site Agreement for Direct Observation of Physical Behavior Across Four Research Groups

Sarah Kozey Keadle, Julian Martinez, Scott J. Strath, John Sirard, Dinesh John, Stephen Intille, Diego Arguello, Marcos Amalbert-Birriel, Rachel Barnett, Binod Thapa-Chhetry, Melanna Cox, John Chase, Erin Dooley, Rob Marcotte, Alexander Tolas, and John W. Staudemayer

Direct observation (DO) is a widely accepted ground-truth measure, but the field lacks standard operational definitions. Research groups develop project-specific annotation platforms, limiting the utility of DO if labels are not consistent. Purpose: The purpose was to evaluate within- and between-site agreement for DO taxonomies (e.g., activity intensity category) across four independent research groups who have used video-recorded DO. Methods : Each site contributed video files (508 min) and had two trained research assistants annotate the shared video files according to their existing annotation protocols. The authors calculated (a) within-site agreement for the two coders at the same site expressed as intraclass correlation and (b) between-site agreement, the proportion of seconds that agree between any two coders regardless of site. Results: Within-site agreement at all sites was good–excellent for both activity intensity categories (intraclass correlation range: .82–.9) and posture/whole-body movement (intraclass correlation range: .77–.98). Between-site agreement for intensity categories was 94.6% for sedentary, 80.9% for light, and 82.8% for moderate–vigorous. Three of the four sites had common labels for eight posture/whole-body movements and had within-site agreements of 94.5% and between-site agreements of 86.1%. Conclusions: Distinct research groups can annotate key features of physical behavior with good-to-excellent interrater reliability. Operational definitions are provided for core metrics for researchers to consider in future studies to facilitate between-study comparisons and data pooling, enabling the deployment of deep learning approaches to wearable device algorithm calibration.

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Comparison of Six Accelerometer Metrics for Assessing the Temporal Patterns of Children’s Free-Play Physical Activity

Katherine L. McKee, Karin A. Pfeiffer, Amber L. Pearson, and Kimberly A. Clevenger

Accelerometers are frequently used to measure physical activity in children, but lack of uniformity in data processing methods, such as the metric used to summarize accelerometer data, limits comparability between studies. The objective was to compare six accelerometer metrics (raw: mean amplitude deviation, Euclidean norm minus one, activity index, monitor-independent movement summary units; count: vertical axis, vector magnitude) for characterizing the intensity and temporal patterns of first and second graders’ (n = 88; age = 7.8 ± 0.7 years) recess physical activity. At a 5-s epoch level, Pearson’s correlations (r) between metrics ranged from .66 to .98. When each epoch was classified into one of four intensity levels based on quartiles, agreement between metrics as indicated by weighted kappa ranged from .81 to .96. When collapsed to time spent in each intensity level, metrics were strongly correlated (r = .76–.99) and most often statistically equivalent for estimating time spent in Quartile 3 or 4. Children were ranked from least to most active, and agreement between metrics was strong (Spearman’s correlation ≥ .87). Temporal patterns were characterized using five fragmentation indices calculated using each of the six metrics, which were fair-to-strongly correlated (r = .53–.99), with the strongest associations for number of high-intensity activity bouts (r ≥ .89). Most fragmentation indices were not statistically equivalent between metrics. While metrics captured similar trends in activity intensity and temporal patterns, caution is warranted when making comparisons of point estimates derived from different metrics. However, all metrics were able to similarly capture higher intensity activity (i.e., Quartile 3 or 4), the most common outcome of interest in intervention studies.