Calibration of Accelerometer Output for Ambulatory Adults With Multiple Sclerosis

doi:10.1016/j.apmr.2009.03.020

Archives of Physical Medicine and Rehabilitation

Volume 90, Issue 10, October 2009, Pages 1778-1784

https://doi.org/10.1016/j.apmr.2009.03.020 Get rights and content

Abstract

Motl RW, Snook EM, Agiovlasitis S, Suh Y. Calibration of accelerometer output for ambulatory adults with multiple sclerosis.

Objectives

To examine the association between the rates of accelerometer activity counts and energy expenditure during walking in persons with multiple sclerosis (MS) versus controls and then to calibrate the output of accelerometers for computing time spent in light, moderate, and vigorous physical activity based on common metabolic equivalent unit categories in persons with MS.

Design

Mixed-model design.

Setting

Laboratory.

Participants

People with MS (n=24) and people without MS (n=24) who were similar in age, sex, height, and weight.

Interventions

The participants undertook three 6-minute periods of walking at 3.2, 4.8, and 6.4km·h⁻¹ on a motor-driven treadmill.

Main Outcome Measures

Activity counts and energy expenditure were measured with an accelerometer worn on the right hip and open-circuit spirometry, respectively.

Results

The results indicated that (1) persons with MS had greater energy expenditure, but not activity counts, during walking on a treadmill than did controls; (2) there was a strong linear relationship between activity counts and energy expenditure during treadmill walking, but the slope of the relationship was steeper in persons with MS than in controls; and (3) the cut-points for light, moderate, and vigorous physical activity were lower in persons with MS than in controls.

Conclusions

Such findings provide evidence for a strong linear relationship between activity counts and energy expenditure during walking in persons with MS and cut-points based on counts per minute for quantifying time spent in light, moderate, and vigorous physical activity using accelerometers in this population.

Section snippets

Participants

We recruited a convenience sample of people with MS who resided in central Illinois and were participants from previous research studies in our laboratory. The sample of people without MS was recruited from the university community to be similar in age, sex, height, and weight compared with the sample of those who had MS. The method of recruitment involved a telephone call from a member of the research team who described the study and its procedures, answered all questions, and conducted a

Results

The sample consisted of 24 individuals (20 women) with a diagnosis of MS that was confirmed in writing by a neurologist, and 24 individuals without MS (20 women) who were similar in age, sex, height, and weight. The mean ± SD age, height, and weight for those with MS were 43.5±12.2 years, 167.5±11.6cm, and 76.7±19.2kg, respectively. The mean ± SD age, height, and weight for the control sample were 40.9±11.4 years, 170.1±8.0cm, and 72.5±15.0kg, respectively. The 2 groups did not differ in age (P

Discussion

The present study involved an examination of the association between the rates of ActiGraph accelerometer activity counts and energy expenditure during the dynamic activity of walking in persons with MS versus controls, and the generation of cut-points based on counts per minute that represent categories of light, moderate, and vigorous physical activity based on common MET categories in persons with MS. The primary findings were that (1) individuals with MS had a greater energy expenditure,

Conclusions

Our findings provide evidence for a strong linear relationship between activity counts and energy expenditure during walking in persons with MS and cut-points based on counts per minute for quantifying time spent in light, moderate, and vigorous physical activity using accelerometers in this population. This evidence supports the validity of quantifying physical activity using accelerometers and associated cut-points in ambulatory persons with MS.

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Calibration and validation of accelerometry to measure physical activity in adult clinical groups: A systematic review
2019, Preventive Medicine Reports
Citation Excerpt :
The statistical approach adopted to translate activity counts and EE into cut-points could substantially impact the derived thresholds. For example, whilst linear regression has been most widely used (Aadland and Anderssen, 2012; Aadland and Steene-Johannessen, 2012; Motl et al., 2009; Sandroff et al., 2014a,b; Serra et al., 2017; Weikert et al., 2011), it assumes that the relationship between activity counts and metabolic data (i.e. VO2, METs) is linear. To address this issue, recent calibration studies have incorporated more flexible statistical methods, such as ROC analysis, hierarchical models, and machine learning (Bassett et al., 2000; Crouter et al., 2011; Freedson et al., 2005; Montoye et al., 2017).
A growing body of research calibrating and validating accelerometers to classify physical activity intensities has led to a range of cut-points. However, the applicability of current calibration protocols to clinical populations remains to be addressed. The aim of this review was to evaluate the accuracy of the methods for calibrating and validating of accelerometers to estimate physical activity intensity thresholds for clinical populations. Six databases were searched between March and July to 2017 using text words and subject headings. Studies developing moderate-to-vigorous intensity physical activity cut-points for adult clinical populations were included. The risk of bias was assessed using the health measurement instruments and a specific checklist for calibration studies. A total of 543,741 titles were found and 323 articles were selected for full-text assessment, with 11 meeting the inclusion criteria. Twenty-three different methods for calibration were identified using different models of ActiGraph and Actical accelerometers. Disease-specific cut-points ranged from 591 to 2717 counts·min⁻¹ and were identified for two main groups of clinical conditions: neuromusculoskeletal disorders and metabolic diseases. The heterogeneity in the available clinical protocols hinders the applicability and comparison of the developed cut-points. As such, a mixed protocol containing a controlled laboratory exercise test and activities of daily-life is suggested. It is recommended that this be combined with a statistical approach that allows for adjustments according to disease severity or the use of machine learning models. Finally, this review highlights the generalisation of cut-points developed on healthy populations to clinical populations is inappropriate.
Six-Minute Walk Test Performance in Persons With Multiple Sclerosis While Using Passive or Powered Ankle-Foot Orthoses
2018, Archives of Physical Medicine and Rehabilitation
To determine whether a powered ankle-foot orthosis (AFO) that provides dorsiflexor and plantar flexor assistance at the ankle can improve walking endurance of persons with multiple sclerosis (MS).
Short-term intervention.
University research laboratory.
Participants (N=16) with a neurologist-confirmed diagnosis of MS and daily use of a prescribed custom unilateral passive AFO.
Three 6-minute walk tests (6MWTs), 1 per footwear condition: shoes (no AFO), prescribed passive AFO, and portable powered AFO (PPAFO). Assistive devices were worn on the impaired limb.
Distance walked and metabolic cost of transport were recorded during each 6MWT and compared between footwear conditions.
Each participant completed all three 6MWTs within the experimental design. PPAFO use resulted in a shorter 6MWT distance than did a passive AFO or shoe use. No differences were observed in metabolic cost of transport between footwear conditions.
The current embodiment of this PPAFO did not improve endurance walking performance during the 6MWT in a sample of participants with gait impairment due to MS. Further research is required to determine whether expanded training or modified design of this powered orthosis can be effective in improving endurance walking performance in persons with gait impairment due to MS.
Is physical behavior affected in fatigued persons with multiple sclerosis?
2015, Archives of Physical Medicine and Rehabilitation
Citation Excerpt :
Physical behavior assessment was performed using 3-dimensional accelerometry (ActiGraph GT3X+ modela; 4.6×3.3×1.5cm; 19g). This device has demonstrated validity and reliability in measuring physical behavior in persons with MS and healthy adults.22,23 Participants wore the accelerometer on an elastic belt that was positioned at the waist.
To study physical behavior in detail in fatigued persons with multiple sclerosis (MS).
Case-control explorative study.
Outpatient rehabilitation department and participants' daily environment.
Fatigued persons with MS (n=23) were selected from a randomized controlled trial. Cases were matched by age and sex to healthy, nonfatigued controls (n=23). Eligible persons with MS were severely fatigued (Checklist Individual Strength fatigue domain mean score, 43.2±6.6) and ambulatory (Expanded Disability Status Scale mean score, 2.5±1.5).
Not applicable.
Measurements were performed using an accelerometer over 7 days. Outcomes included the following: amount of physical activity expressed in counts per day, counts per minute (CPM), and counts per day period (morning, afternoon, evening); duration of activity intensity categories (sedentary, light physical activity, moderate-to-vigorous physical activity [MVPA]); and distribution of MVPA and sedentary periods over the day.
Persons with MS had fewer counts per day (mean difference, −156×10³; 95% confidence interval [CI], −273×10³ to −39×10³; P=.010), had fewer CPM (mean difference, −135; 95% CI, −256 to −14; P=.030), and were less physically active in the morning (mean difference, −200; 95% CI, −389 to −11; P=.039) and evening (mean difference, −175; 95% CI, −336 to −14; P=.034) than controls. Persons with MS spent a higher percentage of their time sedentary (mean difference, 5.6; 95% CI, .1–11.1; P=.045) and spent less time at the higher MVPA intensity (mean difference, −2.4; 95% CI, −4.7 to −0.09; P=.042). They had fewer MVPA periods (mean difference, 29; 95% CI, −56.2 to −2.6; P=.032) and a different distribution of sedentary (mean difference, .033; 95% CI, .002 to .064; P=.039) and MVPA periods (mean difference, −.08; 95% CI, −.15 to −.01; P=.023).
Detailed analyses of physical behavior showed that ambulatory fatigued persons with MS do differ from healthy controls not only in physical activity level, but also in other physical behavior dimensions (eg, day patterns, intensity, distribution).
Measurement of Physical Activity Using Accelerometry in Persons With Multiple Sclerosis
2023, Journal for the Measurement of Physical Behaviour
Wearable Sensor Technologies to Assess Motor Functions in People With Multiple Sclerosis: Systematic Scoping Review and Perspective
2023, Journal of Medical Internet Research
Accelerometer Cut-Points for Physical Activity Assessment in Adults with Mild to Moderate Huntington’s Disease: A Cross-Sectional Multicentre Study
2022, International Journal of Environmental Research and Public Health

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Original articleCalibration of Accelerometer Output for Ambulatory Adults With Multiple Sclerosis

Abstract

Objectives

Design

Setting

Participants

Interventions

Main Outcome Measures

Results

Conclusions

Section snippets

Participants

Results

Discussion

Conclusions

Pain

Physical exercise in multiple sclerosis: supportive care or a putative disease-modifying treatment

Expert Rev Neurother

Effect of exercise training on quality of life in multiple sclerosis: a meta-analysis

Mult Scler

Effect of exercise training on walking mobility in multiple sclerosis: a meta-analysis

Neurorehabil Neural Repair

Calibration of the Computer Science and Applications, Inc. accelerometer

Med Sci Sports Exerc

An exploratory study of two measures of free-living physical activity for people with multiple sclerosis

Clin Rehabil

Measuring activity patterns using actigraphy in multiple sclerosis

Chronobiol Int

Validity of physical activity measures in ambulatory individuals with multiple sclerosis

Disabil Rehabil

Physical activity and multiple sclerosis: validity of self-report and objective measures

Fam Community Health

Quantification of lower physical activity in persons with multiple sclerosis

Med Sci Sports Exerc

Original article
Calibration of Accelerometer Output for Ambulatory Adults With Multiple Sclerosis