title: Which activity monitor to use? Validity, reproducibility and user friendliness of three activity monitors.
abstract: BACKGROUND
  Health is associated with amount of daily physical activity. Recently, the identification of sedentary time as an independent factor, has gained interest. A valid and easy to use activity monitor is needed to objectively investigate the relationship between physical activity, sedentary time and health. We compared validity and reproducibility of physical activity measurement and posture identification of three activity monitors, as well as user friendliness.
  
  
  METHODS
  Healthy volunteers wore three activity monitors simultaneously: ActivPAL3, ActiGraphGT3X and CAM. Data were acquired under both controlled (n = 5) and free-living conditions (n = 9). The controlled laboratory measurement, that included standardized walking intensity and posture allocation, was performed twice. User friendliness was evaluated with a questionnaire. Posture classification was compared with direct observation (controlled measurement) and with diaries (free living). Accelerometer intensity accuracy was tested by correlations with walking speed. User friendliness was compared between activity monitors.
  
  
  RESULTS
  Reproducibility was at least substantial in all monitors. The difference between the two CAM measurements increased with walking intensity. Amount of correct posture classification by ActivPAL3 was 100.0% (kappa 0.98), 33.9% by ActiGraphGT3X (kappa 0.29) and 100.0% by CAM (kappa 0.99). Correlations between accelerometer intensity and walking speed were 0.98 for ActivPAL3, 1.00 for ActiGraphGT3X and 0.98 for CAM. ICCs between activity monitors and diary were 0.98 in ActivPAL3, 0.59 and 0.96 in ActiGraphGT3X and 0.98 in CAM. ActivPAL3 and ActiGraphGT3X had higher user friendliness scores than the CAM.
  
  
  CONCLUSIONS
  The ActivPAL3 is valid, reproducible and user friendly. The posture classification by the ActiGraphGT3X is not valid, but reflection of walking intensity and user friendliness are good. The CAM is valid; however, reproducibility at higher walking intensity and user friendliness might cause problems. Further validity studies in free living are recommended.
authors: Department of Human Movement Science, NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, PO Box 616, Maastricht, 6200 MD, the Netherlands. Brenda.Berendsen@maastrichtuniversity.nl.
authors: Brenda A J
authors: BA
authors: Berendsen
authors: Marike R  C
authors: MR
authors: Hendriks
authors: Kenneth
authors: K
authors: Meijer
authors: Guy
authors: G
authors: Plasqui
authors: Nicolaas C
authors: NC
authors: Schaper
authors: Hans H C M
authors: HH
authors: Savelberg
mesh_terms: D061725:Accelerometry / Q000295:instrumentation*; D000328:Adult; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011187:Posture; D012016:Reference Values; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D016138:Walking; D055815:Young Adult