Calibration and Validation of a Wrist- and Hip-Worn Actigraph Accelerometer in 4-Year-Old Children.
BACKGROUND
To determine time spent at different physical activity intensities, accelerometers need calibration. The aim of this study was to develop and cross-validate intensity thresholds for the Actigraph GT3X+ accelerometer for wrist and hip placement in four-year-old children.


METHODS
In total 30 children (49 months, SD 3.7) were recruited from five preschools in Stockholm. Equipped with an accelerometer on the wrist and another on the hip, children performed three indoor activities and one free-play session while being video recorded. Subsequently, physical activity intensity levels were coded every 5th second according to the Children's Activity Rating Scale. Receiver Operating Characteristic (ROC) curves was used to develop wrist and hip intensity thresholds, the upper threshold for sedentary, and lower threshold for moderate-to-vigorous physical activity (MVPA), for the vertical axis (VA) and for the vector magnitude (VM). A leave-one-out method was used to cross-validate the thresholds.


RESULTS
Intensity thresholds for wrist placement were ≤ 178 (VA) and ≤ 328 (VM) for sedentary and ≥ 871 (VA) and ≥ 1393 (VM) counts/5 seconds for MVPA. The corresponding thresholds for hip placement were ≤ 43 (VA) and ≤ 105 (VM) for sedentary and ≥ 290 (VA) and ≥ 512 (VM) for MVPA. The quadratic weighted Kappa was 0.92 (95% CI 0.91-0.93) (VA) and 0.95 (95% CI 0.94-0.96) (VM) for the wrist-worn accelerometer and 0.76 (98% CI 0.74-0.77) and 0.86 (95% CI 0.85-0.87) for the hip-worn.


CONCLUSIONS
Using wrist placement and the VM when measuring physical activity with accelerometry in 4-year-old children is recommended.
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Elin
E
Johansson
Department of Clinical Science, Technology and Intervention, Karolinska Institutet, Stockholm, Sweden.
Lisa-Marie
LM
Larisch
Department of Clinical Science, Technology and Intervention, Karolinska Institutet, Stockholm, Sweden.
Claude
C
Marcus
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Maria
M
Hagströmer
D061725:Accelerometry / Q000295:instrumentation*; D002138:Calibration; D002675:Child, Preschool; D015444:Exercise; D005240:Feasibility Studies; D006615:Hip; D006801:Humans; D012372:ROC Curve; D013548:Sweden; D014953:Wrist