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Abstract
Background: The objective of this paper is to derive a wrist-placed cut-point threshold for distinguishing sedentary behaviors from light-intensity walking using the ActiGraph GT3X+ in children. Methods: This study employed a cross-sectional study design, typically used in measurement-related studies. A sample of 167 children, ages 5–11 years (mean ± SD: 8.0 ± 1.8 years), performed up to eight seated sedentary activities while wearing accelerometers on both wrists. Activities included: reading books, sorting cards, cutting and pasting, playing board games, eating snacks, playing with tablets, watching TV, and writing. Direct observation verified sedentary behavior from light activity. Receiver operator characteristic (ROC) analyses were used to determine optimal cut-point thresholds. Quantile regression models estimated differences between dominant and non-dominant placement. Results: The optimal cut-point threshold for the non-dominant wrist was 203 counts/5 s with sensitivity, specificity, and area under the curve (AUC) of 71.56, 70.83, and 0.72, respectively. A 10-fold cross-validation revealed an average AUC of 0.70. Statistically significant (p ≤ 0.05) differences in median counts ranging from 7 to 46 counts/5 s were found between dominant and non-dominant placement in five out of eight sedentary activities, with the dominant wrist eliciting higher counts/5 s. Conclusion: Results from this study support the recommendation to place accelerometers on the non-dominant wrist to minimize “noise” during seated sedentary behaviors.
Highlights
Physical activity (PA) promotion in youth is a public health priority, as the incidence of childhood obesity remains alarmingly high
The purpose of this study is to examine differences between counts produced from accelerometers placed on dominant and non-dominant wrists during commonly performed seated sedentary activities that require upper extremity movement among 5–11-year-old children, and to determine optimal cut-point thresholds to distinguish sedentary behavior from light physical activity
The dominant wrist produced higher counts/5 s compared to the non-dominant wrist, resulting in a higher cut-point threshold for distinguishing light physical activity from sedentary behavior
Summary
Physical activity (PA) promotion in youth is a public health priority, as the incidence of childhood obesity remains alarmingly high. Measurement of physical activity and sedentary behavior is evolving. Health and Nutrition Examination Survey (NHANES) discontinued the use of the previously validated, hip-mounted ActiGraph GT3x+ to measure physical activity and time spent sedentary, replacing it with the wrist-mounted ActiGraph GT3x+ [1]. The objective of this paper is to derive a wrist-placed cut-point threshold for distinguishing sedentary behaviors from light-intensity walking using the ActiGraph GT3X+. Results: The optimal cut-point threshold for the non-dominant wrist was 203 counts/5 s with sensitivity, specificity, and area under the curve (AUC) of 71.56, 70.83, and 0.72, respectively. Conclusion: Results from this study support the recommendation to place accelerometers on the non-dominant wrist to minimize “noise” during seated sedentary behaviors
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