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Criterion Validity of Commonly Used Sedentary Behavior Questionnaires to Measure Total Sedentary Time in Adults

Madeline E. Shivgulam, Derek S. Kimmerly, and Myles W. O’Brien

Background: Self-report questionnaires are a fast and cost-efficient method to determine habitual sedentary time (sitting/lying time while awake), but their accuracy versus thigh-worn accelerometry (criterion), which can distinguish between sitting and standing postures, is unclear. While the validity of sedentary questionnaires has previously been evaluated, they have not been investigated simultaneously in the same sample population. We tested the hypothesis that common sedentary questionnaires underpredict habitual sedentary time compared with an objective, monitor-based assessment. Methods: Ninety-three participants (30 ± 18 years, 59 females) wore the activPAL inclinometer on the midthigh 24 hr per day for 6.9 ± 0.4 days and completed the SIT-Q, Sedentary Behavior Questionnaire (SBQ), International Physical Activity Questionnaire (IPAQ), and Physical Activity and Sedentary Behavior Questionnaire (PASB-Q). Results: In comparison to the activPAL (9.9 ± 1.9 hr/day), the SIT-Q measured more time (12.9 ± 5.4 hr/day), but the SBQ (7.5 ± 3.3 hr/day), IPAQ (7.4 ± 3.0 hr/day), and PASB-Q (6.6 ± 3.0 hr/day) measured less time (all p < .001). The SIT-Q was positively and weakly correlated (ρ = .230 [95% confidence interval: .020, .422], p = .028) with the activPAL, but the SBQ, IPAQ, and PASB-Q were not (all ps > .760). Equivalence testing demonstrated poor equivalence for the SIT-Q (±40%), SBQ (±31%), IPAQ (±36%), and PASB-Q (±29%). The SIT-Q (β = −1.36), SBQ (β = −0.97), and IPAQ (β = −0.78) exhibited a negative proportional bias (all ps < .002). Conclusions: In summary, the SIT-Q, SBQ, IPAQ, and PASB-Q demonstrated poor validity. Researchers and health promoters should be cautious when implementing these self-report sedentary time questionnaires, as they may not reflect the true sedentary activity and negatively impact study results.

Free access

agcounts: An R Package to Calculate ActiGraph Activity Counts From Portable Accelerometers

Brian C. Helsel, Paul R. Hibbing, Robert N. Montgomery, Eric D. Vidoni, Lauren T. Ptomey, Jonathan Clutton, and Richard A. Washburn

Portable accelerometers are used to capture physical activity in free-living individuals with the ActiGraph being one of the most widely used device brands in physical activity and health research. Recently, in February 2022, ActiGraph published their activity count algorithm and released a Python package for generating activity counts from raw acceleration data for five generations of ActiGraph devices. The nonproprietary derivation of the ActiGraph count improved the transparency and interpretation of accelerometer device-measured physical activity, but the Python release of the count algorithm does not integrate with packages developed by the physical activity research community using the R Statistical Programming Language. In this technical note, we describe our efforts to create an R-based translation of ActiGraph’s Python package with additional extensions to make data processing easier and faster for end users. We call the resulting R package agcounts and provide an inside look at its key functionalities and extensions while discussing its prospective impacts on collaborative open-source software development in physical behavior research. We recommend that device manufacturers follow ActiGraph’s lead by providing open-source access to their data processing algorithms and encourage physical activity researchers to contribute to the further development and refinement of agcounts and other open-source software.

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Comparing Accelerometer Processing Metrics and Hyperparameter Optimization for Physical Activity Classification Accuracy Using Machine Learning Methods

Sumayyah Bamidele Musa, Arnab Barua, Kevin G. Stanley, Fabien A. Basset, Hiroshi Mamyia, Kevin Mongeon, and Daniel Fuller

Background: Physical activity (PA) is a crucial factor in maintaining good health and preventing chronic diseases. However, accurately measuring PA is challenging. Euclidean Norm Minus One (ENMO), ActiGraph Counts, and Monitor-Independent Movement Summary (MIMS) units are processing metrics used to classify PA through accelerometry, but they employ different methods to calculate activity levels. This study aimed to compare ENMO, ActiGraph Counts, and MIMS accelerometer metrics using machine learning algorithms. Methods: Data from a smartphone accelerometer were collected from 50 participants who held the smartphone in their right hand while completing six activities. The data were used to generate ENMO, ActiGraph Counts, and MIMS acceleration metrics. Random Forest, K-Nearest Neighbor, and Support Vector Machine algorithms were applied to the data to classify PA into different levels of activity intensity and types. The algorithms’ performance was evaluated using various metrics such as accuracy, precision, and recall. Results: The results showed that both the Random Forest and K-Nearest Neighbor algorithms performed well, achieving above 80% accuracy in classifying PA into different intensity levels and types. Both the ENMO and MIMS metrics proved more accurate than ActiGraph Counts in classifying moderate to vigorous PA. Conclusions: This study provides evidence that both ENMO and MIMS metrics can accurately measure PA with accelerometry, and machine learning algorithms can classify the activity into different intensity levels. These metrics and methods are valuable tools for monitoring PA and understanding the relationship between PA and health outcomes.

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Examining the Agreement Between the activPAL micro4 and ActiGraph GT9X Accelerometers on Daily Movement Behaviors Among Adults With Total Knee Replacement

Katherine E. DeVivo, Chih-Hsiang Yang, and Christine A. Pellegrini

Objective: The primary purpose was to examine the agreement in sedentary, light, and moderate to vigorous minutes and step counts between the activPAL micro4 and ActiGraph GT9X in adults following total knee replacement. A secondary purpose was to examine the agreement between the activPAL micro4 and ActiGraph GT9X accelerometers at two different time points after surgery (∼1 and 3 months). Methods: Participants in a randomized trial wore ActiGraph GT9X and activPAL micro4 monitors simultaneously for 7 days at ∼1 and 3 months after total knee replacement. The intraclass correlations for time spent in sedentary behavior, light, and moderate to vigorous activity in addition to step counts were estimated to determine consistency between the two monitors. Bland–Altman plot demonstrated the 95% limits of agreement between the monitors at both time points. Results: A total of 480 observations (days) were used from 41 participants (64.9 ± 7 years, 32.4 ± 6.5 kg/m2, 75.6% White, 61% female). The intraclass correlations between the ActiGraph GT9X and activPAL micro4 accelerometers was .839 for sedentary behavior, .853 for light activity, .806 for moderate to vigorous activity, and .937 for steps. The 95% confidence intervals of intraclass correlations between time points indicate a significantly higher agreement between the monitors at 3 months as compared with 1 month. Conclusion: The results suggest that either the ActiGraph GT9X or the activPAL micro4 accelerometers may be used for measuring sedentary, light, and moderate to vigorous minutes and step counts in adults after knee replacement.

Free access

From Research to Application of Wearable-Derived Digital Health Measures—A Perspective From ActiGraph

Jeremy Wyatt and Christine C. Guo

ActiGraph counts were first conceptualized in 1996 to provide an accelerometer-derived metric that can quantify physical activity based on intensity. ActiGraph incorporated this metric into its product suite, enabling its wide adoption in research studies. Over the last 20 years, ActiGraph activity counts have become one of the most common metrics and building blocks of health outcome measures used in wearable research, with >24,000 journal articles published (based on Google Scholar search in 2023). Recently, this field of research is increasingly moving toward clinical application where wearable-derived metrics are growing in industry-sponsored clinical trials, including several use cases endorsed by the regulatory authorities. We celebrate this emerging trend as these patient-generated measures help reduce trial burden and enhance the meaningfulness of developed medical products to the patients. However, true adoption of digital measures in industry research is only in its infancy and still faces many challenges. As a digital health technology provider, ActiGraph has launched several strategic initiatives to support the research community to overcome these challenges and accelerate the translation of research to clinical application. The open-source release of the ActiGraph count algorithm was one of those initiatives. In this commentary, we take the opportunity to share our perspective in supporting the research community with this metric over the last 20 years, the motivation for making this open source, and what we are building to accelerate clinical adoption and realize the promise of better patient care.

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Measurement Reactivity in Ecological Momentary Assessment Studies of Movement-Related Behaviors

Jaclyn P. Maher, Danielle Arigo, Kiri Baga, Gabrielle M. Salvatore, Kristen Pasko, Brynn L. Hudgins, and Laura M. König

Measurement reactivity has implications for behavioral science, as it is crucial to determine whether changes in constructs of interest represent true change or are an artifact of assessment. This study investigated whether measurement reactivity occurs for movement-related behaviors, motivational antecedents of behavior, and associations between them. Data from ecological momentary assessment studies of older adults (n = 195) and women in midlife (n = 75) lasting 8–10 days with 5–6 prompts/day and ambulatory monitoring of movement were used for this secondary data analysis. To examine potential drop-off patterns indicative of measurement reactivity, multilevel models tested whether behavior, antecedents, and associations changed after the first or first 2 prompts compared with remaining prompts and the first, first 2, or first 3 days compared with remaining days. Older adults’ sedentary behavior was lower, and time spent upright and intentions and self-efficacy to stand/move were higher on the first 2 and first 3 days compared with remaining days. Associations between intentions and self-efficacy and subsequent sedentary behavior were weaker earlier in the study compared to later. For women in midlife, light physical activity was higher at the first and first 2 prompts compared with remaining prompts, and physical activity motivation was higher across all prompts and days tested. There was a stronger association between intended and observed minutes of moderate to vigorous physical activity on the first 2 days compared with remaining days. Measurement reactivity appeared as expected for movement-related behaviors and motivational antecedents, though changes in associations between these constructs are likely do not reflect measurement reactivity.

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Characterizing ActiGraph’s Idle Sleep Mode in Free-Living Assessments of Physical Behavior

Samuel R. LaMunion, Robert J. Brychta, Joshua R. Freeman, Pedro F. Saint-Maurice, Charles E. Matthews, Asuka Ishihara, and Kong Y. Chen

ActiGraph’s idle sleep mode (ISM) is an optional battery- and memory-conserving feature believed to engage during periods of nonwear, inactivity, and sleep, but it has not been well studied in free-living environments. Thus, we investigated ISM during a 7-day assessment in a nationally representative sample of 13,649 participants (6–80 years) in the United States and found it engaged 43.6% ± 0.2% (mean ± SE) of the 24 hr per day. ISM engagement was highest (78.4% ± 0.2%) during early morning (00:00–05:59) and lowest (20.4% ± 0.3%) during afternoon (12:00–17:59), corresponding to quadrants of lowest and highest of movement, respectively. ISM engagement was also inversely correlated with daily activity across all participants (R = −.72, p < .001). When restricted to participants averaging ≥21 hr per day of wear (N = 10,482), ISM still engaged 39.5% ± 0.2% of the day and inversely correlated to daily activity (R = −.58, p < .001). These results suggest ISM engages in activity level-dependent temporal patterns. Additional research is needed to better inform analyses and interpretation of ISM-enabled data including whether it is appropriate to process them with existing methods that were developed and validated using data without ISM enabled. This issue may be particularly relevant for methods used to detect and score sleep, as ISM engaged during a substantial portion of the typical overnight sleep period in the 8-hr window between ≥22:00 and <06:00 (74.0% ± 12.6%, mean ± SD).

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Comparability of 24-hr Activity Cycle Outputs From ActiGraph Counts Generated in ActiLife and RStudio

Alexander H.K. Montoye, Kimberly A. Clevenger, Benjamin D. Boudreaux, and Michael D. Schmidt

Data from ActiGraph accelerometers have long been imported into ActiLife software, where the company’s proprietary “activity counts” were generated in order to understand physical behavior metrics. In 2022, ActiGraph released an open-source method to generate activity counts from any raw, triaxial accelerometer data using Python, which has been translated into RStudio packages. However, it is unclear if outcomes are comparable when generated in ActiLife and RStudio. Therefore, the authors’ technical note systematically compared activity counts and related physical behavior metrics generated from ActiGraph accelerometer data using ActiLife or available packages in RStudio and provides example code to ease implementation of such analyses in RStudio. In addition to comparing triaxial activity counts, physical behavior outputs (sleep, sedentary behavior, light-intensity physical activity, and moderate- to vigorous-intensity physical activity) were compared using multiple nonwear algorithms, epochs, cut points, sleep scoring algorithms, and accelerometer placement sites. Activity counts and physical behavior outcomes were largely the same between ActiLife and the tested packages in RStudio. However, peculiarities in the application of nonwear algorithms to the first and last portions of a data file (that occurred on partial, first or last days of data collection), differences in rounding, and handling of counts values on the borderline of activity intensities resulted in small but inconsequential differences in some files. The hope is that researchers and both hardware and software manufacturers continue to push efforts toward transparency in data analysis and interpretation, which will enhance comparability across devices and studies and help to advance fields examining links between physical behavior and health.

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Pre- Versus Postmeal Sedentary Duration—Impact on Postprandial Glucose in Older Adults With Overweight or Obesity

Elizabeth Chun, Irina Gaynanova, Edward L. Melanson, and Kate Lyden

Introduction : Reducing sedentary time is associated with improved postprandial glucose regulation. However, it is not known if the timing of sedentary behavior (i.e., pre- vs. postmeal) differentially impacts postprandial glucose in older adults with overweight or obesity. Methods : In this secondary analysis, older adults (≥65 years) with overweight and obesity (body mass index ≥ 25 kg/m2) wore a continuous glucose monitor and a sedentary behavior monitor continuously in their real-world environments for four consecutive days on four separate occasions. Throughout each 4-day measurement period, participants followed a standardized eucaloric diet and recorded mealtimes in a diary. Glucose, sedentary behavior, and meal intake data were fused using sensor and diary timestamps. Mixed-effect linear regression models were used to evaluate the impact of sedentary timing relative to meal intake. Results : Premeal sedentary time was significantly associated with both the increase from premeal glucose to the postmeal peak (ΔG) and the percent of premeal glucose increase that was recovered 1-hr postmeal glucose peak (%Baseline Recovery; p < .05), with higher levels of premeal sedentary time leading to both a larger ΔG and a smaller %Baseline Recovery. Postmeal sedentary time was significantly associated with the time from meal intake to glucose peak (ΔT; p < .05), with higher levels of postmeal sedentary time leading to a longer time to peak. Conclusions : Pre- versus postmeal sedentary behavior differentially impacts postprandial glucose response in older adults with overweight or obesity, suggesting that the timing of sedentary behavior reductions might play an influential role on long-term glycemic control.

Open access

A Self-Paced Walk Test for Individual Calibration of Heart Rate to Energy Expenditure

Kate Westgate, Tomas I. Gonzales, Stefanie Hollidge, Tim Lindsay, Nick Wareham, and Søren Brage

Introduction: Estimating free-living physical activity (PA) with continuous heart rate (HR) monitoring is challenging due to individual variation in the relationship between HR and energy expenditure. This variation can be captured through individual calibration with graded exercise tests, but structured tests with prescribed load require medical screening and are not always feasible in population settings. We present and evaluate an individual calibration method using HR response to a less demanding self-paced walk test. Methods: Six hundred and forty-three participants from the Fenland Study (Cambridgeshire, the United Kingdom) completed a 200-m self-paced walk test, a treadmill test, and 1 week of continuous HR and accelerometry monitoring. Mixed-effects regression was used to derive a walk test calibration model from HR response to the walk using treadmill-based parameters as criterion. Free-living PA estimates from the calibration model were compared with treadmill-calibrated and non-exercise-calibrated estimates. Results: Walk calibration captured 57% of the variance in the HR–energy expenditure relationship determined by the treadmill test. Applying walk calibration to data from free-living yielded similar PA estimates to those using treadmill calibration (52.7 vs. 52.0 kJ·kg−1·day−1; mean difference: 0.7 kJ·kg−1·day−1, 95% confidence interval [−0.0, 1.5]) and high correlation (r = .89). Individual differences were observed (root mean square error: 10.0 kJ·kg−1·day−1; 95% limits of agreement: −20.6, 19.1 kJ·kg−1·day−1). Walk calibration improved precision by 29% compared with nonexercise group calibration (root mean square error: 14.0 kJ·kg−1·day−1; 95% limits of agreement: −30.4, 24.5 kJ·kg−1·day−1). Conclusions: A 200-m self-paced walk test captures between-individual variation in the HR–energy expenditure relationship and facilitates estimation of free-living PA in population settings.