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Wrist Accelerometry for Physical Activity Measurement in Individuals With Spinal Cord Injury—A Need for Individually Calibrated Cut-Points

  • Laura A. McCracken
    Affiliations
    International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre, University of British Columbia, Vancouver, British Columbia, Canada

    School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
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  • Jasmin K. Ma
    Affiliations
    International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre, University of British Columbia, Vancouver, British Columbia, Canada

    School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
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  • Christine Voss
    Affiliations
    Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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  • Franco H. Chan
    Affiliations
    International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre, University of British Columbia, Vancouver, British Columbia, Canada
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  • Kathleen A. Martin Ginis
    Affiliations
    International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre, University of British Columbia, Vancouver, British Columbia, Canada

    School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
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  • Christopher R. West
    Correspondence
    Corresponding author Christopher R. West, PhD, International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre, 818 W 10th Ave, Vancouver, BC, Canada V5Z 1M9.
    Affiliations
    International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre, University of British Columbia, Vancouver, British Columbia, Canada

    School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
    Search for articles by this author
Published:December 05, 2017DOI:https://doi.org/10.1016/j.apmr.2017.10.024

      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)
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