Validation of the Actical and Actiheart monitor in ambulatory children with Spina Bifida

Abstract

BACKGROUND: Ambulatory children with Spina Bifida (SB) often show a decline in physical activity leading to deconditioning and functional decline. Therefore, assessment and promotion of physical activity is important. Because energy expenditure during activities is higher in these children, the use of existing pediatric equations to predict physical activity energy expenditure (PAEE) may not be valid. AIMS: (1) To evaluate criterion validity of existing predictions converting accelerocounts into PAEE in ambulatory children with SB and (2) to establish new disease-specific equations for PAEE. METHODS: Simultaneous measurements using the Actical, the Actiheart, and indirect calorimetry took place to determine PAEE in 26 ambulatory children with SB. DATA ANALYSIS: Paired T-tests, Intra-class correlations limits of agreement (LoA), and explained variance (R 2 ) were used to analyze validity of the prediction equations using true PAEE as criterion. New equations were derived using regression techniques. RESULTS: While T-tests showed no significant differences for some models, the predictions developed in healthy children showed moderate ICC's and large LoA with true PAEE. The best regression models to predict PAEE were: PAEE = 174.049 + 3.861 × HRAR -60.285 × ambulatory status (R 2 = 0.720) and PAEE = 220.484 + 0.67 × Actical counts -60.717 × ambulatory status (R 2 = 0.681). CONCLUSIONS: Existing equations to predict PAEE are not valid for use in children with SB for the individual evaluation of PAEE. The best regression model was based on HRAR in combination with ambulatory status, followed by a new model for the Actical monitor. A benefit of HRAR is that it does not require the use of expensive accelerometry equipment. Further cross-validation of these models is still needed.

Health in Adapted Youth Sports Study (HAYS): health effects of sports participation in children and adolescents with a chronic disease or physical disability

“…The Actiheart (Camntech), will be used to detect the intensity of physical activity (Brage et al 2005 ). The Actiheart is a small device detecting the heart rate frequency via two electrode-stickers on the chest and has been used previously in children with Spina Bifida (De Groot et al 2013 ). During the 1 week of wearing the activity monitor, the participant will also fill out an activity diary in order to interpret missing data of the activity monitor.…”

Physical activity and sedentary behaviour in children with spina bifida

“…35 Indeed, a study using the Actical, an accelerometer also worn at the hip, in adolescents with spina bifida showed poor validity in predicting energy expenditure. 23 The use of heart rate as determined by the Actiheart may be the preferred method to evaluate physical activity and sedentary behaviour. A former study evaluating the use of the Actiheart in adolescents with spina bifida found that use of heart rate was preferred over additional use of accelerometer counts, which did not add to the validity of the models predicting energy expenditure during sedentary and active behaviour.…”

“…A former study evaluating the use of the Actiheart in adolescents with spina bifida found that use of heart rate was preferred over additional use of accelerometer counts, which did not add to the validity of the models predicting energy expenditure during sedentary and active behaviour. 23 Furthermore, the Actiheart has been validated for use in children with various chronic diseases 36 and the Actiheart placement on the chest may allow appropriate measurement of heart rate in ambulatory and non-ambulatory adolescents. It should be noted that while the Actiheart measures a physiological response to activity, it is not measuring actual movement; heart rate measurement may be influenced by emotions and stress.…”

“…In a validation study by de Groot et al, prediction of physical activity energy expenditure using heart rate was superior to prediction of physical activity energy expenditure using accelerometry data in ambulatory children with spina bifida. 23…”

“…Former studies have reported the Actiheart demonstrates high intra-and interinstrument reliability 27 and is valid for the measurement of physical activity in children with spina bifida. 23 The monitor was set to record data using a 30-second epoch.…”