Comparability of ActivPAL-Based Estimates of Meeting Physical Activity Guidelines for Preschool Children

The activPAL (PAL Technologies, Glasgow, UK) has been increasingly used on children to assess sedentary time and physical activity (PA). However, there is no consensus on how it can estimate PA at different intensities. This study compared three commonly used, activPAL-based classifications of moderate-to-vigorous physical activity (MVPA) (daily steps, acceleration counts, and step rate) in determining compliance with the World Health Organization (WHO)'s PA guidelines for preschool children on a daily basis. One hundred and fourteen preschool children aged 3-6 years wore an activPAL^TM for 24 h over 7 consecutive days and provided valid data for a total of 548 days. MVPA was calculated based on published cut-points of counts (MVPA-counts) and step rate (MVPA-step rate). Compliance with standard PA guidelines (≥180 min/day of PA including ≥60 min/day of MVPA) was determined based on three criteria: ≥11,500 steps/day, a threshold of 1418 acceleration counts/15 s, and 25 steps/15 s for MVPA. Applying cut-points of daily steps and acceleration counts provided the same estimates of compliance with the WHO PA guidelines (20%), while the estimated compliance based on the step rate was lower (7.7%). There was a moderate agreement between the daily steps- (or counts-) derived and step rate-derived compliances (κ = 0.41; 95% confidence interval (CI): 0.31, 0.51). The amount of MVPA derived from counts (1.95 ± 0.72 h/day) was significantly higher than that from step rates (0.47 ± 0.31 h/day). The activPAL may be useful for surveillance studies to estimate total PA in preschool children. Further development of the activPAL algorithms based on either counts or step rate is warranted before it can be used to accurately estimate MVPA in this age group.