Comparing accelerometer, pedometer and a questionnaire for measuring physical activity in bronchiectasis: a validity and feasibility study?

Abstract

Background: There are challenges for researchers and clinicians to select the most appropriate physical activity tool, and a balance between precision and feasibility is needed. Currently it is unclear which physical activity tool should be used to assess physical activity in Bronchiectasis. The aim of this research is to compare assessment methods (pedometer and IPAQ) to our criterion method (ActiGraph) for the measurement of physical activity dimensions in Bronchiectasis (BE), and to assess their feasibility and acceptability.

Methods: Patients in this analysis were enrolled in a cross-sectional study. The ActiGraph and pedometer were worn for seven consecutive days and the IPAQ was completed for the same period. Statistical analyses were performed using SPSS 20 (IBM). Descriptive statistics were used; the percentage agreement between ActiGraph and the other measures were calculated using limits of agreement. Feedback about the feasibility of the activity monitors and the IPAQ was obtained.

Results: There were 55 (22 male) data sets available. For step count there was no significant difference between the ActiGraph and Pedometer, however, total physical activity time (mins) as recorded by the ActiGraph was significantly higher than the pedometer (mean ± SD, 232 (75) vs. 63 (32)). Levels of agreement between the two devices was very good for step count (97% agreement); and variation in the levels of agreement were within accepted limits of ±2 standard deviations from the mean value. IPAQ reported more bouted- moderate - vigorous physical activity (MVPA) [mean, SD; 167(170) vs 6(9) mins/day], and significantly less sedentary time than ActiGraph [mean, SD; 362(115) vs 634(76) vmins/day]. There were low levels of agreement between the two tools (57% sedentary behaviour; 0% MVPA₁₀₊), with IPAQ under-reporting sedentary behaviour and over-reporting MVPA₁₀₊ compared to ActiGraph. The monitors were found to be feasible and acceptable by participants and researchers; while the IPAQ was accepta ble to use, most patients required assistance to complete it.

Conclusions: Accurate measurement of physical activity is feasible in BE and will be valuable for future trials of therapeutic interventions. ActiGraph or pedometer could be used to measure simple daily step counts, but ActiGraph was superior as it measured intensity of physical activity and was a more precise measure of time spent walking. The IPAQ does not appear to represent an accurate measure of physical activity in this population.

Trial registration: Clinical Trials Registration Number NCT01569009 : Physical Activity in Bronchiectasis.

Keywords: Actigraph; Bronchiectasis; Pedometer; Physical activity measurement; Step count.

Fig. 1

Bland-Altman Plot of ActiGraph vs Pedometer step counts. The mean (SD) difference in steps was -167 (1485), and the upper and lower LOA (2745, -3078)

Fig. 2

Bland-Altman Plot of ActiGraph vs Pedometer walk time. The mean (SD) difference in walk time was 165 (53) minutes and the upper and lower LOA (269, 62)

Fig. 3

Bland-Altman Plot of ActiGraph vs IPAQ time in moderate-vigorous physical activity bouts (MVPA₁₀₊). The mean (SD) difference in bouts was 272 (135), and the upper and lower LOA (536, 7)

Fig. 4

Bland-Altman Plot of ActiGraph vs IPAQ time in sedentary behaviour. The mean (SD) difference in sedentary behaviour was -160 (171) minutes, and upper and lower LOA (175, -495)