title: Measuring Physical Activity in Free-Living Conditions-Comparison of Three Accelerometry-Based Methods.
abstract: We examined the agreement in time spent on different physical activity (PA) levels using (1) mean amplitude deviation (MAD) of raw acceleration from the hip, (2) wrist-worn Polar Active, and (3) hip-worn Actigraph counts using Freedson's cut-points among adults under free-living conditions. PA was measured in 41 volunteers (mean age 47.6 years) for 14 days. Two MET-based threshold sets were used for MAD and Polar Active for sedentary time (ST) and time spent in light (LPA), moderate (MPA), and vigorous (VPA) PA. Actigraph counts were divided into PA classes, ≤100 counts/min for ST and Freedson's cut-points for LPA, MPA, and VPA. Analysis criteria were simultaneous use of devices for at least 4 days of >500 min/d. The between-method differences were analyzed using a repeated measures analysis of variance test. Bland-Altman plots and ROC graphs were also employed. Valid data were available from 27 participants. Polar Active produced the highest amount of VPA with both thresholds (≥5 and ≥6 MET; mean difference 17.9-30.9 min/d,P< 0.001). With the threshold 3-6 MET for MPA, Polar Active indicated 19.2 min/d more than MAD (95% CI 5.8-32.6) and 51.0 min/d more than Actigraph (95% CI 36.7-65.2). The results did not differ with 3.5-5 MET for MPA [F(1.44, 37.43)= 1.92,P= 0.170]. MAD and Actigraph were closest to each other for ST with the threshold < 1.5 MET (mean difference 22.2 min/d, 95% CI 7.1-37.3). With the threshold <2 MET, Polar Active and Actigraph provided similar results (mean difference 7.0 min/d, 95% CI -17.8-31.7). Moderate to high agreement (area under the ROC curve 0.806-0.963) was found between the methods for the fulfillment of the recommendation for daily moderate-to-vigorous PA of 60 min. In free-living conditions the agreement between MAD, Polar Active, and Actigraph for measuring time spent on different activity levels in adults was dependent on the activity thresholds used and PA intensity. ROC analyses showed moderate to high agreement for the fulfillment of the recommendation for daily MVPA. Without additional statistical adjustment, these methods cannot be used interchangeably when measuring daily PA, but any of the methods can be used to identify persons with insufficient daily amount of MVPA.
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, University of OuluOulu, Finland; Infotech Oulu, University of OuluOulu, Finland; Department of Sports and Exercise Medicine, Oulu Deaconess InstituteOulu, Finland.
authors.forename: Anna-Maiju
authors.initials: AM
authors.lastname: Leinonen
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, University of OuluOulu, Finland; Medical Research Center, Oulu University Hospital and University of OuluOulu, Finland.
authors.forename: Riikka
authors.initials: R
authors.lastname: Ahola
authors.affiliation: LIKES - Research Center for Sport and Health Sciences Jyväskylä, Finland.
authors.forename: Janne
authors.initials: J
authors.lastname: Kulmala
authors.affiliation: LIKES - Research Center for Sport and Health Sciences Jyväskylä, Finland.
authors.forename: Harto
authors.initials: H
authors.lastname: Hakonen
authors.affiliation: UKK Institute for Health Promotion Research Tampere, Finland.
authors.forename: Henri
authors.initials: H
authors.lastname: Vähä-Ypyä
authors.affiliation: Medical Research Center, Oulu University Hospital and University of OuluOulu, Finland; Research Unit of Biomedicine, University of OuluOulu, Finland; Department of Gastroenterology and Metabolism, Poznan University of Medical SciencesPoznan, Poland; Biocenter Oulu, University of OuluOulu, Finland.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Herzig
authors.affiliation: Medical Research Center, Oulu University Hospital and University of OuluOulu, Finland; Center for Life Course Health Research, University of OuluOulu, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Auvinen
authors.affiliation: Medical Research Center, Oulu University Hospital and University of OuluOulu, Finland; Center for Life Course Health Research, University of OuluOulu, Finland.
authors.forename: Sirkka
authors.initials: S
authors.lastname: Keinänen-Kiukaanniemi
authors.affiliation: UKK Institute for Health Promotion Research Tampere, Finland.
authors.forename: Harri
authors.initials: H
authors.lastname: Sievänen
authors.affiliation: LIKES - Research Center for Sport and Health Sciences Jyväskylä, Finland.
authors.forename: Tuija H
authors.initials: TH
authors.lastname: Tammelin
authors.affiliation: Department of Sports and Exercise Medicine, Oulu Deaconess InstituteOulu, Finland; Medical Research Center, Oulu University Hospital and University of OuluOulu, Finland; Center for Life Course Health Research, University of OuluOulu, Finland.
authors.forename: Raija
authors.initials: R
authors.lastname: Korpelainen
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, University of OuluOulu, Finland; Infotech Oulu, University of OuluOulu, Finland; Medical Research Center, Oulu University Hospital and University of OuluOulu, Finland; Diagnostic Radiology, Oulu University HospitalOulu, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Jämsä
keywords: accelerometer; agreement; middle-aged; objective measurement; sedentary time