Background Research has shown the feasibility of human activity recognition using wearable accelerometer devices. Different studies have used varying numbers and placements for data collection using sensors. Objective This study aims to compare accuracy performance between multiple and variable placements of accelerometer devices in categorizing the type of physical activity and corresponding energy expenditure in older adults. Methods In total, 93 participants (mean age 72.2 years, SD 7.1) completed a total of 32 activities of daily life in a laboratory setting. Activities were classified as sedentary versus nonsedentary, locomotion versus nonlocomotion, and lifestyle versus nonlifestyle activities (eg, leisure walk vs computer work). A portable metabolic unit was worn during each activity to measure metabolic equivalents (METs). Accelerometers were placed on 5 different body positions: wrist, hip, ankle, upper arm, and thigh. Accelerometer data from each body position and combinations of positions were used to develop random forest models to assess activity category recognition accuracy and MET estimation. Results Model performance for both MET estimation and activity category recognition were strengthened with the use of additional accelerometer devices. However, a single accelerometer on the ankle, upper arm, hip, thigh, or wrist had only a 0.03-0.09 MET increase in prediction error compared with wearing all 5 devices. Balanced accuracy showed similar trends with slight decreases in balanced accuracy for the detection of locomotion (balanced accuracy decrease range 0-0.01), sedentary (balanced accuracy decrease range 0.05-0.13), and lifestyle activities (balanced accuracy decrease range 0.04-0.08) compared with all 5 placements. The accuracy of recognizing activity categories increased with additional placements (accuracy decrease range 0.15-0.29). Notably, the hip was the best single body position for MET estimation and activity category recognition. Conclusions Additional accelerometer devices slightly enhance activity recognition accuracy and MET estimation in older adults. However, given the extra burden of wearing additional devices, single accelerometers with appropriate placement appear to be sufficient for estimating energy expenditure and activity category recognition in older adults.

BACKGROUND Research shows the feasibility of human activity recognition using Wearable accelerometer devices. Different studies have used varying number and placement for data collection using the sensors. OBJECTIVE To compare accuracy performance between multiple and variable placement of accelerometer devices in categorizing the type of physical activity and corresponding energy expenditure in older adults. METHODS Participants (n=93, 72.2±7.1 yrs) completed a total of 32 activities of daily life in a laboratory setting. Activities were classified as sedentary vs. non-sedentary, locomotion vs. non-locomotion, and lifestyle vs. non-lifestyle activities (e.g. leisure walk vs. computer work). A portable metabolic unit was worn during each activity to measure metabolic equivalents (METs). Accelerometers were placed on five different body positions: wrist, hip, ankle, upper arm, and thigh. Accelerometer data from each body position and combinations of positions were used in developing Random Forest models to assess activity category recognition accuracy and MET estimation. RESULTS Model performance for both MET estimation and activity category recognition strengthened with additional accelerometer devices. However, a single accelerometer on the ankle, upper arm, hip, thigh, or wrist had only a 0.03 to 0.09 MET increase in prediction error as compared to wearing all five devices. Balanced accuracy showed similar trends with slight decreases in balanced accuracy for detection of locomotion (0-0.01 METs), sedentary (0.13-0.05 METs) and lifestyle activities (0.08-0.04 METs) compared to all five placements. The accuracy of recognizing activity categories increased with additional placements (0.15-0.29). Notably, the hip was the best single body position for MET estimation and activity category recognition. CONCLUSIONS Additional accelerometer devices only slightly enhance activity recognition accuracy and MET estimation in older adults. However, given the extra burden of wearing additional devices, single accelerometers with appropriate placement appear to be sufficient for estimating energy expenditure and activity category recognition in older adults.