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Systematic review of accelerometer-based methods for 24-h physical behavior assessment in young children (0-5 years
Annelinde Lettink1,2,3, Teatske M Altenburg4,5,6, Jelle Arts4,6
1Amsterdam UMC Location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands. a.lettink@amsterdamumc.nl.
Insights
Accurate accelerometer methods for assessing young children's 24-hour physical behavior are emerging. Multi-parameter methods show promise, especially for preschoolers, but more research on diverse sensor placements is needed.
Area of Science:
- Pediatrics
- Biomedical Engineering
- Physical Activity Measurement
Background:
- Accurate assessment of 24-hour physical behavior in young children is crucial.
- Accelerometer-based methods are increasingly used for this purpose.
- Evidence on the measurement properties of these methods in young children requires synthesis.
Purpose of the Study:
- To summarize the evidence on the reliability and validity of accelerometer-based methods for assessing 24-hour physical behavior in children aged 0-5 years.
- To identify the strengths and limitations of existing methods.
- To provide recommendations for future research and practice.
Main Methods:
- A systematic literature search was conducted in PubMed (MEDLINE) up to June 2021.
- Studies evaluating reliability or validity of accelerometer-based methods for physical activity (PA), sedentary behavior (SB), or sleep in 0-5-year-olds were included.
- A novel checklist, CAMQAM, was developed to assess study quality.
Main Results:
- Sixty-two studies were included, evaluating cut-point-based and multi-parameter methods.
- Multi-parameter methods showed validity for classifying SB and PA in infants and SB, light PA (LPA), and moderate-to-vigorous PA (MVPA) in toddlers.
- Valid methods for sleep assessment were identified in infants and preschoolers, but not toddlers. Cut-points were valid for preschoolers across all behaviors.
Conclusions:
- Valid accelerometer-based methods for assessing 24-hour physical behavior are available for preschoolers, but less so for children under three.
- Multi-parameter methods show promise, particularly when using data from multiple sensor placements and axes.
- Further high-quality research with standardized protocols and validated behaviors is recommended, utilizing tools like CAMQAM to enhance methodological rigor.
Background:
Accurate accelerometer-based methods are required for assessment of 24-h physical behavior in young children. We aimed to summarize evidence on measurement properties of accelerometer-based methods for assessing 24-h physical behavior in young children.
Methods:
We searched PubMed (MEDLINE) up to June 2021 for studies evaluating reliability or validity of accelerometer-based methods for assessing physical activity (PA), sedentary behavior (SB), or sleep in 0-5-year-olds. Studies using a subjective comparison measure or an accelerometer-based device that did not directly output time series data were excluded. We developed a Checklist for Assessing the Methodological Quality of studies using Accelerometer-based Methods (CAMQAM) inspired by COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN).
Results:
Sixty-two studies were included, examining conventional cut-point-based methods or multi-parameter methods. For infants (0-12 months), several multi-parameter methods proved valid for classifying SB and PA. From three months of age, methods were valid for identifying sleep. In toddlers (1-3 years), cut-points appeared valid for distinguishing SB and light PA (LPA) from moderate-to-vigorous PA (MVPA). One multi-parameter method distinguished toddler specific SB. For sleep, no studies were found in toddlers. In preschoolers (3-5 years), valid hip and wrist cut-points for assessing SB, LPA, MVPA, and wrist cut-points for sleep were identified. Several multi-parameter methods proved valid for identifying SB, LPA, and MVPA, and sleep. Despite promising results of multi-parameter methods, few models were open-source. While most studies used a single device or axis to measure physical behavior, more promising results were found when combining data derived from different sensor placements or multiple axes.
Conclusions:
Up to age three, valid cut-points to assess 24-h physical behavior were lacking, while multi-parameter methods proved valid for distinguishing some waking behaviors. For preschoolers, valid cut-points and algorithms were identified for all physical behaviors. Overall, we recommend more high-quality studies evaluating 24-h accelerometer data from multiple sensor placements and axes for physical behavior assessment. Standardized protocols focusing on including well-defined physical behaviors in different settings representative for children's developmental stage are required. Using our CAMQAM checklist may further improve methodological study quality.
Prospero Registration Number:
CRD42020184751.
