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Kayla J. Nuss, Nicholas A. Hulett, Alden Erickson, Eric Burton, Kyle Carr, Lauren Mooney, Jacob Anderson, Ashley Comstock, Ethan J. Schlemer, Lucas J. Archambault, and Kaigang Li

Objective: To validate and compare the accuracy of energy expenditure (EE) and step counts measured by ActiGraph accelerometers (ACT) at dominant and nondominant wrist and hip sites. Methods: Thirty young adults (15 females, age 22.93 ± 3.30 years) wore four ActiGraph wGT3X accelerometers while walking and running on a treadmill for 7 min at seven different speeds (1.7, 2.5, 3.4, 4.2, 5.0, 5.5, and 6.0 mph). The EE from each ACT was calculated using the Freedson Adult equation, and the “worn on the wrist” option was selected for the wrist data. Indirect calorimetry and manually counted steps were used as criterion measures. Mean absolute percentage error and two one-sided test procedures for equivalence were used for the analyses. Results: All ACTs underestimated the EE with mean absolute percentage errors over 30% for wrist placement and over 20% for hip placement. The wrist-worn ACTs underestimated the step count with mean absolute percentage errors above 30% for both dominant and nondominant placements. The hip-worn ACTs accurately assessed steps for the whole sample and for women and men (p < .001 to .05 for two one-sided tests procedures), but not at speeds slower than 2.0 mph. Conclusion: Neither hip nor wrist placements assess EE accurately. More algorithms and methods to derive EE estimates from wrist-worn ACTs must be developed and validated. For step counts, both dominant and nondominant hip placements, but not wrist placements, lead to accurate results for both men and women.