Calculation and Comparison of Step Guidelines for Preschooler Physical Activity While Indoors

Preschooler physical activity (PA) is vital for growth and development. The World Health Organization PA guidelines state preschoolers should achieve ≥ 180 min/day of Total PA (TPA) of which ≥ 60 min is moderate-to-vigorous PA (MVPA). A step/day recommendation to match these guidelines may be a more practical metric for caregivers to promote PA. The purpose of our investigation is to improve upon existing step recommendations by creating one for indoor-based activities, acknowledging where preschoolers spend most of their time, and various cut-points for PA.

In a laboratory study (Aim 1), a validated direct observation protocol was used to quantify preschooler PA intensity while performing indoor activities (n = 35). Actigraph GT3x accelerometers were placed on the waist, wrist, and ankle to measure step count. In a field study (Aim 2), habitual PA of 881 preschoolers (7113 valid days) via waist-worn accelerometers was used to assess the agreement between created guidelines (Aim 1) and other step recommendations with PA guidelines using Receiver Operating Characteristic and Area Under the Curve (ROC-AUC).

In the laboratory study, calculated indoor step ranges were 6960-7440 (waist), 7200-8640 (wrist), and 7680-9120 (ankle) to align with existing PA guidance. In the field, the higher step guidelines (> 12 000) achieved very limited agreement, due to few preschoolers achieving this metric. The 6000 step/day guidelines had the highest agreement (AUCs: TPA: 0.637; MVPA: 0.751; TPA + MVPA: 0.761) with PA guideline.

When preschoolers are indoors, 6000 steps may be the minimum for adequate PA.