Wrist Acceleration Cut Points for Moderate-to-Vigorous Physical Activity in Youth

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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.


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 (ENMO192+), GENEActiv software (GENEA250+), and band-pass filter followed by Euclidian norm (BFEN314+), were evaluated against indirect calorimetry. Analyses included classification accuracy, equivalence testing, and Bland–Altman procedures.


All cut points classified MPA, VPA, and MVPA with substantial accuracy (ENMO192+: 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]; GENEA250+: κ = 0.75 [0.74–0.76], MVPA: ROC-AUC = 0.85 [0.85–0.86]; BFEN314+: κ = 0.73 [0.72–0.74], MVPA: ROC-AUC = 0.86 [0.86–0.87]). BFEN314+ misclassified 19.7% non-MVPA epochs as MPA, whereas ENMO192+ and GENEA250+ 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 BFEN314+ 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 ENMO192+ (mean bias = −1.1%, LoA = −53.7% to 55.9%) and GENEA250+ (mean bias = 2.2%, LoA = −56.5% to 52.2%) cut points. Individual variability (LoA) was large for MPA (min: BFEN314+, −60.6% to 57.5%; max: GENEA250+, −42.0% to 104.1%), VPA (min: BFEN314+, −238.9% to 54.6%; max: ENMO192+, −244.5% to 127.4%), and MVPA (min: ENMO192+, −53.7% to 55.0%; max: BFEN314+, −83.9% to 25.3%).


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.

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