title: Comparison of methods to assess energy expenditure and physical activity in people with spinal cord injury.
abstract: OBJECTIVE
  To compare different methods of assessing energy expenditure (EE) and physical activity (PA) in people with spinal cord injury (SCI) under community-dwelling conditions.
  
  
  METHODS
  A reference standard encompassing the doubly labelled water (DLW)  technique, heart rate monitoring (FLEX-HR), a multi-sensor armband (SenseWear Armband (SWA)), and two PA recall questionnaires were employed in 14 people with SCI to estimate EE and leisure-time PA.
  
  
  RESULTS
  Mean total daily energy expenditure (TDEE) assessed by DLW, FLEX-HR,  and SWA were 9817 ± 2491 kJ/day, 8498 ± 1516 kJ/day, and 11414 ± 3242 kJ/day, respectively. Physical activity energy expenditure (PAEE) quantified by DLW was 2841 ± 1626 kJ/day, 2935 ± 1732 kJ/day  estimated from FLEX-HR, and 2773 ± 2966 kJ/day derived from SWA. After converting the PA recall questionnaire data to EE in kJ/day, PAEE for the Physical Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI) was 2339 ± 1171 kJ/day  and for Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) 749 ± 1026 kJ/day. DLW-quantified PAEE was moderately associated with PARA-SCI (R(2) = 0.62, P < 0.05), but not with the other estimates  of PAEE (R(2) ranged between 0.13 and 0.30, P > 0.05).
  
  
  CONCLUSIONS
  Our findings revealed that the PARA-SCI recall questionnaire was the best estimate of PAEE compared to the reference standard DLW approach. Although the between-method  variability for SWA, FLEX-HR, and PASIPD-derived PAEE was small, there was a weak association between these methods and the criterion DLW technique. The best estimate of DLW-quantified TDEE was by FLEX-HR. SWA significantly overestimated TDEE in this population.
authors.affiliation: University of Sydney, Sydney, NSW, Australia. ricardo.tanhoffer@gmail.com
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Tanhoffer
authors.forename: Aldre I P
authors.initials: AI
authors.lastname: Tanhoffer
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Raymond
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Hills
authors.forename: Glen M
authors.initials: GM
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000886:Anthropometry; D001481:Basal Metabolism / Q000502:physiology*; D002151:Calorimetry; D004734:Energy Metabolism / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009043:Motor Activity / Q000502:physiology*; D011237:Predictive Value of Tests; D012016:Reference Values; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D055815:Young Adult