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      How many days are needed to estimate wrist-worn accelerometry-assessed physical activity during the second trimester in pregnancy?

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          Abstract

          Background

          Objective methods to measure physical activity (PA) can lead to better cross-cultural comparisons, monitoring temporal PA trends, and measuring the effect of interventions. However, when applying this technology in field-work, the accelerometer data processing is prone to methodological issues. One of the most challenging issues relates to standardizing total wear time to provide reliable data across participants. It is generally accepted that at least 4 complete days of accelerometer wear represent a week for adults. It is not known if this same assumption holds true for pregnant women.

          Aim

          We assessed the optimal number of days needed to obtain reliable estimates of overall PA and moderate-to-vigorous physical activity (MVPA) during the 2nd trimester in pregnancy using a raw triaxial wrist-worn accelerometer.

          Methods

          Cross-sectional analyses were carried out in the antenatal wave of the 2015 Pelotas (Brazil) Birth Cohort Study. Participants wore the wrist ActiGraph wGT3X-BT accelerometer for seven consecutive days. The daily average acceleration, which indicated overall PA, was measured as milli- g (m g), and time spent in MVPA (minutes/day) was analyzed in 5-minute bouts. ANOVA and Kruskal-Wallis tests were used to compare variability across days of the week. Bland-Altman plots and the Spearman-Brown Prophecy Formula were applied to determine the reliability coefficient associated with one to seven days of measurement.

          Results

          Among 2,082 pregnant women who wore the accelerometer for seven complete days, overall and MVPA were lower on Sundays compared to other days of the week. Reliability of > = 0.80 to evaluate overall PA was reached with at least three monitoring days, whereas seven days were needed to estimate reliable measures of MVPA.

          Conclusions

          Our findings indicate that obtaining one week of accelerometry in adults is appropriate for pregnant women, particularly to obtain differences on weekend days and reliably estimate overall PA and MVPA.

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          Most cited references18

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          Conducting accelerometer-based activity assessments in field-based research.

          The purpose of this review is to address important methodological issues related to conducting accelerometer-based assessments of physical activity in free-living individuals. We review the extant scientific literature for empirical information related to the following issues: product selection, number of accelerometers needed, placement of accelerometers, epoch length, and days of monitoring required to estimate habitual physical activity. We also discuss the various options related to distributing and collecting monitors and strategies to enhance compliance with the monitoring protocol. No definitive evidence exists currently to indicate that one make and model of accelerometer is more valid and reliable than another. Selection of accelerometer therefore remains primarily an issue of practicality, technical support, and comparability with other studies. Studies employing multiple accelerometers to estimate energy expenditure report only marginal improvements in explanatory power. Accelerometers are best placed on hip or the lower back. Although the issue of epoch length has not been studied in adults, the use of count cut points based on 1-min time intervals maybe inappropriate in children and may result in underestimation of physical activity. Among adults, 3-5 d of monitoring is required to reliably estimate habitual physical activity. Among children and adolescents, the number of monitoring days required ranges from 4 to 9 d, making it difficult to draw a definitive conclusion for this population. Face-to-face distribution and collection of accelerometers is probably the best option in field-based research, but delivery and return by express carrier or registered mail is a viable option. Accelerometer-based activity assessments requires careful planning and the use of appropriate strategies to increase compliance.
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            Assessment of physical activity - a review of methodologies with reference to epidemiological research: a report of the exercise physiology section of the European Association of Cardiovascular Prevention and Rehabilitation.

            Physical activity has a fundamental role in the prevention and treatment of chronic disease. The precise measurement of physical activity is key to many surveillance and epidemiological studies investigating trends and associations with disease. Public health initiatives aimed at increasing physical activity rely on the measurement of physical activity to monitor their effectiveness. Physical activity is multidimensional, and a complex behaviour to measure; its various domains are often misunderstood. Inappropriate or crude measures of physical activity have serious implications, and are likely to lead to misleading results and underestimate effect size. In this review, key definitions and theoretical aspects, which underpin the measurement of physical activity, are briefly discussed. Methodologies particularly suited for use in epidemiological research are reviewed, with particular reference to their validity, primary outcome measure and considerations when using each in the field. It is acknowledged that the choice of method may be a compromise between accuracy level and feasibility, but the ultimate choice of tool must suit the stated aim of the research. A framework is presented to guide researchers on the selection of the most suitable tool for use in a specific study.
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              Objective measurement of physical activity and sedentary behaviour: review with new data.

              Objective methods are being used increasingly for the quantification of the amount of physical activity, intensity of physical activity and amount of sedentary behaviour in children. The accelerometer is currently the objective method of choice. In this review we address the advantages of objective measurement compared with more traditional subjective methods, notably the avoidance of bias, greater confidence in the amount of activity and sedentary behaviour measured, and improved ability to relate variation in physical activity and sedentary behaviour to variation in health outcomes. We also consider unresolved practical issues in paediatric accelerometry by critically reviewing the existing evidence and by providing new evidence.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: Writing – original draft
                Role: SupervisionRole: Writing – review & editing
                Role: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: Funding acquisitionRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                27 June 2019
                2019
                : 14
                : 6
                : e0211442
                Affiliations
                [1 ] PostGraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
                [2 ] Medical School, Federal University of Fronteira Sul–Passo Fundo, Passo Fundo, RS, Brazil
                [3 ] Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
                [4 ] Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
                [5 ] PostGraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
                University of Maiduguri College of Medical Sciences, NIGERIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                ‡ These authors also contributed equally to this work.

                Author information
                http://orcid.org/0000-0003-1504-6936
                http://orcid.org/0000-0002-5590-5750
                http://orcid.org/0000-0002-4951-5991
                Article
                PONE-D-19-01094
                10.1371/journal.pone.0211442
                6597041
                31246953
                2e9368c7-a368-47e2-82ab-8bcbb1f3190e
                © 2019 da Silva et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 21 January 2019
                : 15 June 2019
                Page count
                Figures: 3, Tables: 3, Pages: 12
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Award ID: 095582/z/11/z
                Award Recipient :
                The 2015 Birth Cohort Study was funded by the Wellcome Trust (grant 095582/z/11/z to PCH), the Brazilian National Research Council and the Coordination for the Improvement of Higher Education Personnel. SGdS would like to thank CAPES and CNPq (n.439505/2016-0) for the scholarship and financial support. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Pregnancy
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Pregnancy
                Engineering and Technology
                Electronics
                Accelerometers
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Physical Fitness
                Exercise
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Exercise
                Biology and Life Sciences
                Sports Science
                Sports and Exercise Medicine
                Exercise
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Medicine and Health Sciences
                Health Care
                Socioeconomic Aspects of Health
                Medicine and Health Sciences
                Public and Occupational Health
                Socioeconomic Aspects of Health
                Research and Analysis Methods
                Research Design
                Cohort Studies
                Biology and Life Sciences
                Anatomy
                Musculoskeletal System
                Body Limbs
                Arms
                Wrist
                Medicine and Health Sciences
                Anatomy
                Musculoskeletal System
                Body Limbs
                Arms
                Wrist
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Medicine and Health Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Custom metadata
                All relevant data are within the paper and its Supporting Information files (Data URL).

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