Accelerometer-assessed physical activity in epidemiology: Are monitors equivalent?

PURPOSE: Accelerometers are increasingly being used to assess physical activity in large-scale surveys. Establishing whether key physical activity outcomes can be considered equivalent between three widely-used accelerometer brands would be a significant step towards capitalising on the increasing availability of accelerometry data for epidemiological research. METHODS: Twenty participants wore a GENEActiv, Axivity AX3 and ActiGraph GT9X on their non-dominant wrist and were observed for two-hours in a simulated living space. Participants undertook a series of seated and upright light/active behaviours at their own pace. All accelerometer data were processed identically using open-source software (GGIR) to generate physical activity outcomes (including average dynamic acceleration (ACC) and time within intensity cut-points). Data were analysed using pairwise 95% equivalence tests (±10% equivalence zone), intra-class correlation coefficients (ICC) and limits of agreement. RESULTS: The GENEActiv and Axivity could be considered equivalent for ACC (ICC=0.95, 95% confidence interval (CI) 0.87 to 0.98), but ACC measured by the ActiGraph was approximately 10% lower (ICC: GENEActiv/ActiGraph 0.86, 95% CI 0.56 to 0.95; Axivity/ActiGraph 0.82, 95% CI 0.50 to 0.94). For time spent within intensity cut-points, all three accelerometers could be considered equivalent to each other for over 85% of outcomes (ICC≥0.69, lower 95% CI≥0.36), with the GENEActiv and Axivity equivalent for 100% of outcomes (ICC≥0.95, lower 95% CI≥0.86). CONCLUSIONS: GENEActiv and Axivity data processed in GGIR are largely equivalent. If comparing GENEActiv or Axivity to the ActiGraph, time spent within intensity cut-points has good agreement. These findings can be used to inform selection of appropriate outcomes if comparing outputs from these accelerometer brands.