Wrist acceleration cut points for moderate-to-vigorous physical activity in youth

© 2017 by the American College of Sports Medicine. Purpose This study aimed to examine the validity of wrist acceleration cut points for classifying moderate (MPA), vigorous (VPA), and moderate-to-vigorous (MVPA) physical activity. Methods Fifty-seven children (5-12 yr) completed 15 semistructured activities. Three sets of wrist cut points (>192 mg, >250 mg, and >314 mg), previously developed using Euclidian norm minus one (ENMO 192+), GENEActiv software (GENEA 250+), and band-pass filter followed by Euclidian norm (BFEN 314+), were evaluated against indirect calorimetry. Analyses included classification accuracy, equivalence testing, and Bland-Altman procedures. Results All cut points classified MPA, VPA, and MVPA with substantial accuracy (ENMO 192+: κ = 0.72 [95% confidence interval = 0.72-0.73], MVPA: area under the receiver operating characteristic curve (ROC-AUC) = 0.85 [0.85-0.86]; GENEA 250+: κ = 0.75 [0.74-0.76], MVPA: ROC-AUC = 0.85 [0.85-0.86]; BFEN 314+: κ = 0.73 [0.72-0.74], MVPA: ROC-AUC = 0.86 [0.86-0.87]). BFEN 314+ misclassified 19.7% non-MVPA epochs as MPA, whereas ENMO 192+ and GENEA 250+ misclassified 32.6% and 26.5% of MPA epochs as non-MVPA, respectively. Group estimates of MPA time were equivalent (P < 0.01) to indirect calorimetry for the BFEN 314+ MPA cut point (mean bias = -1.5%, limits of agreement [LoA] = -57.5% to 60.6%), whereas estimates of MVPA time were equivalent (P < 0.01) to indirect calorimetry for the ENMO 192+ (mean bias = -1.1%, LoA = -53.7% to 55.9%) and GENEA 250+ (mean bias = 2.2%, LoA = -56.5% to 52.2%) cut points. Individual variability (LoA) was large for MPA (min: BFEN 314+, -60.6% to 57.5%; max: GENEA 250+, -42.0% to 104.1%), VPA (min: BFEN 314+, -238.9% to 54.6%; max: ENMO 192+, -244.5% to 127.4%), and MVPA (min: ENMO 192+, -53.7% to 55.0%; max: BFEN 314+, -83.9% to 25.3%). Conclusion Wrist acceleration cut points misclassified a considerable proportion of non-MVPA and MVPA. Group-level estimates of MVPA were acceptable; however, error for individual-level prediction was larger.