Physical Activity Intensity Cut-Points for Wrist-Worn GENEActiv in Older Adults

Abstract

Purpose: This study aims to (1) establish GENEActiv intensity cutpoints in older adults and (2) compare the classification accuracy between dominant (D) or non-dominant (ND) wrist, using both laboratory and free-living data.Methods: Thirty-one older adults participated in the study. They wore a GENEActiv Original on each wrist and performed nine activities of daily living. A portable gas analyzer was used to measure energy expenditure for each task. Testing was performed on two occasions separated by at least 8 days. Some of the same participants (n = 13) also wore one device on each wrist during 3 days of free-living. Receiver operating characteristic analysis was performed to establish the optimal cutpoints.Results: For sedentary time, both dominant and non-dominant wrist had excellent classification accuracy (sensitivity 0.99 and 0.97, respectively; specificity 0.91 and 0.86, respectively). For Moderate to Vigorous Physical Activity (MVPA), the non-dominant wrist device had better accuracy (ND sensitivity: 0.90, specificity 0.79; D sensitivity: 0.90, specificity 0.64). The corresponding cutpoints for sedentary-to-light were 255 and 375 g · min (epoch independent: 42.5 and 62.5 mg), and those for the light-to-moderate were 588 and 555 g · min (epoch-independent: 98.0 and 92.5 mg) for the non-dominant and dominant wrist, respectively. For free-living data, the dominant wrist device resulted in significantly more sedentary time and significantly less light and MVPA time compared to the non-dominant wrist.

Objectively Measured Total Sedentary Time and Pattern of Sedentary Accumulation in Older Adults: Associations With Incident Cardiovascular Disease and All-Cause Mortality

“…In absence of gold standard cut points to classify movement behaviors in older adults, we used cut points based on a study wherein adult participants undertook 10 activities in laboratory in order to mimic free-living posture/behaviors with the aim to elicit average accelerations that were similar to those observed in a free-living situation ( 29 ). These cut points were in agreement with a recent study among older adults which derived cut points using oxygen consumption when performing 9 laboratory-based activities of daily living and showed good classification accuracy ( 30 ). Based on these studies, movement behavior during waking period was classified as SB when average acceleration over a 60-second epoch was <40 milligravity (m g ), 40–99 m g for light intensity physical activity (LIPA), and ≥100 m g for MVPA ( 29 , 31 ).…”

“…29 These cut-points were in agreement with a recent study among older adults which derived cut-points using oxygen consumption when performing nine laboratory based activities of daily living and showed good classification accuracy. 30 Based on these studies, movement behaviour during waking period was classified as SB when average acceleration over a 60-second epoch was <40 milligravity (mg), 40-99 mg for A c c e p t e d M a n u s c r i p t light intensity physical activity (LIPA) and ≥100 mg for MVPA. 29,31 Sedentary accumulation pattern was measured using 8 metrics: mean sedentary bout duration, 5 time in prolonged sedentary bouts, Gini index, 32,33 number of sedentary breaks, 32,33 breaks per sedentary hour, 34,35 Alpha, 32 and transition probability from sedentary to LIPA or MVPA states (Figure 1; see eMethods in the Supplement for description).…”

Association of daily composition of physical activity and sedentary behaviour with incidence of cardiovascular disease in older adults

“…As there is no gold standard to classify movement behaviours in older adults, we referred to cut-points from a study where adult participants undertook series of activities in a laboratory and mimic free-living posture/behaviours eliciting average accelerations similar to that observed in free living situations [ 33 ]. These cut-points are in agreement with a more recent study among older adults that showed good classification accuracy based on oxygen consumption during nine laboratory-based activities of daily living [ 34 ]. Based on these studies, movement behaviour during waking period was classified as SB when average acceleration over a 60-s epoch was < 40 milligravity (m g ), 40–99 m g for LIPA and ≥ 100 m g for MVPA [ 33 , 34 ].…”

“…These cutpoints are in agreement with a more recent study among older adults that showed good classification accuracy based on oxygen consumption during nine laboratorybased activities of daily living [34]. Based on these studies, movement behaviour during waking period was classified as SB when average acceleration over a 60-s epoch was < 40 milligravity (mg), 40-99 mg for LIPA and ≥ 100 mg for MVPA [33,34]. The daily time in each movement behaviour was calculated as the mean of measures over 7 days.…”

Objectively Measured Physical Activity Levels and Associated Factors in Older US Women During the COVID-19 Pandemic: Cross-sectional Study

“…Furthermore, the cut-off points to classify PA intensity for wrist-worn accelerometers for older adults have not been firmly established yet. The nondominant wrist ENMO cut-off points for older adults, reported in the existing literature, range from 18 to 57 mg for the LPA threshold and 60 to 104 mg for the MVPA threshold [71][72][73], which limits the comparability of results among studies with different cut-off points. Moreover, due to the cross-sectional study design, we were not able quantify the change in PA behavior in our participants between the prepandemic period and the pandemic time, since we did not have their objectively measured pre-COVID-19 PA data.…”