Children and Adolescents Treated for Valvular Aortic Stenosis Have Different Physical Activity Patterns Compared to Healthy Controls: A Methodological Study in a National Cohort

Abstract

Previous research in children and adolescents with congenital heart defects presents contradictory findings concerning their physical activity (PA) level, due to methodological limitations in the PA assessment. The aim of the present cross-sectional study was to compare PA in children and adolescents treated for valvular aortic stenosis with healthy controls using an improved accelerometer method. Seven-day accelerometer data were collected from the hip in a national Swedish sample of 46 patients 6–18 years old treated for valvular aortic stenosis and 44 healthy controls matched for age, gender, geography, and measurement period. Sports participation was self-reported. Accelerometer data were processed with the new improved Frequency Extended Method and with the traditional ActiGraph method for comparison. A high-resolution PA intensity spectrum was investigated as well as traditional crude PA intensity categories. Children treated for aortic stenosis had a pattern of less PA in the highest intensity spectra and had more sedentary time, while the adolescent patients tended to be less physically active in higher intensities overall and with less sedentary time, compared to the controls. These patterns were evident using the Frequency Extended Method with the detailed PA intensity spectrum, but not to the same degree using the ActiGraph method and traditional crude PA intensity categories. Patients reported less sports participation than their controls in both age-groups. Specific differences in PA patterns were revealed using the Frequency Extended Method with the high-resolution PA intensity spectrum in Swedish children and adolescents treated for valvular aortic stenosis.

High-intensity activity is more strongly associated with metabolic health in children compared to sedentary time: a cross-sectional study of the I.Family cohort

“…In children, this is an even more prominent issue because their step frequency is higher than adults and often children spend more time being active when compared to adults [ 16 , 18 ]. By applying a wider frequency filter that is able to distinguish VPA from MPA, more accurate results are obtained [ 16 , 19 , 20 ].…”

Validation of Oura ring energy expenditure and steps in laboratory and free-living

“…Figure 1 illustrates an example of raw data gathered from the laboratory setting. Raw accelerometer data was extracted with OmGUI software (Axivity Ltd., Newcastle upon Tyne, UK) and filtered using frequency extended method (FEM, 0.29-10 Hz) [9,21,22], which is a wider filter and shown to outperform the original actigraph filter (0.29-1.63 Hz) [21,22]. Linear regression was used for calibration between filtered accelerometer output and measured EE in the laboratory.…”

“…Those studies were only performed with ActiGraph reference monitors in free-living over 4.5 [20] or 7 days [6] with participants recruited through convenience sampling with either omitted or undefined daily PA. In addition to not validating the Oura variables with goldstandard methods, they used a narrow frequency filter (ActiGraph filter 0.29-1.63 Hz [21,22]) for the reference methods in free-living. Although Henriksen, Svartdal [6] found strong correlations between Oura and the reference monitor for TEE and step count, measurement error and limits of agreement (LoA) were high, which was in line with Niela-Vilen, Azimi [20] findings for step count.…”