title: Estimation of Energy Expenditure for Wheelchair Users Using a Physical Activity Monitoring System.
abstract: To develop and evaluate energy expenditure (EE) estimation models for a physical activity monitoring system (PAMS) in manual wheelchair users with spinal cord injury (SCI).
  
  
  
  Cross-sectional study.
  
  
  
  University-based laboratory environment, a semistructured environment at the National Veterans Wheelchair Games, and the participants' home environments.
  
  
  
  Volunteer sample of manual wheelchair users with SCI (N=45).
  
  
  
  Participants were asked to perform 10 physical activities (PAs) of various intensities from a list. The PAMS consists of a gyroscope-based wheel rotation monitor (G-WRM) and an accelerometer device worn on the upper arm or on the wrist. Criterion EE using a portable metabolic cart and raw sensor data from PAMS were collected during each of these activities.
  
  
  
  Estimated EE using custom models for manual wheelchair users based on either the G-WRM and arm accelerometer (PAMS-Arm) or the G-WRM and wrist accelerometer (PAMS-Wrist).
  
  
  
  EE estimation performance for the PAMS-Arm (average error ± SD: -9.82%±37.03%) and PAMS-Wrist (-5.65%±32.61%) on the validation dataset indicated that both PAMS-Arm and PAMS-Wrist were able to estimate EE for a range of PAs with <10% error. Moderate to high intraclass correlation coefficients (ICCs) indicated that the EE estimated by PAMS-Arm (ICC3,1=.82, P<.05) and PAMS-Wrist (ICC3,1=.89, P<.05) are consistent with the criterion EE.
  
  
  
  Availability of PA monitors can assist wheelchair users to track PA levels, leading toward a healthier lifestyle. The new models we developed can estimate PA levels in manual wheelchair users with SCI in laboratory and community settings.
authors.affiliation: Department of Veterans Affairs, Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Department of Physical Therapy, Temple University, Philadelphia, PA. Electronic address: Shiv.Hiremath@temple.edu.
authors.forename: Shivayogi V
authors.initials: SV
authors.lastname: Hiremath
authors.affiliation: College of Computer and Information Science, Northeastern University, Boston, MA; Department of Health Sciences, Northeastern University, Boston, MA.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Intille
authors.affiliation: Department of Veterans Affairs, Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Annmarie
authors.initials: A
authors.lastname: Kelleher
authors.affiliation: Department of Veterans Affairs, Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Rory A
authors.initials: RA
authors.lastname: Cooper
authors.affiliation: Department of Veterans Affairs, Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Dan
authors.initials: D
authors.lastname: Ding
mesh_terms: D061725:Accelerometry; D000328:Adult; D003430:Cross-Sectional Studies; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods*; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D014910:Wheelchairs
keywords: Energy metabolism; Estimation; Exercise test; Motor activity; Rehabilitation; Smartphone; Spinal cord injuries; Wheelchairs