Validity of accelerometry for predicting physical activity and sedentary time in ambulatory children and young adults with cerebral palsy

Ruirui Xing, Wendy Y J HUANG*, Cindy Hui ping Sit

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: /Objectives: This study aimed to validate five published ActiGraph (AG) cut-off points for the measurements of physical activity (PA) and sedentary time (ST) in ambulatory children and young adults with cerebral palsy (CP). Additionally, four energy expenditure (EE) prediction equations based on AG counts and activPAL (AP) steps were examined in this population, using oxygen uptake (VO2) as the criterion. Methods: Four male and six female participants with CP (Gross Motor Function Classification System levels I–III, ages 9–21 years) completed seven activities while simultaneously wearing an AG, AP monitor and indirect calorimetry unit. VO2 was measured on a breath-by-breath basis using the indirect calorimetry and was converted into EE using metabolic equivalents. AG counts were classified as sedentary, light PA (LPA) or moderate-to-vigorous PA (MVPA) using five cut-off points: Puyau, Evenson, Romanzini, Clanchy and Baque. The predicted EE was computed using three AG-based equations (Freedson, Trost and Treuth) and an AP step-based equation. Results: Based on 1920 available data points from the 10 participants, Baque (r = 0.896, κ = 0.773) and Clanchy (r = 0.935, κ = 0.721) AG cut-off points classified PA and ST most accurately. All the equations overestimated EE during sitting activities and underestimated EE during rapid walking. The Freedson, Treuth and AP equations exhibited systematic bias during rapid walking, as their differences from the criterion measure increased progressively with increasing activity intensity. Conclusions: The AG accurately classified PA and ST when the Baque and Clanchy cut-off points were used. However, none of the available AG or AP equations accurately predicted the EE during PA and ST in children and young adults with CP. Further development is needed to ensure that both devices can estimate EE accurately in this population.

Original languageEnglish
Pages (from-to)19-24
Number of pages6
JournalJournal of Exercise Science and Fitness
Volume19
Issue number1
DOIs
Publication statusPublished - Jan 2021

Scopus Subject Areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Public Health, Environmental and Occupational Health

User-Defined Keywords

  • actigraph
  • activPAL
  • Cerebral palsy
  • Energy expenditure
  • Physical activity
  • Sedentary time

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