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1. Agreement of Sedentary Behavior Metrics Derived From Hip- and Thigh-Worn Accelerometers Among Older Adults: With Implications for Studying Physical and Cognitive Health

   https://doi.org/10.1123/jmpb.2020-0036  

   Bellettiere, John; Tuz-Zahra, Fatima; Carlson, Jordan A.; Ridgers, Nicola D.; Liles, Sandy; Greenwood-Hickman, Mikael Anne; Walker, Rod L.; LaCroix, Andrea Z.; Jankowska, Marta M.; Rosenberg, Dori E.; et al (March 2021, Journal for the Measurement of Physical Behaviour)

   null (Ed.)

   Little is known about how sedentary behavior (SB) metrics derived from hip- and thigh-worn accelerometers agree for older adults. Thigh-worn activPAL (AP) micro monitors were concurrently worn with hip-worn ActiGraph (AG) GT3X+ accelerometers (with SB measured using the 100 counts per minute [cpm] cut point; AG 100cpm ) by 953 older adults (age 77 ± 6.6, 54% women) for 4–7 days. Device agreement for sedentary time and five SB pattern metrics was assessed using mean error and correlations. Logistic regression tested associations with four health outcomes using standardized (i.e.,  z scores) and unstandardized SB metrics. Mean errors (AP − AG 100cpm ) and 95% limits of agreement were: sedentary time −54.7 [−223.4, 113.9] min/day; time in 30+ min bouts 77.6 [−74.8, 230.1] min/day; mean bout duration 5.9 [0.5, 11.4] min; usual bout duration 15.2 [0.4, 30] min; breaks in sedentary time −35.4 [−63.1, −7.6] breaks/day; and alpha −.5 [−.6, −.4]. Respective Pearson correlations were: .66, .78, .73, .79, .51, and .40. Concordance correlations were: .57, .67, .40, .50, .14, and .02. The statistical significance and direction of associations were identical for AG 100cpm and AP metrics in 46 of 48 tests, though significant differences in the magnitude of odds ratios were observed among 13 of 24 tests for unstandardized and five of 24 for standardized SB metrics. Caution is needed when interpreting SB metrics and associations with health from AG 100cpm due to the tendency for it to overestimate breaks in sedentary time relative to AP. However, high correlations between AP and AG 100cpm measures and similar standardized associations with health outcomes suggest that studies using AG 100cpm are useful, though not ideal, for studying SB in older adults. 

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2. CHAP-child: an open source method for estimating sit-to-stand transitions and sedentary bout patterns from hip accelerometers among children

   https://doi.org/10.1186/s12966-022-01349-2  

   Carlson, Jordan A.; Ridgers, Nicola D.; Nakandala, Supun; Zablocki, Rong; Tuz-Zahra, Fatima; Bellettiere, John; Hibbing, Paul R.; Steel, Chelsea; Jankowska, Marta M.; Rosenberg, Dori E.; et al (December 2022, International Journal of Behavioral Nutrition and Physical Activity)

   Abstract Background Hip-worn accelerometer cut-points have poor validity for assessing children’s sedentary time, which may partly explain the equivocal health associations shown in prior research. Improved processing/classification methods for these monitors would enrich the evidence base and inform the development of more effective public health guidelines. The present study aimed to develop and evaluate a novel computational method (CHAP-child) for classifying sedentary time from hip-worn accelerometer data. Methods Participants were 278, 8–11-year-olds recruited from nine primary schools in Melbourne, Australia with differing socioeconomic status. Participants concurrently wore a thigh-worn activPAL (ground truth) and hip-worn ActiGraph (test measure) during up to 4 seasonal assessment periods, each lasting up to 8 days. activPAL data were used to train and evaluate the CHAP-child deep learning model to classify each 10-s epoch of raw ActiGraph acceleration data as sitting or non-sitting, creating comparable information from the two monitors. CHAP-child was evaluated alongside the current practice 100 counts per minute (cpm) method for hip-worn ActiGraph monitors. Performance was tested for each 10-s epoch and for participant-season level sedentary time and bout variables (e.g., mean bout duration). Results Across participant-seasons, CHAP-child correctly classified each epoch as sitting or non-sitting relative to activPAL, with mean balanced accuracy of 87.6% (SD = 5.3%). Sit-to-stand transitions were correctly classified with mean sensitivity of 76.3% (SD = 8.3). For most participant-season level variables, CHAP-child estimates were within ± 11% (mean absolute percent error [MAPE]) of activPAL, and correlations between CHAP-child and activPAL were generally very large (> 0.80). For the current practice 100 cpm method, most MAPEs were greater than ± 30% and most correlations were small or moderate (≤ 0.60) relative to activPAL. Conclusions There was strong support for the concurrent validity of the CHAP-child classification method, which allows researchers to derive activPAL-equivalent measures of sedentary time, sit-to-stand transitions, and sedentary bout patterns from hip-worn triaxial ActiGraph data. Applying CHAP-child to existing datasets may provide greater insights into the potential impacts and influences of sedentary time in children. 

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3. Comparison of raw accelerometry data from ActiGraph, Apple Watch, Garmin, and Fitbit using a mechanical shaker table

   https://doi.org/10.1371/journal.pone.0286898  

   White, James W; Finnegan, Olivia L; Tindall, Nick; Nelakuditi, Srihari; Brown, David E; Pate, Russell R; Welk, Gregory J; de_Zambotti, Massimiliano; Ghosal, Rahul; Wang, Yuan; et al (March 2024, PLOS ONE)

   Yamada, Yosuke (Ed.)

   The purpose of this study was to evaluate the reliability and validity of the raw accelerometry output from research-grade and consumer wearable devices compared to accelerations produced by a mechanical shaker table. Raw accelerometry data from a total of 40 devices (i.e., n = 10 ActiGraph wGT3X-BT, n = 10 Apple Watch Series 7, n = 10 Garmin Vivoactive 4S, and n = 10 Fitbit Sense) were compared to reference accelerations produced by an orbital shaker table at speeds ranging from 0.6 Hz (4.4 milligravity-mg) to 3.2 Hz (124.7mg). Two-way random effects absolute intraclass correlation coefficients (ICC) tested inter-device reliability. Pearson product moment, Lin’s concordance correlation coefficient (CCC), absolute error, mean bias, and equivalence testing were calculated to assess the validity between the raw estimates from the devices and the reference metric. Estimates from Apple, ActiGraph, Garmin, and Fitbit were reliable, with ICCs = 0.99, 0.97, 0.88, and 0.88, respectively. Estimates from ActiGraph, Apple, and Fitbit devices exhibited excellent concordance with the reference CCCs = 0.88, 0.83, and 0.85, respectively, while estimates from Garmin exhibited moderate concordance CCC = 0.59 based on the mean aggregation method. ActiGraph, Apple, and Fitbit produced similar absolute errors = 16.9mg, 21.6mg, and 22.0mg, respectively, while Garmin produced higher absolute error = 32.5mg compared to the reference. ActiGraph produced the lowest mean bias 0.0mg (95%CI = -40.0, 41.0). Equivalence testing revealed raw accelerometry data from all devices were not statistically significantly within the equivalence bounds of the shaker speed. Findings from this study provide evidence that raw accelerometry data from Apple, Garmin, and Fitbit devices can be used to reliably estimate movement; however, no estimates were statistically significantly equivalent to the reference. Future studies could explore device-agnostic and harmonization methods for estimating physical activity using the raw accelerometry signals from the consumer wearables studied herein. 

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4. CHAP-Adult: A Reliable and Valid Algorithm to Classify Sitting and Measure Sitting Patterns Using Data From Hip-Worn Accelerometers in Adults Aged 35+

   https://doi.org/10.1123/jmpb.2021-0062  

   Bellettiere, John; Nakandala, Supun; Tuz-Zahra, Fatima; Winkler, Elisabeth A.H.; Hibbing, Paul R.; Healy, Genevieve N.; Dunstan, David W.; Owen, Neville; Anne Greenwood-Hickman, Mikael; Rosenberg, Dori E.; et al (December 2022, Journal for the Measurement of Physical Behaviour)

   Background : Hip-worn accelerometers are commonly used, but data processed using the 100 counts per minute cut point do not accurately measure sitting patterns. We developed and validated a model to accurately classify sitting and sitting patterns using hip-worn accelerometer data from a wide age range of older adults. Methods : Deep learning models were trained with 30-Hz triaxial hip-worn accelerometer data as inputs and activPAL sitting/nonsitting events as ground truth. Data from 981 adults aged 35–99 years from cohorts in two continents were used to train the model, which we call CHAP-Adult (Convolutional Neural Network Hip Accelerometer Posture-Adult). Validation was conducted among 419 randomly selected adults not included in model training. Results : Mean errors (activPAL − CHAP-Adult) and 95% limits of agreement were: sedentary time −10.5 (−63.0, 42.0) min/day, breaks in sedentary time 1.9 (−9.2, 12.9) breaks/day, mean bout duration −0.6 (−4.0, 2.7) min, usual bout duration −1.4 (−8.3, 5.4) min, alpha .00 (−.04, .04), and time in ≥30-min bouts −15.1 (−84.3, 54.1) min/day. Respective mean (and absolute) percent errors were: −2.0% (4.0%), −4.7% (12.2%), 4.1% (11.6%), −4.4% (9.6%), 0.0% (1.4%), and 5.4% (9.6%). Pearson’s correlations were: .96, .92, .86, .92, .78, and .96. Error was generally consistent across age, gender, and body mass index groups with the largest deviations observed for those with body mass index ≥30 kg/m 2 . Conclusions : Overall, these strong validation results indicate CHAP-Adult represents a significant advancement in the ambulatory measurement of sitting and sitting patterns using hip-worn accelerometers. Pending external validation, it could be widely applied to data from around the world to extend understanding of the epidemiology and health consequences of sitting. 

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5. CHAP-Adult: A Reliable and Valid Algorithm to Classify Sitting and Measure Sitting Patterns Using Data From Hip-Worn Accelerometers in Adults Aged 35+

   John Bellettiere; Supun Nakandala; Fatima Tuz-Zahra; Elisabeth A.H. Winkler; Paul R. Hibbing; Genevieve N. Healy; David W. Dunstan; Neville Owen; Mikael Anne Greenwood-Hickman; Dori E. Rosenberg; et al (September 2022, Journal for the measurement of physical behaviour)

   Hip-worn accelerometers are commonly used, but data processed using the 100 counts per minute cut point do not accurately measure sitting patterns. We developed and validated a model to accurately classify sitting and sitting patterns using hip-worn accelerometer data from a wide age range of older adults. Methods: Deep learning models were trained with 30-Hz triaxial hip-worn accelerometer data as inputs and activPAL sitting/nonsitting events as ground truth. Data from 981 adults aged 35–99 years from cohorts in two continents were used to train the model, which we call CHAP-Adult (Convolutional Neural Network Hip Accelerometer Posture-Adult). Validation was conducted among 419 randomly selected adults not included in model training. Results: Mean errors (activPAL − CHAP-Adult) and 95% limits of agreement were: sedentary time −10.5 (−63.0, 42.0) min/day, breaks in sedentary time 1.9 (−9.2, 12.9) breaks/day, mean bout duration −0.6 (−4.0, 2.7) min, usual bout duration −1.4 (−8.3, 5.4) min, alpha .00 (−.04, .04), and time in ≥30-min bouts −15.1 (−84.3, 54.1) min/day. Respective mean (and absolute) percent errors were: −2.0% (4.0%), −4.7% (12.2%), 4.1% (11.6%), −4.4% (9.6%), 0.0% (1.4%), and 5.4% (9.6%). Pearson’s correlations were: .96, .92, .86, .92, .78, and .96. Error was generally consistent across age, gender, and body mass index groups with the largest deviations observed for those with body mass index ≥30 kg/m2. Conclusions: Overall, these strong validation results indicate CHAP-Adult represents a significant advancement in the ambulatory measurement of sitting and sitting patterns using hip-worn accelerometers. Pending external validation, it could be widely applied to data from around the world to extend understanding of the epidemiology and health consequences of sitting. 

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