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A Comparison of Accelerometer Cut-Points among Individuals with Coronary Artery Disease.

ABSTRACT: Accurate assessment of physical activity among coronary artery disease patients is important for assessing adherence to interventions. The study compared moderate-to-vigorous physical intensity activity and relationships with cardiometabolic health/fitness indicators using accelerometer cut-points developed for coronary artery disease patients versus those developed in younger and middle-aged adults.A total of 231 adults with coronary artery disease wore an Actigraph GT3X accelerometer for ?4 days (?10 hours/day). Moderate-to-vigorous intensity physical activity between cut-points was compared using Bland-Altman analyses. Partial spearman correlations assessed relationships between moderate-to-vigorous intensity physical activity from each cut-point with markers of cardiometabolic health and fitness while controlling for age and sex.Average time spent in bouts of moderate-to-vigorous intensity physical activity using coronary artery disease cut-points was significantly higher than the young (mean difference: 13.0±12.8 minutes/day) or middle-aged (17.0±15.2 minutes/day) cut-points. Young and middle-aged cut-points were more strongly correlated with body mass index, waist circumference and systolic blood pressure, while coronary artery disease cut-points had stronger relationships with triglycerides, high-density and low-density lipoproteins. All were similarly correlated with measures of fitness.Researchers need to exert caution when deciding on which cut-points to apply to their population. Further work is needed to validate which cut-points provide a true reflection of moderate-to-vigorous intensity physical activity and to examine relationships among patients with varying fitness.

SUBMITTER: Prince SA

PROVIDER: S-EPMC4567312 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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A Comparison of Accelerometer Cut-Points among Individuals with Coronary Artery Disease.

Prince Stephanie A SA Reed Jennifer L JL Mark Amy E AE Blanchard Christopher M CM Grace Sherry L SL Reid Robert D RD

PloS one 20150911 9

<h4>Background</h4>Accurate assessment of physical activity among coronary artery disease patients is important for assessing adherence to interventions. The study compared moderate-to-vigorous physical intensity activity and relationships with cardiometabolic health/fitness indicators using accelerometer cut-points developed for coronary artery disease patients versus those developed in younger and middle-aged adults.<h4>Methods</h4>A total of 231 adults with coronary artery disease wore an Act ...[more]

PMID: 26361345

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Project description:This study aimed to examine the validity and accuracy of wrist accelerometers for classifying sedentary behavior (SB) in children.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).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 < 0.01; -2.5%, -27.9% to 22.9%). The mean bias of SB time estimates from Kim were smaller than ActiGraph hip (5-8 yr: 15.8%, -5.7% to 37.2%; 9-12 yr: 17.8%, -3.9% to 39.5%) and similar to or smaller than activPAL3 (5-8 yr: 12.6%, -39.8% to 14.7%; 9-12 yr: -1.4%, -13.9% to 11.0%), although classification accuracy was similar to ActiGraph hip (ROC-AUC = 0.85) but lower than activPAL3 (ROC-AUC = 0.92-0.97). Mean bias (5-8 yr: 6.5%, -16.1% to 29.1%; 9-12 yr: 10.5%, -13.6% to 34.6%) for the most accurate GENEActiv wrist cut point (Schaefer: ?0.19 g) was smaller than ActiGraph hip, and activPAL3 in 5-8 yr, but larger than activPAL3 in 9-12 yr. However, SB time estimates from Schaefer were not equivalent to direct observation (equivalence P > 0.05) and classification accuracy (ROC-AUC = 0.79-0.80) was lower than for ActiGraph hip and activPAL3.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.

Project description:BackgroundIncorporating physical activity into lifestyle routines is recommended for individuals with type 2 diabetes. Accelerometers offer a promising method for objectively measuring physical activity and for assessing interventions. However, the existing literature for accelerometer-measured physical activity among middle-aged and older adults with type 2 diabetes is lacking.ObjectiveThis study aims to identify research studies in which accelerometer-based cut points were used to classify the physical activity intensity of middle-aged to older adults with type 2 diabetes as sedentary, light, moderate, vigorous, and very vigorous, and to determine if validated accelerometer cut points specifically for this population exist.MethodsWe followed the Joanna Briggs Institute methodology for scoping reviews. Between June 23 and July 12, 2020, two reviewers independently screened records from four databases (PubMed, Web of Science, Embase, Engineering Village) and the ActiGraph Corp web site for eligible studies that included patients with type 2 diabetes with a sample mean age ≥50 years, used research-grade accelerometers, applied cut points to categorize objectively measured physical activity, and were available in English. We excluded studies reporting exclusively steps or step counts measured by accelerometers or pedometers and conference abstracts or other sources that did not have a full text available. Data extraction was completed using Microsoft Excel. Data for the following variables were tabulated based on frequency distributions: study design, accelerometer type, device placement, epoch length, total wear time, and cut points used. Study aims and participant demographic data were summarized.ResultsA total of 748 records were screened at the abstract level, and 88 full-text articles were assessed for eligibility. Ultimately, 46 articles were retained and analyzed. Participants' mean ages ranged from 50 to 79.9 years. The ActiGraph accelerometer and the Freedson et al and Troiano et al counts-per-minute cut points were the most frequently used across the literature. Freedson et al and Troiano et al counts-per-minute cut points for light, moderate, and vigorous activity correspond to <1952, 1952-5724, and ≥5725, and 100-2019, 2020-5998, and ≥5999, respectively. The Lopes et al cut points were developed by calibrating the ActiGraph in middle-aged and older adults with overweight/obesity and type 2 diabetes. These counts-per-minute thresholds are ≥200 (light), ≥1240 (moderate), and ≥2400 (vigorous), and were applied in 1 interventional study.ConclusionsAn assortment of accelerometer cut points have been used by researchers to categorize physical activity intensity for middle-aged and older adults with diabetes. Only one set of cut points was validated and calibrated in our population of interest. Additional research is warranted to address the need for diabetes-specific cut points to inform public health recommendations. This includes confirmation that the Lopes et al cut points reflect clinically meaningful changes in physical activity for adults with diabetes who have comorbidities other than overweight/obesity and the development of relative intensity cut points that may be more suitable for those with suboptimal physical functioning.

Dataset Information

A Comparison of Accelerometer Cut-Points among Individuals with Coronary Artery Disease.

Publications

A Comparison of Accelerometer Cut-Points among Individuals with Coronary Artery Disease.

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