Abstract
Objective
To create and compare individual and group-based cut-points for wrist accelerometry
that correspond to moderate-to-vigorous physical activity (MVPA) in people with spinal
cord injury (SCI).
Design
Participants completed a graded treadmill-wheeling test while being assessed for oxygen
consumption, wrist-acceleration vector magnitude, and spoke acceleration. Oxygen consumption
was converted to SCI metabolic equivalents (METs), and linear regression was applied
to determine an individualized vector magnitude cut-point (counts per minute, VM-CPM)
corresponding with MVPA (≥3 SCI METs). Multilevel linear regression was applied to
determine a group MVPA cut-point. Participants then completed a 6-day monitoring period
while wearing the accelerometers.
Setting
A local SCI research center.
Participants
Manual wheelchair users (N=20; aged 31–64y; injury levels, C5 to L2) with chronic
(>1y) SCI.
Interventions
Not applicable.
Main Outcome Measures
Mean total daily MVPA, wheeled MVPA, and nonwheeled MVPA were calculated using both
the individual and group cut-points. Agreement on measures of minutes per day of MVPA
between the individual and group mean cut-point method was assessed using Bland-Altman
plots.
Results
Individual cut-points for MVPA ranged from 6040 to 21,540 VM-CPM, with a group cut-point
of 11,652 (95% confidence interval, 7395–15,909). For total daily MVPA, Bland-Altman
analysis revealed a bias of .22±33.0 minutes, with 95% limits of agreement from −64.5
to 64.9 minutes, suggesting a large discrepancy between total MVPA calculated from
individual and group mean cut-points.
Conclusions
Individual calibration of wrist-worn accelerometry is recommended for effective habitual
PA monitoring in this population.
Keywords
List of abbreviations:
MET (metabolic equivalent), MVPA (moderate-to-vigorous physical activity), PA (physical activity), PARA-SCI (Physical Activity Recall Assessment for People with SCI), SCI (spinal cord injury), VM-CPM (vector magnitude–counts per minute)To read this article in full you will need to make a payment
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References
- Cardiovascular disease and spinal cord injury: results from a national population health survey.Neurology. 2013; 81: 723-728
- Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.Public Health Rep. 1985; 100: 126-131
- Objective measures of neighborhood environment and self-reported physical activity in spinal cord injured men.Arch Phys Med Rehabil. 2008; 89: 1468-1473
- Greater daily leisure time physical activity is associated with lower chronic disease risk in adults with spinal cord injury.Appl Physiol Nutr Metab. 2009; 34: 640-647
- The development of evidence-informed physical activity guidelines for adults with spinal cord injury.Spinal Cord. 2011; 49: 1088-1096
- New Canadian physical activity guidelines.Appl Physiol Nutr Metab. 2011; 46: 36-46
- Use of accelerometry based activity monitors to assess physical activity.in: Physical activity assessments for health-related research. Human Kinetics, Champaign2002: 125-140
- Predicting activity energy expenditure using the Actical activity monitor.Res Q Exerc Sport. 2006; 77: 64-80
- Validity of wrist worn accelerometers and comparability between hip and wrist placement sites in estimating physical activity behaviour in preschool children.Physiol Meas. 2016; 37: 1701-1714
- Comparison of methods to assess energy expenditure and physical activity in people with spinal cord injury.J Spinal Cord Med. 2012; 35: 35-45
- Development and evaluation of an activity measure for people with spinal cord injury.Med Sci Sports Exerc. 2005; 37: 1099-1111
- Manual wheelchair-related mobility characteristics of older adults in nursing homes.Disabil Rehabil Assist Technol. 2010; 5: 428-437
- Use of power assist wheels results in increased distance traveled compared with conventional manual wheeling.Am J Phys Med Rehabil. 2010; 89: 625-634
- Predicting physical activity energy expenditure in manual wheelchair users.Med Sci Sport Exerc. 2014; 46: 1849-1858
- Validation of the use of Actigraph GT3X accelerometers to estimate energy expenditure in full time manual wheelchair users with spinal cord injury.Spinal Cord. 2013; 51: 898-903
- Assessing physical activity during wheelchair pushing: validity of a portable accelerometer.Adapt Phys Activ Q. 1999; 16: 290-299
- Validity of physical activity monitors for estimating energy expenditure during wheelchair propulsion.J Phys Act Health. 2015; 12: 1520-1526
- Accelerometer output and its association with energy expenditure during manual wheelchair propulsion.Spinal Cord. 2016; 54: 110-114
- Objective measurement of physical activity and sedentary behavior among US adults aged 60 years or older.Prev Chronic Dis. 2012; 9: 1-10
- Validation of an accelerometer-based method to measure the use of manual wheelchairs.Med Eng Phys. 2012; 34: 781-786
- 2011 compendium of physical activities: a second update of codes and MET values.Med Sci Sports Exerc. 2011; 43: 1575-1581
- Energy cost of physical activities in persons with spinal cord injury.Med Sci Sports Exerc. 2010; 42: 691-700
- International standards for neurological and functional classification of spinal cord injury. American Spinal Injury Association.Spinal Cord. 1997; 35: 266-274
- Wheelchair propulsion: effects of experience and push strategy on efficiency and perceived exertion.Appl Physiol Nutr Metab. 2008; 33: 870-879
- A prospective study on physical activity levels after spinal cord injury during inpatient rehabilitation and the year after discharge.Arch Phys Med Rehabil. 2008; 89: 2094-2101
- The Physical Activity Recall Assessment for People with Spinal Cord Injury.Med Sci Sport Exerc. 2006; 38: 208-216
- Physical activity is related to lower levels of pain, fatigue and depression in individuals with spinal-cord injury: a correlational study.Spinal Cord. 2009; 47: 301-306
Article info
Publication history
Published online: December 05, 2017
Footnotes
Supported by the Heart and Stroke Foundation of Canada, the Rick Hansen Institute, a scholar award from the Michael Smith Foundation for Health Research and the Rick Hansen Institute, and a Frederick Banting and Charles Best Canada Graduate Scholarship from the Canadian Institutes of Health Research.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
