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Heontae Kim and Minsoo Kang

Background: To establish evidence for the validity of the Sedentary Behavior Record (SBR) instrument using a criterion measure through a proxy of direct observation. Methods: A total of 27 study participants (aged ≥18 y; 15 male) participated in this study. Throughout a 4-day measurement period, each participant recorded their sedentary behavior using the SBR in 10-minute blocks every night. During the measurement period, participants also wore wearable Autographer cameras as a proxy for direct observation. Autographer data were aggregated into 10-minute intervals. To establish evidence of validity, contingency (C) and Kappa (K) coefficients were calculated between the SBR and the Autographer data. For C and K, agreements were determined between 2 measures every cell. The coefficient C was compared across domains, types, and time of day, and K was compared across types of day and times of day. Results: Overall, the coefficients C and K were acceptable (C = .70) and substantial (K = .64), respectively. Among all domains, the highest C was reported for work-related sitting (C = .87). Values of C ranged from .49 to .91 among all activities; the highest accuracy was for work-related, screen-based sitting. Conclusions: This study suggests that the SBR is an acceptable self-report measure of sedentary behavior in adults.

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Minsoo Kang and Thomas M. Brinthaupt

This study examined the effect of a 6-week school-based pedometer intervention for children. It compared the number of step counts between group- and individual-based step goal conditions over time, and compared the number of goal attainments between the two step goal conditions by physical activity levels. Ninety-nine 4th-grade students’ (50 boys, 49 girls) data were analyzed. Overall step counts continued to increase over time, increasing about 19% from baseline. Different step goal conditions produced similar effects on children’s physical activity levels across all time points. The number of goal attainments was higher for low active children with individual-based step goals than those with group-based step goals. Using pedometers in school is promising for enhancing physical activity in children.

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Youngdeok Kim, Ilhyeok Park, and Minsoo Kang

The purpose of this study was to investigate rater effects on the TGMD-2 when it applied to children with intellectual disability. A total of 22 children with intellectual disabilities participated in this study. Children’s performances in each of 12 subtests of the TGMD-2 were recorded via video and scored by three adapted physical activity specialists who have expertise in the TGMD-2. Two advanced measurement theories, Generalizability-theory (G-theory) and many-facet Rasch model (MFRM), were applied in data analyses. There were relatively large variances attributed to rater effects on the scores of the TGMD-2 awarded to children with intellectual disabilities. The severity of each rater significantly differed across all subtests of the TGMD-2. There was a set of biased ratings interacted with measurement conditions of the TGMD-2.

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James L. Farnsworth, Youngdeok Kim, and Minsoo Kang

Background:

Disruptive sleeping patterns have been linked to serious medical conditions. Regular physical activity (PA) has a positive impact on health; however, few research have investigated the relationships between PA, body mass index (BMI), sedentary behaviors (SB), and sleep disorders (SD).

Methods:

Data from the 2005–2006 NHANES were analyzed for this study. Participants (N = 2989; mean age = 50.44 years) were grouped based upon responses to SD questions. Accelerometers were used to measure the average time spent in moderate or vigorous physical activity (MVPA) and SB. Multinomial logistic regression analyses were used to examine the associations between PA, SB, and SD after controlling for covariates and to explore potential moderation effects among common risk factors and the main study variables.

Results:

Among middle-aged adults, PA was significantly associated with SD [Wald χ2 (8) = 22.21; P < .001]. Furthermore, among adults in the highest tertile of SB, PA was significantly associated with SD [Wald χ2 (8) = 32.29; P < .001].

Conclusions:

These results indicate that middle-aged adults who are less active may have increased likelihoods of SD. It is important for health care professionals to continue developing methods for increasing PA to decrease the risk of SD.

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Minsoo Kang, Youngdeok Kim, and David A. Rowe

Background:

This study examined the optimal measurement conditions to obtain reliable peak cadence measures using the accelerometer-determined step data from the National Health and Nutrition Examination Survey 2005–2006.

Methods:

A total of 1282 adults (> 17 years) who provided valid accelerometer data for 7 consecutive days were included. The peak 1- and 30-minute cadences were extracted. The sources of variance in peak stepping cadences were estimated using Generalizability theory analysis. A simulation analysis was conducted to examine the effect of the inclusion of weekend days. The optimal number of monitoring days to achieve 80% reliability for peak stepping cadences were estimated.

Results:

Intraindividual variability was the largest variance component of peak cadences for young and middle-aged adults aged < 60 years (50.55%–59.24%) compared with older adults aged ≥ 60 years (31.62%–41.72%). In general, the minimum of 7 and 5 days of monitoring were required for peak 1- and 30-minute cadences among young and middle-aged adults, respectively, whereas 3 days of monitoring was sufficient for older adults to achieve the desired reliability (0.80). The inclusion of weekend days in the monitoring frame may not be practically important.

Conclusions:

The findings could be applied in future research as the reference measurement conditions for peak cadences.

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James L. Farnsworth II, Todd Evans, Helen Binkley, and Minsoo Kang

Context: Previous research suggests that several knee-specific patient-reported outcome measures have poor measurement properties. The patient-reported outcomes knee assessment tool (PROKAT) was created to improve assessment of knee-specific function. Examination of the measurement properties of this new measure is critical to determine its clinical value. Objective: Examine the measurement properties of the PROKAT. Design: Cross-sectional study. Setting: Clinical athletic training setting. Patients or Other Participants: The pilot study included 32 student-athletes (mean age = 20.78 [1.01], males = 56.30%). The full study included 203 student-athletes (mean age = 21.46 [4.64], males = 54.70%) from 3 separate institutions. The participants were recruited for both the pilot and full study using face-to-face and electronic (eg, email and social media sites) communications. Intervention(s): Evaluation of the measurement properties of the PROKAT occurred using the Rasch partial-credit model. Main Outcome Measures: Infit and outfit statistics, item step difficulties, person ability parameters, category function, item and test information functions, and Cronbach alpha. An independent samples t test was used to evaluate the differences in injured and noninjured athletes’ scores. Results: The Rasch partial-credit model analysis of pilot test items and qualitative participant feedback were used to modify the initial PROKAT. Evaluation of the revised PROKAT (32 items) indicated 27 items had acceptable model–data fit. The injured athletes scored significantly worse than the noninjured athletes (t 188 = 12.89; P < .01). The ceiling effects for the PROKAT were minimal (3.9%). Conclusions: A major advantage of this study was the use of the Rasch measurement and the targeted population. Compared with alternative knee-specific patient-reported outcome measures (eg, Knee Injury Osteoarthritis Outcome Score, International Knee Documentation Committee Subjective Knee Form), the PROKAT has low ceiling effects in athletic populations. In addition, evidence suggests the measure may be capable of distinguishing between injured and noninjured athletes.

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Youngdeok Kim, Jaehoon Cho, Dana K Fuller, and Minsoo Kang

Background:

The purpose of this study was to examine the correlates of physical activity (PA) with personal and environmental factors among people with disabilities in South Korea.

Methods:

Data from the 2011 National Survey for Physical Activity and Exercise for the Disabled, conducted by Korea Sports Association for the Disabled, was used (n = 1478). The personal characteristics (age, gender, occupation, types of disabilities, family income) and the numbers of public PA-related facilities (welfare center, public indoor gym, and public outdoor facilities) and social sports/exercise clubs for people with disabilities across 16 local areas were also obtained. Hierarchical generalized linear model was used to examine subjectively measured PA in relation to personal and environmental factors.

Results:

The likelihood of engaging in PA was significantly lower for women with disabilities. People with hearing and intellectual disabilities were less likely to engage in PA compared with those with physical disabilities. The availability of sports/exercise clubs for people with disabilities was the only environmental factor that was significantly associated with PA.

Conclusions:

These findings suggest the need of systematic intervention strategies based upon personal characteristics of people with disabilities. Further public efforts to promote sports/exercise club activities should be encouraged in this population.

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Elizabeth A. Holbrook, Minsoo Kang, and Don W. Morgan

As a first step toward the development of adapted physical activity (PA) programs for adults with visual impairment (VI), the purpose of this study was to determine the time frame needed to reliably estimate weekly PA in adults with VI. Thirty-three adults with VI completed 7 days of pedometer-based PA assessment. Generalizability theory analyses were conducted to quantify sources of variance within the PA estimate and determine the appropriate number of days of PA monitoring needed for the total sample and for participants with mild-to-moderate and severe VI. A single-facet, crossed design was employed including participants and days. Participants and days correspondingly accounted for 33–55% and 0–3% of the total variance in PA. While a reliable account of PA was obtained for the total sample over a 6-day period, shorter (4-day) and longer (9-day) periods were required for persons with mild-to-moderate and severe VI, respectively.

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James L. Farnsworth II, Todd Evans, Helen Binkley, and Minsoo Kang

Context: Documentation of patient outcomes following injury is critical to ensure that patients are receiving the best care. Several patient-reported outcome measures (PROMs) have been developed to assess knee-related function following injury; however, there is limited data investigating the measurement properties of these instruments using Rasch model analyses. Objective: To evaluate the measurement properties of several PROMs through application of the Rasch measurement model. Design: Cross-sectional study. Setting: Clinical setting. Patients or Other Participants: A convenience sample of 160 adults (mean age = 28.08 [10.95] y; male = 38.10%) were recruited for this study. Data collected were combined with existing pilot data from an earlier study containing de-identified Knee Injury and Osteoarthritis Outcome Score (KOOS) data from 79 adults with knee injuries resulting in a total sample size of 239 adults. Intervention(s): Psychometric evaluation of the KOOS, International Knee Documentation Committee subjective knee form, and the Marx Activity Rating Scale using the Rasch partial credit model. Main Outcome Measures: Infit and outfit statistics, item step difficulties, person ability parameters, category function, and item and test information functions. Results: Large ceiling effects were present in the KOOS and International Knee Documentation Committee subjective knee form. Of the 65 items examined in this study, 35 items showed poor measurement properties. Item step difficulty for the remaining 30 items ranged from −5.45 (least difficult) to 0.57 logits (most difficult). The 5-category response options did not function well. Measurement precision decreased significantly as ability score increased beyond 0.30 logits. Conclusions: Despite their use in clinical practice, several items showed poor measurement properties. Future studies are needed to develop and evaluate novel items that are suitable for measuring knee-related function in high-functioning populations to ensure continuity of PROMs as individuals recover from injuries.

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Tiago V. Barreira, John P. Bennett, and Minsoo Kang

Purpose:

To obtain validity evidence for the measurement of step counts by spring-levered and piezoelectric pedometers during dance.

Methods:

Thirty-five adults in a college dance class participated in this study. Participants completed trials of 3- and 5-min of different styles of dance wearing Walk4life MVP and Omron HJ-303 pedometers, while their steps were visually counted. Pearson correlation, paired t-test, mean absolute percent error (MAPE), and mean bias were calculated between actual step and pedometer step counts for the 3- and 5-min dances separately.

Results:

For the Walk4life trials the correlations were .92 and .77 for the 3- and 5-min dances. No significant differences were shown by t-test for the 3- (P = .16) and 5-min dances (P = .60). However, MAPE was high, 17.7 ± 17.7% and 19.4 ± 18.3% for the 2 dance durations, respectively. For the Omron, the correlations were .44 and .58 for the 3- and 5-min dances, respectively. No significant differences were shown by t-test for the 3-min (P = .38) and for the 5-min (P = .88) dances. However, MAPE was high, 19.3 ± 16.4% and 26.6 ± 15.2% for the 2 dance durations, respectively.

Conclusions:

This study demonstrated that pedometers can be used to estimate the number of steps taken by a group of college students while dancing, however caution is necessary with individual values.