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  • Title: Wrist Accelerometry for Physical Activity Measurement in Individuals With Spinal Cord Injury-A Need for Individually Calibrated Cut-Points.
    Author: McCracken LA, Ma JK, Voss C, Chan FH, Martin Ginis KA, West CR.
    Journal: Arch Phys Med Rehabil; 2018 Apr; 99(4):684-689. PubMed ID: 29222006.
    Abstract:
    OBJECTIVE: To create and compare individual and group-based cut-points for wrist accelerometry that correspond to moderate-to-vigorous physical activity (MVPA) in people with spinal cord injury (SCI). DESIGN: Participants completed a graded treadmill-wheeling test while being assessed for oxygen consumption, wrist-acceleration vector magnitude, and spoke acceleration. Oxygen consumption was converted to SCI metabolic equivalents (METs), and linear regression was applied to determine an individualized vector magnitude cut-point (counts per minute, VM-CPM) corresponding with MVPA (≥3 SCI METs). Multilevel linear regression was applied to determine a group MVPA cut-point. Participants then completed a 6-day monitoring period while wearing the accelerometers. SETTING: A local SCI research center. PARTICIPANTS: Manual wheelchair users (N=20; aged 31-64y; injury levels, C5 to L2) with chronic (>1y) SCI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Mean total daily MVPA, wheeled MVPA, and nonwheeled MVPA were calculated using both the individual and group cut-points. Agreement on measures of minutes per day of MVPA between the individual and group mean cut-point method was assessed using Bland-Altman plots. RESULTS: Individual cut-points for MVPA ranged from 6040 to 21,540 VM-CPM, with a group cut-point of 11,652 (95% confidence interval, 7395-15,909). For total daily MVPA, Bland-Altman analysis revealed a bias of .22±33.0 minutes, with 95% limits of agreement from -64.5 to 64.9 minutes, suggesting a large discrepancy between total MVPA calculated from individual and group mean cut-points. CONCLUSIONS: Individual calibration of wrist-worn accelerometry is recommended for effective habitual PA monitoring in this population.
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