title: Validation of an activity monitor for children who are partly or completely wheelchair-dependent.
abstract: BACKGROUND
  Children who are wheelchair-dependent are at risk for developing unfavorable physical behavior; therefore, assessment, monitoring and efforts to improve physical behavior should start early in life. VitaMove is an accelerometer-based activity monitor and can be used to detect and distinguish different categories of physical behavior, including activities performed in a wheelchair and activities using the legs. The purpose of this study was to assess the validity of the VitaMove activity monitor to quantify physical behavior in children who are partly or completely wheelchair-dependent.
  
  
  METHODS
  Twelve children with spina bifida (SB) or cerebral palsy (CP) (mean age, 14 ± 4 years) performed a series of wheelchair activities (wheelchair protocol) and, if possible, activities using their legs (n = 5, leg protocol). Activities were performed at their own home or school. In children who were completely wheelchair-dependent, VitaMove monitoring consisted of one accelerometer-based recorder attached to the sternum and one to each wrist. For children who were partly ambulatory, an additional recorder was attached to each thigh. Using video-recordings as a reference, primary the total duration of active behavior, including wheeled activity and leg activity, and secondary agreement, sensitivity and specificity scores were determined.
  
  
  RESULTS
  Detection of active behaviour with the VitaMove activity monitor showed absolute percentage errors of 6% for the wheelchair protocol and 10% for the leg protocol. For the wheelchair protocol, the mean agreement was 84%, sensitivity was 80% and specificity was 85%. For the leg protocol, the mean agreement was 83%, sensitivity was 78% and specificity was 90%. Validity scores were lower in severely affected children with CP.
  
  
  CONCLUSIONS
  The VitaMove activity monitor is a valid device to quantify physical behavior in children who are partly or completely wheelchair-dependent, except for severely affected children and for bicycling.
authors: Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040 , 3000 , CA, Rotterdam, The Netherlands. c.nooijen@erasmusmc.nl.
authors: Carla Fj
authors: CF
authors: Nooijen
authors: Research Group Lifestyle and Health, HU University of Applied Sciences, Utrecht, the Netherlands. janke.degroot@hu.nl.
authors: Janke F
authors: JF
authors: de Groot
authors: Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040 , 3000 , CA, Rotterdam, The Netherlands. h.j.stam@erasmusmc.nl.
authors: Henk J
authors: HJ
authors: Stam
authors: Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040 , 3000 , CA, Rotterdam, The Netherlands. h.j.g.vandenberg@erasmusmc.nl.
authors: Rita Jg
authors: RJ
authors: van den Berg-Emons
authors: Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040 , 3000 , CA, Rotterdam, The Netherlands. j.b.j.bussmann@erasmusmc.nl.
authors: Hans Bj
authors: HB
authors: Bussmann
mesh_terms: D061725:Accelerometry / Q000295:instrumentation* / Q000379:methods; D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D019988:Children with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D009043:Motor Activity / Q000502:physiology*; D016135:Spinal Dysraphism / Q000150:complications; D014910:Wheelchairs
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