Practical considerations in using accelerometers to assess physical activity, sedentary behavior, and sleep.

Increasingly, behavioral and epidemiological research uses activity-based measurements (accelerometry) to provide objective estimates of physical activity, sedentary behavior, and sleep in a variety of study designs. As interest in concurrently assessing these domains grows, there are key methodological considerations that influence the choice of monitoring instrument, analysis algorithm, and protocol for measuring these behaviors. The purpose of this review is to summarize evidence-guided information for 7 areas that are of importance in the design and interpretation of studies using actigraphy: (1) choice of cut-points; (2) impact of epoch length; (3) accelerometer placement; (4) duration of monitoring; (5) approaches for distinguishing sleep, nonwear times, and sedentary behavior; (6) role for a sleep and activity diary; and (7) epidemiological applications. Recommendations for future research are outlined and are intended to enhance the appropriate use of accelerometry for assessing physical activity, sedentary behavior, and sleep behaviors in research studies.

[1]  J Lellouch,et al.  Marked 24-h rest/activity rhythms are associated with better quality of life, better response, and longer survival in patients with metastatic colorectal cancer and good performance status. , 2000, Clinical cancer research : an official journal of the American Association for Cancer Research.

[2]  Leena Choi,et al.  Separating Bedtime Rest from Activity Using Waist or Wrist-Worn Accelerometers in Youth , 2014, PloS one.

[3]  Song Yang,et al.  Imputation of missing data when measuring physical activity by accelerometry. , 2005, Medicine and science in sports and exercise.

[4]  Lucas J Carr,et al.  Accuracy of Intensity and Inclinometer Output of Three Activity Monitors for Identification of Sedentary Behavior and Light-Intensity Activity , 2011, Journal of obesity.

[5]  Søren Brage,et al.  Accelerometers and pedometers: methodology and clinical application , 2007, Current opinion in clinical nutrition and metabolic care.

[6]  Stewart G Trost,et al.  Conducting accelerometer-based activity assessments in field-based research. , 2005, Medicine and science in sports and exercise.

[7]  K. Watson,et al.  Comparison of accelerometer cut points to estimate physical activity in US adults , 2014, Journal of sports sciences.

[8]  Sheana S Bull,et al.  Putting prevention in their pockets: developing mobile phone-based HIV interventions for black men who have sex with men. , 2013, AIDS patient care and STDs.

[9]  Michael Rueschman,et al.  Reproducibility of a Standardized Actigraphy Scoring Algorithm for Sleep in a US Hispanic/Latino Population. , 2015, Sleep.

[10]  Kelly R Evenson,et al.  Accelerometer use in physical activity: best practices and research recommendations. , 2005, Medicine and science in sports and exercise.

[11]  Scott E Crouter,et al.  Validity of ActiGraph 2-regression model, Matthews cut-points, and NHANES cut-points for assessing free-living physical activity. , 2013, Journal of physical activity & health.

[12]  D. Kripke,et al.  Wrist actigraphic scoring for sleep laboratory patients: algorithm development , 2010, Journal of sleep research.

[13]  U. Ekelund,et al.  Sedentary time in children: influence of accelerometer processing on health relations. , 2013, Medicine and science in sports and exercise.

[14]  Leslie B. Hammer,et al.  A workplace intervention improves sleep: results from the randomized controlled Work, Family, and Health Study. , 2015, Sleep health.

[15]  Wendy J Brown,et al.  ActiGraph GT3X+ cut-points for identifying sedentary behaviour in older adults in free-living environments. , 2014, Journal of science and medicine in sport.

[16]  K. Matthews,et al.  Utility of actiwatch sleep monitor to assess waking movement behavior in older women. , 2014, Medicine and science in sports and exercise.

[17]  D Peach,et al.  Exploring the ActiLife® filtration algorithm: converting raw acceleration data to counts , 2014, Physiological measurement.

[18]  Scott Duncan,et al.  Accelerometer data reduction in adolescents: effects on sample retention and bias , 2013, International Journal of Behavioral Nutrition and Physical Activity.

[19]  Nicole Probst-Hensch,et al.  Effects of filter choice in GT3X accelerometer assessments of free-living activity. , 2013, Medicine and science in sports and exercise.

[20]  C. Pollak,et al.  The role of actigraphy in the study of sleep and circadian rhythms. , 2003, Sleep.

[21]  Scott E Crouter,et al.  Estimating physical activity in youth using a wrist accelerometer. , 2015, Medicine and science in sports and exercise.

[22]  Kai Hockerts,et al.  A Validation Study , 2015 .

[23]  J. Witt,et al.  The stability of children's physical activity as measured by accelerometry and self-report. , 1995, Medicine and science in sports and exercise.

[24]  Inge Tetens,et al.  Measure of sleep and physical activity by a single accelerometer: Can a waist-worn Actigraph adequately measure sleep in children? , 2012 .

[25]  Dinesh John,et al.  Comment on "estimating activity and sedentary behavior from an accelerometer on the hip and wrist". , 2013, Medicine and science in sports and exercise.

[26]  J. Staudenmayer,et al.  Validation of wearable monitors for assessing sedentary behavior. , 2011, Medicine and science in sports and exercise.

[27]  Richard P Troiano,et al.  Large-scale applications of accelerometers: new frontiers and new questions. , 2007, Medicine and science in sports and exercise.

[28]  Kenneth Meijer,et al.  Activity identification using body-mounted sensors—a review of classification techniques , 2009, Physiological measurement.

[29]  Scott J Strath,et al.  Accelerometer use with children, older adults, and adults with functional limitations. , 2012, Medicine and science in sports and exercise.

[30]  Thomas Penzel,et al.  Agreement of different methods for assessing sleep characteristics: a comparison of two actigraphs, wrist and hip placement, and self-report with polysomnography. , 2014, Sleep medicine.

[31]  M. Kothare,et al.  Algorithms for sleep–wake identification using actigraphy: a comparative study and new results , 2009, Journal of sleep research.

[32]  A. Sadeh,et al.  Activity-based sleep-wake identification: an empirical test of methodological issues. , 1994, Sleep.

[33]  P. Freedson,et al.  Using objective physical activity measures with youth: how many days of monitoring are needed? , 2000, Medicine and science in sports and exercise.

[34]  N. Wareham,et al.  Use of accelerometers in a large field-based study of children: protocols, design issues, and effects on precision. , 2008, Journal of physical activity & health.

[35]  M. Puyau,et al.  Validation and calibration of physical activity monitors in children. , 2002, Obesity research.

[36]  I-Min Lee,et al.  Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges , 2013, British Journal of Sports Medicine.

[37]  Greet Cardon,et al.  Calibration and comparison of accelerometer cut points in preschool children. , 2011, International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity.

[38]  Mark S Tremblay,et al.  Quality control and data reduction procedures for accelerometry-derived measures of physical activity. , 2010, Health reports.

[39]  Adrian Bauman,et al.  Accelerometer-based measures in physical activity surveillance: current practices and issues , 2014, British Journal of Sports Medicine.

[40]  S. Iacobelli,et al.  Circadian rhythm in rest and activity: a biological correlate of quality of life and a predictor of survival in patients with metastatic colorectal cancer. , 2009, Cancer research.

[41]  U. Ekelund,et al.  Reliability and validity of the combined heart rate and movement sensor Actiheart , 2005, European Journal of Clinical Nutrition.

[42]  C. Matthews,et al.  Too much sitting: the population health science of sedentary behavior. , 2010, Exercise and sport sciences reviews.

[43]  J. Mota,et al.  Accelerometer cut-points and youth physical activity prevalence , 2007 .

[44]  S. Grant,et al.  An objective method for measurement of sedentary behavior in 3- to 4-year olds. , 2003, Obesity research.

[45]  S. Trost,et al.  Calibration and Evaluation of an Objective Measure of Physical Activity in Preschool Children , 2005 .

[46]  A. Sadeh,et al.  Estimating sleep patterns with activity monitoring in children and adolescents: how many nights are necessary for reliable measures? , 1999, Sleep.

[47]  Sari A Acra,et al.  Predicting energy expenditure of physical activity using hip- and wrist-worn accelerometers. , 2003, Diabetes technology & therapeutics.

[48]  Vincent Onywera,et al.  Improving wear time compliance with a 24-hour waist-worn accelerometer protocol in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) , 2015, International Journal of Behavioral Nutrition and Physical Activity.

[49]  Warren W Tryon,et al.  Issues of validity in actigraphic sleep assessment. , 2004, Sleep.

[50]  M. Vitiello,et al.  Concordance of polysomnographic and actigraphic measurement of sleep and wake in older women with insomnia. , 2013, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[51]  Derek M. Peters,et al.  Discrepancies in accelerometer-measured physical activity in children due to cut-point non-equivalence and placement site , 2012, Journal of sports sciences.

[52]  P. Freedson,et al.  Amount of time spent in sedentary behaviors in the United States, 2003-2004. , 2008, American journal of epidemiology.

[53]  D. Kupfer,et al.  Comparison of Five Actigraphy Scoring Methods with Bipolar Disorder , 2013, Behavioral sleep medicine.

[54]  John Staudenmayer,et al.  Evaluation of artificial neural network algorithms for predicting METs and activity type from accelerometer data: validation on an independent sample. , 2011, Journal of applied physiology.

[55]  P. Lavie,et al.  The relationship between sleep and temperament revisited: evidence for 12-month-olds: a research note. , 1998, Journal of child psychology and psychiatry, and allied disciplines.

[56]  R. Colley,et al.  Impact of accelerometer epoch length on physical activity and sedentary behaviour outcomes for preschool-aged children. , 2014, Health reports.

[57]  Joss Langford,et al.  Autocalibration of accelerometer data for free-living physical activity assessment using local gravity and temperature: an evaluation on four continents , 2014, Journal of applied physiology.

[58]  Beatrix Vereijken,et al.  Physical activity monitoring by use of accelerometer-based body-worn sensors in older adults: a systematic literature review of current knowledge and applications. , 2012, Maturitas.

[59]  Minsoo Kang,et al.  Impact of accelerometer wear time on physical activity data: a NHANES semisimulation data approach , 2012, British Journal of Sports Medicine.

[60]  P. Gallagher,et al.  Accuracy of computer algorithms and the human eye in scoring actigraphy , 2013, Sleep and Breathing.

[61]  C. Pollak,et al.  Direct comparison of two widely used activity recorders. , 1998, Sleep.

[62]  S. Going,et al.  Defining accelerometer thresholds for activity intensities in adolescent girls. , 2004, Medicine and science in sports and exercise.

[63]  Alexander Horsch,et al.  Physical Activity in German Adolescents Measured by Accelerometry and Activity Diary: Introducing a Comprehensive Approach for Data Management and Preliminary Results , 2013, PloS one.

[64]  J. Solet,et al.  Measuring sleep: accuracy, sensitivity, and specificity of wrist actigraphy compared to polysomnography. , 2013, Sleep.

[65]  Leena Choi,et al.  Validation of accelerometer wear and nonwear time classification algorithm. , 2011, Medicine and science in sports and exercise.

[66]  C A Czeisler,et al.  Circadian timekeeping in health and disease. Part 2. Clinical implications of circadian rhythmicity. , 1983, The New England journal of medicine.

[67]  B. Guinhouya,et al.  Fuzzy logic for characterizing the moderate intensity of physical activity in children. , 2016, Journal of science and medicine in sport.

[68]  Yeh-Liang Hsu,et al.  A Review of Accelerometry-Based Wearable Motion Detectors for Physical Activity Monitoring , 2010, Sensors.

[69]  Max Hirshkowitz,et al.  Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms: an update for 2002. , 2003, Sleep.

[70]  Daniel J Buysse,et al.  The consensus sleep diary: standardizing prospective sleep self-monitoring. , 2012, Sleep.

[71]  P. Lee.  A sensitivity analysis on the variability in accelerometer data processing for monitoring physical activity. , 2015, Gait & posture.

[72]  C A Czeisler,et al.  Circadian timekeeping in health and disease. Part 1. Basic properties of circadian pacemakers. , 1983, The New England journal of medicine.

[73]  M. Sateia,et al.  International classification of sleep disorders-third edition: highlights and modifications. , 2014, Chest.

[74]  Marie Löf,et al.  Estimation of Daily Energy Expenditure in Pregnant and Non-Pregnant Women Using a Wrist-Worn Tri-Axial Accelerometer , 2011, PloS one.

[75]  Kimberly Topp,et al.  Validation of a hip-worn accelerometer in measuring sleep time in children. , 2012, Journal of pediatric nursing.

[76]  F. Kinnafick,et al.  Actigraph Accelerometer-Defined Boundaries for Sedentary Behaviour and Physical Activity Intensities in 7 Year Old Children , 2011, PloS one.

[77]  Tina L Hurst,et al.  Physical activity classification using the GENEA wrist-worn accelerometer. , 2012, Medicine and science in sports and exercise.

[78]  F. Sera,et al.  Quality Control Methods in Accelerometer Data Processing: Defining Minimum Wear Time , 2013, PloS one.

[79]  Scott E Crouter,et al.  Refined two-regression model for the ActiGraph accelerometer. , 2010, Medicine and science in sports and exercise.

[80]  H J Montoye,et al.  Variability of some objective measures of physical activity. , 1992, Medicine and science in sports and exercise.

[81]  H. Kamphuisen,et al.  Wrist actigraphic assessment of sleep in 116 community based subjects suspected of obstructive sleep apnoea syndrome. , 1995, Thorax.

[82]  B.H.W. te Lindert,et al.  Sleep estimates using microelectromechanical systems (MEMS). , 2013 .

[83]  David R Bassett,et al.  Accelerometer-based physical activity: total volume per day and standardized measures. , 2015, Medicine and science in sports and exercise.

[84]  Lijing L. Yan,et al.  Intra-individual daily and yearly variability in actigraphically recorded sleep measures: the CARDIA study. , 2007, Sleep.

[85]  J. Sallis,et al.  Using accelerometers in youth physical activity studies: a review of methods. , 2013, Journal of physical activity & health.

[86]  Paul D Loprinzi,et al.  The Relationship of Actigraph Accelerometer Cut-Points for Estimating Physical Activity With Selected Health Outcomes , 2012, Research quarterly for exercise and sport.

[87]  Gregory J Welk,et al.  Everything you wanted to know about selecting the "right" Actigraph accelerometer cut-points for youth, but…: a systematic review. , 2012, Journal of science and medicine in sport.

[88]  Catrine Tudor-Locke,et al.  A Catalog of Rules, Variables, and Definitions Applied to Accelerometer Data in the National Health and Nutrition Examination Survey, 2003–2006 , 2012, Preventing chronic disease.

[89]  Julie L Otte,et al.  Nighttime Variability in Wrist Actigraphy , 2011, Journal of Nursing Measurement.

[90]  Nicholas Hart,et al.  Comparison of 7 versus 14 days wrist actigraphy monitoring in a sleep disorders clinic population , 2014, Chronobiology international.

[91]  David R Bassett,et al.  Sources of variance in daily physical activity levels as measured by an accelerometer. , 2002, Medicine and science in sports and exercise.

[92]  Shang-Ming Zhou,et al.  Classification of accelerometer wear and non-wear events in seconds for monitoring free-living physical activity , 2015, BMJ Open.

[93]  C. Waltz.  Validation study. , 1988, NLN publications.

[94]  A. Hofman,et al.  Disagreement between subjective and actigraphic measures of sleep duration in a population‐based study of elderly persons * , 2008, Journal of sleep research.

[95]  K. Meredith-Jones,et al.  Challenges and Emerging Technologies within the Field of Pediatric Actigraphy , 2014, Front. Psychiatry.

[96]  L. Meltzer,et al.  Comparison of actigraphy immobility rules with polysomnographic sleep onset latency in children and adolescents , 2015, Sleep and Breathing.

[97]  J. Staudenmayer,et al.  Classification accuracy of the wrist-worn gravity estimator of normal everyday activity accelerometer. , 2013, Medicine and science in sports and exercise.

[98]  M. Granat,et al.  The validation of a novel activity monitor in the measurement of posture and motion during everyday activities , 2006, British Journal of Sports Medicine.

[99]  S. Grant,et al.  Objective measurement of physical activity and sedentary behaviour: review with new data , 2008, Archives of Disease in Childhood.

[100]  Stewart G Trost,et al.  Prediction of activity type in preschool children using machine learning techniques. , 2015, Journal of science and medicine in sport.

[101]  Gregory J Welk,et al.  Principles of design and analyses for the calibration of accelerometry-based activity monitors. , 2005, Medicine and science in sports and exercise.

[102]  Michael J. Sateia.  Contemporary Reviews in Sleep MedicineInternational Classification of Sleep Disorders-Third Edition , 2014 .

[103]  R. Mcmurray,et al.  Calibration of two objective measures of physical activity for children , 2008, Journal of sports sciences.

[104]  S. Intille,et al.  Estimating activity and sedentary behavior from an accelerometer on the hip or wrist. , 2013, Medicine and science in sports and exercise.

[105]  Scott E Crouter,et al.  A novel method for using accelerometer data to predict energy expenditure. , 2006, Journal of applied physiology.

[106]  S. Grant,et al.  Monitoring of physical activity in young children: How much is enough? , 2006 .

[107]  B. Ainsworth,et al.  Estimation of energy expenditure using CSA accelerometers at hip and wrist sites. , 2000, Medicine and science in sports and exercise.

[108]  Jonathan Lester,et al.  New horizons in sensor development. , 2012, Medicine and science in sports and exercise.

[109]  U. Ekelund,et al.  Validity and comparability of a wrist-worn accelerometer in children. , 2012, Journal of physical activity & health.

[110]  Basel Kikhia,et al.  Optimal Placement of Accelerometers for the Detection of Everyday Activities , 2013, Sensors.

[111]  C. Matthews,et al.  Best practices for using physical activity monitors in population-based research. , 2012, Medicine and science in sports and exercise.

[112]  M. Pearce,et al.  Stability of habitual physical activity and sedentary behavior monitoring by accelerometry in 6- to 8-year-olds. , 2011, Journal of physical activity & health.

[113]  Emanuele Lindo Secco,et al.  A Real-Time and Self-Calibrating Algorithm Based on Triaxial Accelerometer Signals for the Detection of Human Posture and Activity , 2010, IEEE Transactions on Information Technology in Biomedicine.

[114]  M. Carter,et al.  Adherence to a Smartphone Application for Weight Loss Compared to Website and Paper Diary: Pilot Randomized Controlled Trial , 2013, Journal of medical Internet research.

[115]  A. Hofman,et al.  Stability and Fragmentation of the Activity Rhythm Across the Sleep-Wake Cycle: The Importance of Age, Lifestyle, and Mental Health , 2013, Chronobiology international.

[116]  G. Cardon,et al.  Measuring physical activity using accelerometry in 13–15-year-old adolescents: the importance of including non-wear activities , 2011, Public Health Nutrition.

[117]  J. Carrier,et al.  Wake detection capacity of actigraphy during sleep. , 2007, Sleep.

[118]  S. Mednick,et al.  Actigraphic assessment of a polysomnographic‐recorded nap: a validation study , 2011, Journal of sleep research.

[119]  G. Calogiuri,et al.  Methodological Issues for Studying the Rest–Activity Cycle and Sleep Disturbances , 2013, Biological research for nursing.

[120]  Kate Ridley,et al.  Agreement between activPAL and ActiGraph for assessing children's sedentary time , 2012, International Journal of Behavioral Nutrition and Physical Activity.

[121]  T. Robinson,et al.  Estimating physical activity from incomplete accelerometer data in field studies. , 2007, Journal of physical activity & health.

[122]  Bernard F Fuemmeler,et al.  Accelerometer data reduction: a comparison of four reduction algorithms on select outcome variables. , 2005, Medicine and science in sports and exercise.

[123]  Catrine Tudor-Locke,et al.  Fully automated waist-worn accelerometer algorithm for detecting children's sleep-period time separate from 24-h physical activity or sedentary behaviors. , 2014, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[124]  Barbara E Ainsworth,et al.  Objective and subjective measures of sedentary behavior and physical activity. , 2010, Medicine and science in sports and exercise.