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Purpose: Understanding factors that influence accurate assessment of physical activity (PA) and sedentary behavior (SB) is important to measurement development, epidemiologic studies, and interventions. This study examined agreement between self-reported (International Physical Activity Questionnaire—Long Form[IPAQLF]) and accelerometry-based estimates of PA and SB across six countries and identified correlates of between-method agreement. Methods: Self-report and objective (accelerometry-based) PA and SB data were collected in 2002–2011 from 3865 adult participants in eight cities from six countries (Belgium, Czech Republic, Denmark, Spain, United Kingdom, and United States). Between-method relative agreement (correlation) and absolute disagreement (mean difference between conceptually and intensity-matched IPAQ-LF and accelerometry-based PA and SB variables) were estimated. Also, sociodemographic characteristics and PA patterns were examined as correlates of betweenmethod agreement. Results: Observed relative agreement (relationships of IPAQ-LF with accelerometry-based PA and SB variables) was small to moderate (r = 0.05–0.37) and was moderated by sociodemographic (age, sex, weight status, and education) and behavioral (PAtype) factors. The absolute disagreement was large, with participants self-reporting higher PA intensity and total time in moderate-tovigorous-intensity PA than accelerometry. Also, self-reported sitting time was lower than accelerometry-based sedentary behavior. After adjusting for sociodemographic and behavioral factors, the absolute disagreement between pairs of IPAQ-LF and accelerometry-based PA variables remained significantly different across cities/countries. Conclusions: Present findings suggest systematic cultural and/or linguistic and sociodemographic differences in absolute agreement between the IPAQ-LF and the accelerometry-based PA and SB variables. These results have implications for the interpretation of international PA and SB data and correlate/determinant studies. They call for further efforts to improve such measures. ; This work was supported by the National Cancer Institute of the National Institutes of Health (R01 CA127296). US data collection and multisite coordinating center processing was supported by the National Institutes of Health (grant nos. R01 HL67350 [NHLBI] and R01 CA127296 [National Cancer Institute] to J.F.S). E.C. is supported by an Australian Research Council Future Fellowship (FT no. 140100085). The contributions of N.O. were supported by an NHMRC Senior Principal Research Fellowship (no. 1003960) and by the Victorian Government's Operational Infrastructure Support Program. The Danish study was partly funded by the Municipality of Aarhus. Data collection in the Czech Republic was supported by the Ministry of Education, Youth and Sports (grant no. MSM 6198959221). The United Kingdom study was funded by the Medical Research Council under the National Preventive Research Initiative. The Spanish study was partially founded by the Navarra Government Health Department (grant no. 02/09).

Purpose. To assess the relationship between self-reported and objectively measured physical activity (PA) and metabolic syndrome and its risk factors in U.S. adults. Design. A cross-sectional design was used for this study. Setting. The study was set among a nationally representative sample of U.S. adults. Subjects. Adults, ages 20 years and older, from the National Health and Nutrition Examination Survey (NHANES) 2003–2006 (n = 5580) participated in the study. Measures. PA measures included minutes per week of moderate plus vigorous PA estimated by self-report (MVPAsr), total 7-day accelerometry (MVPAa), and accelerometer-based MVPA performed in 10-minute bouts (MVPAb). Risk factors for metabolic syndrome included blood pressure, high-density lipoprotein cholesterol, triglycerides, glucose, and waist circumference. Analysis. Odds ratios (ORs) for having metabolic syndrome were calculated for men and women who met the Physical Activity Guidelines for Americans compared to those who did not. Results. Women who did not meet the PA guidelines had significantly greater odds of having metabolic syndrome according to MVPAsr (OR = 2.20; 95% confidence interval [CI] = 1.65–2.94), MVPAa (OR = 4.40; 95% CI= 2.65–7.31), and MVPAb (OR= 2.91; 95% CI= 1.42–5.96). Men had significantly higher odds of having metabolic syndrome according to MVPAa (OR = 2.57; 95% CI= 1.91–3.45) and MVPAb (OR = 2.83; 95% CI = 1.55–5.17), but not MVPAsr. These ORs remained significant after adjusting for all potential confounders except body mass index, after which only MVPAsr in women and MVPAb in men remained significant. Conclusion. Individuals who do not meet the PA guidelines exhibited greater odds of having metabolic syndrome. This relationship tended to be stronger for objective PA measures than for self-report.

Abstract: Objective: Gait may be a useful biomarker that can be objectively measured with wearable technology to classify Parkinson's disease (PD). This study aims to: (i) comprehensively quantify a battery of commonly utilized gait digital characteristics (spatiotemporal and signal-based), and (ii) identify the best discriminative characteristics for the optimal classification of PD. Methods: Six partial least square discriminant analysis (PLS-DA) models were trained on subsets of 210 characteristics measured in 142 subjects (81 people with PD, 61 controls (CL)). Results: Models accuracy ranged between 70.42-88.73% (AUC: 78.4-94.5%) with a sensitivity of 72.84-90.12% and a specificity of 60.3-86.89%. Signal-based digital gait characteristics independently gave 87.32% accuracy. The most influential characteristics in the classification models were related to root mean square values, power spectral density, step velocity and length, gait regularity and age. Conclusions: This study highlights the importance of signal-based gait characteristics in the development of tools to help classify PD in the early stages of the disease. This work was supported by the Mobilise-D project that has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No. 820820. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation program and the European Federation of Pharmaceutical Industries and Associations (EFPIA). Content in this publication reflects the authors' view and neither IMI nor the European Union, EFPIA, or any Associated Partners are responsible for any use that may be made of the information contained herein.

The preferential use of one leg over another in performing lower-limb motor tasks (i.e., leg dominance) is considered to be one of the internal risk factors for sports-related lower-limb injuries. The current study aimed to investigate the effects of leg dominance on postural control during unipedal balancing on three different support surfaces with increasing levels of instability: a firm surface, a foam pad, and a multiaxial balance board. In addition, the interaction effect between leg dominance and surface stability was also tested. To this end, a tri-axial accelerometer-based smartphone sensor was placed over the lumbar spine (L5) of 22 young adults (21.5 ± 0.6 years) to record postural accelerations. Sample entropy (SampEn) was applied to acceleration data as a measure of postural sway regularity (i.e., postural control complexity). The results show that leg dominance (p < 0.001) and interaction (p < 0.001) effects emerge in all acceleration directions. Specifically, balancing on the dominant (kicking) leg shows more irregular postural acceleration fluctuations (high SampEn), reflecting a higher postural control efficiency or automaticity than balancing on the non-dominant leg. However, the interaction effects suggest that unipedal balancing training on unstable surfaces is recommended to reduce interlimb differences in neuromuscular control for injury prevention and rehabilitation.

In a hospital setting and among older patients, inactivity and bedrest are associated with a wide range of negative outcomes such as functional decline, increased risk of falls, longer hospitalization and institutionalization. Our aim was to assess the distribution, determinants and predictors of physical activity (PA) levels using wrist-worn accelerometers in older patients hospitalized with acute medical illness. Observational study conducted from February to November 2018 at an acute internal medicine unit in the University hospital of Lausanne, Switzerland. We enrolled 177 patients aged ≥65 years, able to walk prior to admission. PA during acute hospital stay was continuously recorded via a 3D wrist accelerometer. Clinical data was collected from medical records or by interview. Autonomy level prior to inclusion was assessed using Barthel Index score. PA levels were defined as < 30 mg for inactivity, 30-99 mg for light and ≥ 100 for moderate PA. Physically active patients were defined as 1) being in the highest quartile of time spent in light and moderate PA or 2) spending ≥20 min/day in moderate PA. Median [interquartile range - IQR] age was 83 [74-87] years and 60% of participants were male. The median [IQR] time spent inactive and in light PA was 613 [518-663] and 63 [30-97] minutes/day, respectively. PA peaked between 8 and 10 am, at 12 am and at 6 pm. Less than 10% of patients were considered physically active according to definition 2. For both definitions, active patients had a lower prevalence of walking aids and a lower dependency level according to Barthel Index score. For definition 1, use of medical equipment was associated with a 70% reduction in the likelihood of being active: odds ratio (OR) 0.30 [0.10-0.92] p = 0.034; for definition 2, use of walking aids was associated with a 75% reduction in the likelihood of being active: OR = 0.24 [0.06-0.89], p = 0.032. Older hospitalized patients are physically active only 10% of daily time and concentrate their PA around eating periods. Whether a ...

Purpose. To examine whether there are differences between demographic, behavioral, and biological variables for those with invalid accelerometry data (IAD) and those with valid accelerometry data (VAD) Design. Cross-sectional Setting. Data from 2003–2006 National Health and Nutrition Examination Survey (NHANES) were used Subjects. Participants included 1,315 children (ie., 6–11 years) with VAD and 534 children with IAD and 1,859 adolescents (i.e., 12–17 years) with VAD and 1,057 with IAD. Measures. Physical activity (PA) was measured using an accelerometer, with questionnaires used to assess demographic and behavioral variables and biological parameters assessed from a blood sample Analysis. Wald and design-based likelihood ratio tests and logistic regression were used to assess differences between those subjects with IAD and those with VAD Results. After adjustments, overweight children, compared to normal weight children, were 1.6 (odds ratio [OR] = 1.67; 95% confidence interval [CI]: 1.22–2.29) times more likely to have IAD. After adjustments, and as an example, adolescents engaging in 4 or more hours of computer use per day, compared to no computer use, were 2.6 (OR = 2.6; 95% CI: 1.38–5.18) times more likely to have IAD. Conclusion. Excluding youth with IAD may introduce bias, limit generalizability, and ultimately underestimate the association between PA and health outcomes Future research is needed to identify reasons for poor monitoring compliance.

Introduction Physical inactivity and sedentary behaviour has been identified as risk factors of childhood obesity and cardiovascular diseases. Triaxial accelerometers provide an objective indicator of free-living physical activity (PA). The purpose of this study was to describe levels and patterns of PA and sedentary time (ST) in Spanish children. Methods Data from 316 (n=166 boys, n=150 girls) healthy students (Age: 11.1±1.3 years, BMI: 19.8±3.6 kg/m2) enrolled in fourth, fifth or sixth grade, from the south, central and north of Spain, were used. The Actigraph GT3X monitor device was used to assess PA. Accelerometers were set to register 1-second epoch cycles, and were programmed to assess 7 days. We selected the cut points from Evenson et al. to determine the time spent on different intensity levels of PA and ST. Results Accelerometer data revealed that children spent an average of 54.4±17.8 min/day in moderate-to-vigorous PA (MVPA) and were sedentary for an average of 10 hours per day (619.2±67.3 min/day). Accumulation of 60 min/day of MVPA was achieved by 37.7% of the students. There was a significant difference in MVPA and ST between boys and girls (MVPA 58.3±16.9 vs 49.9±17.7 min/day, p<0.001; ST 609.8±66.1 vs 629.6±67.4 min/day, p<0.01; respectively). Boys performed 9865 steps/day, while girls performed 9119 steps/day (p<0.05). Discussion Our results suggest that a high percentage of Spanish schoolchildren do not meet PA and daily steps recommendations, where boys are more active than girls. Children spent most of their time in sedentary activities and light PA. Spanish government should consider launching campaigns against sedentary behaviour in schools in order to increase MVPA daily level. References Benítez-Porres J, Alvero-Cruz, JR, Sardinha, LB, Lopez-Fernandez I, Carnero EA (2016). Nutr Hosp, 33(5), 1036-1044. Cesa CC, Sbruzzi G, Ribeiro RA, Barbiero SM, de Oliveira Petkowicz R, Eibel B, Pellanda LC (2014). Prev Med, 69, 54-62. Cordova A, Villa G, Sureda A, Rodriguez-Marroyo JA, ...

This study explored associations between perceived neighborhood walkability and neighborhood-based physical activity (NB-PA) and assessed possible moderation effects of the amount of time spent in the home neighborhood and individual characteristics (i.e., educational level and health-related problems). In 2016 to 2017, 509 Dutch adults, living in the South Limburg area, were included. Context-specific PA levels were measured using the Actigraph GT3X+ accelerometer and the Qstarz BTQ1000XT GPS-logger. Perceived neighborhood walkability, level of education, work status, and health-related quality of life were measured with validated self-report instruments. Results showed that individuals with a lower level of education or health-related problems spent more time in the home neighborhood. The perceived neighborhood walkability only affected NB-PA for individuals spending a relatively large amount of time in their home neighborhood. PA-facilitating features in the home neighborhood, for example, aesthetics, were only associated with more NB-PA for individuals without health-related problems or with a higher level of education.

Despite the documented importance of the neighbourhood environment on youth physical activity, little empirical research exists regarding the geographical boundaries of neighbourhoods within which youth are physically active around their homes. Studies and public policies often arbitrarily assume the extent of these boundaries, which vary from study to study. This paper combines GPS data, diaries and accelerometry to delineate empirically the local area and distance within which youth play in Erie County, New York. The study found that youth tend to be physically active within a quarter-mile radius around their homes and to focus on one section of the often assumed circled neighbourhood.

BACKGROUND: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. METHODS: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2-18 years) from 18 different European countries. RESULTS: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. CONCLUSIONS: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.