Wrist Accelerometer Cut Points for Classifying Sedentary Behavior in Children.

Abstract

INTRODUCTION: This study aimed to examine the validity and accuracy of wrist accelerometers for classifying sedentary behavior (SB) in children. METHODS: Fifty-seven children (5-8 and 9-12 yr) completed an ~170-min protocol, including 15 semistructured activities and transitions. Nine ActiGraph (GT3X+) and two GENEActiv wrist cut points were evaluated. Direct observation was the criterion measure. The accuracy of wrist cut points was compared with that achieved by the ActiGraph hip cut point (≤25 counts per 15 s) and the thigh-mounted activPAL3. Analyses included equivalence testing, Bland-Altman procedures, and area under the receiver operating curve (ROC-AUC). RESULTS: The most accurate ActiGraph wrist cut points (Kim; vector magnitude, ≤3958 counts per 60 s; vertical axis, ≤1756 counts per 60 s) demonstrated good classification accuracy (ROC-AUC = 0.85-0.86) and accurately estimated SB time in 5-8 yr (equivalence P = 0.02; mean bias = 4.1%, limits of agreement = -20.1% to 28.4%) and 9-12 yr (equivalence P 0.05) and classification accuracy (ROC-AUC = 0.79-0.80) was lower than for ActiGraph hip and activPAL3. CONCLUSION: The most accurate SB ActiGraph (Kim) and GENEActiv (Schaefer) wrist cut points can be applied in children with similar confidence as the ActiGraph hip cut point (≤25 counts per 15 s), although activPAL3 was generally more accurate.This study was funded by the National Heart Foundation of Australia (G11S5975). DPC is supported by an Australian Research Council Discovery Early Career Researcher Award (DE140101588). ADO is supported by a National Heart Foundation of Australia Career Development Fellowship (CR11S 6099). TH is funded by a National Health and Medical Research Council Early Career Fellowship (APP1070571). The work of UE and SB is funded by the UK Medical Research Council (MC_UU_12015/3). ST is supported by the National Health and Medical Research Council Centre of Research Excellence on Sitting Time and Chronic Disease Prevention (APP1057608)