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Marco Giurgiu, Carina Nigg, Janis Fiedler, Irina Timm, Ellen Rulf, Johannes B.J. Bussmann, Claudio R. Nigg, Alexander Woll, and Ulrich W. Ebner-Priemer

Purpose: To raise attention to the quality of published validation protocols while comparing (in)consistencies and providing an overview on wearables, and whether they show promise or not. Methods: Searches from five electronic databases were included concerning the following eligibility criteria: (a) laboratory conditions with humans (<18 years), (b) device outcome must belong to one dimension of the 24-hr physical behavior construct (i.e., intensity, posture/activity type outcomes, biological state), (c) must include a criterion measure, and (d) published in a peer-reviewed English language journal between 1980 and 2021. Results: Out of 13,285 unique search results, 123 articles were included. In 86 studies, children <13 years were recruited, whereas in 26 studies adolescents (13–18 years) were recruited. Most studies (73.2%) validated an intensity outcome such as energy expenditure; only 20.3% and 13.8% of studies validated biological state or posture/activity type outcomes, respectively. We identified 14 wearables that had been used to validate outcomes from two or three different dimensions. Most (n = 72) of the identified 88 wearables were only validated once. Risk of bias assessment resulted in 7.3% of studies being classified as “low risk,” 28.5% as “some concerns,” and 71.5% as “high risk.” Conclusion: Overall, laboratory validation studies of wearables are characterized by low methodological quality, large variability in design, and a focus on intensity. No identified wearable provides valid results across all three dimensions of the 24-hr physical behavior construct. Future research should more strongly aim at biological state and posture/activity type outcomes, and strive for standardized protocols embedded in a validation framework.

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Jeong Ah Kim, Sungwoo Park, Linda Fetters, Sandrah P. Eckel, Masayoshi Kubo, and Barbara Sargent

This study quantified the spatial exploration of 13 infants born very and extremely preterm (PT) at 4 months corrected age as they learned that moving their feet vertically to cross a virtual threshold activated an infant kick-activated mobile and compared results to 15 infants born full-term (FT) from a previously published study. Spatial exploration was quantified using two general spatial exploration variables (exploration volume and exploration path), two task-specific spatial variables (duration of time in the task-specific region of interest and vertical variance of kicks), and one non-task-specific spatial variable (horizontal variance of kicks). The infants born PT, similar to FT, increased their general spatial exploration and duration in the region of interest and did not change the vertical and horizontal variances of kicks. However, the infants born PT, compared to FT, spent less time in the task-specific region of interest and had a greater non-task-specific horizontal variance throughout the task. This may indicate that infants born PT and FT exhibit similar general spatial exploration, but infants born PT exhibit less task-specific spatial exploration. Future research is necessary to determine the contribution of learning and motor abilities to the differences in task-specific exploration between infants born PT and FT.

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Hamed Shahidian, Rezaul Begg, and David C. Ackland

Dual-task walking and cell phone usage, which is associated with high cognitive load and reduced situational awareness, can increase risk of a collision, a fall event, or death. The objective of this study was to quantify the effect of dual-task cell phone talking, texting, and reading while walking on spatiotemporal gait parameters; minimum foot clearance; and dynamic stability of the lower limb joints, trunk, and head. Nineteen healthy male participants walked on an instrumented treadmill at their self-selected speed as well as walking while simultaneously (1) reading on a cell phone, (2) texting, and (3) talking on a cell phone. Gait analyses were performed using an optical motion analysis system, and dynamic stability was calculated using the Maximum Lyapunov Exponent. Dual-task cell phone usage had a significant destabilizing influence on the lower limb joints during walking. Cell phone talking while walking significantly increased step width and length and decreased minimum foot clearance height (P < .05). The findings suggest that dual-task walking and cell phone conversation may present a greater risk of a fall event than texting or reading. This may be due to the requirements for more rapid information processing and cognitive demand at the expense of motor control of joint stability.

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Alexander H.K. Montoye, Olivia Coolman, Amberly Keyes, Megan Ready, Jaedyn Shelton, Ethan Willett, and Brian C. Rider

Background: Given the popularity of thigh-worn accelerometers, it is important to understand their reliability and validity. Purpose: Our study evaluated laboratory validity and free-living intermonitor reliability of the Fibion monitor and free-living intermonitor reliability of the activPAL monitor. Free-living comparability of the Fibion and activPAL monitors was also assessed. Methods: Nineteen adult participants wore Fibion monitors on both thighs while performing 11 activities in a laboratory setting. Then, participants wore Fibion and activPAL monitors on both thighs for 3 days during waking hours. Accuracy of the Fibion monitor was determined for recognizing lying/sitting, standing, slow walking, fast walking, jogging, and cycling. For the 3-day free-living wear, outputs from the Fibion monitors were compared, with similar analyses conducted for the activPAL monitors. Finally, free-living comparability of the Fibion and activPAL monitors was determined for nonwear, sitting, standing, stepping, and cycling. Results: The Fibion monitor had an overall accuracy of 85%–89%, with high accuracy (94%–100%) for detecting prone and supine lying, sitting, and standing but some misclassification among ambulatory activities and for left-/right-side lying with standing. Intermonitor reliability was similar for the Fibion and activPAL monitors, with best reliability for sitting but poorer reliability for activities performed least often (e.g., cycling). The Fibion and activPAL monitors were not equivalent for most tested metrics. Conclusion: The Fibion monitor appears suitable for assessment of sedentary and nonsedentary waking postures, and the Fibion and activPAL monitors have comparable intermonitor reliability. However, studies using thigh-worn monitors should use the same monitor brand worn on the same leg to optimize reliability.