Abstract
Physical activity behavior varies naturally from day to day, from week to week and even across seasons. In order to assess the habitual level of physical activity of a person, the person must be monitored for long enough so that the level can be identified, taking into account this natural within-person variation. An important question, and one whose answer has implications for study- and survey design, epidemiological research and population surveillance, is, for how long does an individual need to be monitored before such a habitual level or pattern can be identified to a desired level of precision? The aim of this study was to estimate the number of repeated observations needed to identify the habitual physical activity behaviour of an individual to a given degree of precision. A convenience sample of 50 Swedish adults wore accelerometers during four consecutive weeks. The number of days needed to come within 5–50% of an individual's usual physical activity 95% of the time was calculated. To get an idea of the uncertainty of the estimates all statistical estimates were bootstrapped 2000 times. The mean number of days of measurement needed for the observation to, with 95% confidence, be within 20% of the habitual physical activity of an individual is highest for vigorous physical activity, for which 182 days are needed. For sedentary behaviour the equivalent number of days is 2.4. To capture 80% of the sample to within ±20% of their habitual level of physical activity, 3.4 days is needed if sedentary behavior is the outcome of interest, and 34.8 days for MVPA. The present study shows that for analyses requiring accurate data at the individual level a longer measurement collection period than the traditional 7-day protocol should be used. In addition, the amount of MVPA was negatively associated with the number of days required to identify the habitual physical activity level indicating that the least active are also those whose habitual physical activity level is the most difficult to identify. These results could have important implications for researchers whose aim is to analyse data on an individual level. Before recommendations regarding an appropriate monitoring protocol are updated, the present study should be replicated in different populations.
Highlights
A large body of evidence exists that shows the benefits of physical activity and the negative consequences of sedentary behaviour for physical and mental health [1,2,3]
Men were more sedentary compared to women (p = 0.038), those with more valid days of monitoring were more physically active on a light intensity (p = 0.005) and moderate intensity level (p = 0.024) and accumulated more time at MVPA (p = 0.014) compared to those with fewer days of monitoring (Table 1)
The mean number of days needed is highest for vigorous physical activity in which 182 days are needed
Summary
A large body of evidence exists that shows the benefits of physical activity and the negative consequences of sedentary behaviour for physical and mental health [1,2,3]. A central property of physical activity behaviour is that in free-living populations, it naturally varies from day-today around a true mean level of physical activity. This true mean level of physical activity is often referred to as the habitual level of physical activity of an individual and in this study is defined, slightly modified from Lui’s version for diet, as: "the hypothetical average around which that individual’s physical activity varies" [4]. Level 3 is the accuracy required in order to rank individuals in a group from the most active to the least active, used quite often in epidemiology to create heterogenous groups (differing in level of exposure). In order to measure effects of interventions, such as counseling or “physical activity on prescription”, or to perform analysis correlating a biomarker measured on individual level with the activity level of the same individual; this is level 4
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