Agreement of objectively measured physical activity and sedentary time in preschool children

Abstract

Objective: To determine the intra-individual agreement for objectively measured physical activity (PA) and sedentary behavior (SED) over two subsequent weeks in preschool children.

Method: Ninety-one children aged 3 to 5 years (49% boys) from three preschools in Sogn og Fjordane, Norway, provided 14 consecutive days of accelerometer data (Actigraph GT3X +) during the autumn of 2014. Week-by-week reliability was assessed using intraclass correlation (ICC), Bland-Altman plots and 95% limits of agreement for different wear time criteria (≥ 6, 8 and 10 h/day and ≥ 3 and 5 days/week).

Results: The week-by-week ICC was ≥ 0.75 for all variables across all wear criteria applied, except for absolute sedentary time (ICC 0.61-0.81). Using a ≥ 8 h/day and ≥ 3 days/week criterion (n = 78), limits of agreement were ± 209.5 cpm for overall PA, ± 68.6 min/day for SED, ± 43.8 min/day for light PA, ± 20.2 min/day for moderate-to-vigorous PA, and ± 55.9 min/day for light-to-vigorous PA, equaling 1.0-1.6 standard deviation units.

Conclusion: Considerable week-by-week variability was found for all variables. Researchers need to be aware of substantial intra-individual variability in accelerometer-measurements and take necessary actions according to the hypothesis under study, as noise in any measurement will preclude researchers' ability to arrive at valid conclusions in epidemiology.

Keywords: Accelerometry; Bland–Altman plot; Measurement; Test–retest.

Fig. 1

Bland Altman plots of agreement for different outcome variables over two consecutive weeks of measurement. Bland Altman plots (mean of two weeks of measurement on the x-axis versus the difference between them on the y-axis) for (A) overall physical activity (cpm) and (B) minutes per day spent sedentary (SED), (C) in moderate-to-vigorous physical activity (MVPA) and (D) in light-to-vigorous physical activity. Results are based on a ≥ 8 h & ≥ 3 days wear time criterion (n = 78). The full line is the bias between weeks, whereas the dotted lines are 95% limits of agreement. The study was conducted in Sogn og Fjordane, Norway, 2014.