Abstract
BackgroundTo validate physical activity estimates by the Sensewear Pro3 activity monitor compared with indirect calorimetry during simulated free living in patients diagnosed with osteoarthritis of the hip pre or post total hip arthroplasty.MethodsTwenty patients diagnosed with hip osteoarthritis (10 pre- and 10 post total hip arthroplasty; 40% female; age: 63.3 ± 9.0; BMI: 23.7 ± 3.7). All patients completed a 2 hour protocol of simulated free living with 8 different typical physical activity types. Energy consumption (kcal/min) was estimated by the Sense Wear pro3 Armband activity monitor and validated against indirect calorimetry (criterion method) by means of a portable unit (Cosmed K4b2). Bias and variance was analyzed using functional ANOVA.ResultsMean bias during all activities was 1.5 Kcal/min 95%CI [1.3; 1.8] corresponding to 72% (overestimation). Normal gait speed showed an overestimation of 2.8 Kcal/min, 95%CI [2.3; 3.3] (93%) while an underestimation of -1.1 Kcal/min, 95%CI [-1.8; -0.3] (-25%) was recorded during stair climb. Activities dominated by upper body movements showed large overestimation with 4.37 Kcal/min, 95%CI [3.8; 5.1] (170%) being recorded during gardening. Both bias and variance appeared to be dependent on activity type.ConclusionThe activity monitor generally overestimated the energy consumption during common activities of low to medium intensity in the patient group. The size and direction of the bias was highly dependent on the activity type which indicates the activity monitor is of limited value in patients with hip osteoarthritis and that the results do not express the real energy expenditure.
Highlights
To validate physical activity estimates by the Sensewear Pro3 activity monitor compared with indirect calorimetry during simulated free living in patients diagnosed with osteoarthritis of the hip pre or post total hip arthroplasty
Patients with osteoarthritis (OA) of the hip have excess all cause mortality including increased mortality related to cardiovascular disease which has been associated with reduced patient reported physical activity (PA) [1]
The purpose of this study was to investigate the validity of the Sensewear pro3 (SWA) activity monitor in patients with hip osteoarthritis during a simulated free living protocol according to the following 3 proprieties: i) Bias between activity monitor estimates and indirect calorimetry, ii) correlation between methods and iii) difference in variance [35]
Summary
To validate physical activity estimates by the Sensewear Pro activity monitor compared with indirect calorimetry during simulated free living in patients diagnosed with osteoarthritis of the hip pre or post total hip arthroplasty. Energy expenditure during PA is commonly investigated by indirect calorimetry which requires either isolation of individuals in closed spaces or portable apparatus for gas analysis of air exchange [8,9] These methods are often referred to as criterion methods [10] but their application is limited to small laboratory settings [8,9]. In free living small bodyworn multisensory activity monitors based on accelerometry can be used as a feasible surrogate measure of energy expenditure during PA [11,12,13] In clinical studies such activity monitors are applied due to their objectivity compared to self-reported physical activity questionnaires [5,14] and they may become a tool in future etiological and prognostic studies in patients with lower extremity osteoarthritis [15]. In hip OA patients altered movement patterns may occur [16,17] and functional impairment and pain may affect the speed of exercises both potentially affecting estimations of energy expenditure based on accelerometry
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