Physical activity and energy expenditure in clinical settings using multisensor activity monitors.

Background: Objective methods need to replace subjective methods for accurate quantification of physical activity. To be used in clinical settings objective methods have to show high reliability, validity and feasibility. The commonly used activity monitors are unable to detect the variety of physical activities. Multisensor activity monitors have larger potential for a more accurate quantification of physical activity. Children who have undergone surgery for congenital heart defects have the possibility to a physical active lifestyle because of the progress in cardiac surgery and cardiology. Aims: To evaluate the ability of the multisensor activity monitors ActiReg, SenseWear Armband and IDEEA to assess physical activity and energy expenditure (I-IV), and to assess physical activity, sports participation and aerobic fitness in children who have undergone surgery for congenital heart defects (V). Methods: I) Patients with chronic obstructive pulmonary disease (COPD) wore the ActiReg during 7 days with doubly labelled water as criterion for energy expenditure; II-III) 11-13 years old children performed different physical activities while wearing the ActiReg, SenseWear Armband and IDEEA with indirect calorimetry as criterion for energy expenditure; IV) a new ActiReg algorithm calibrated in 11-13 years old children was tested in 14-15 years old children wearing the ActiReg but also the SenseWear Armband during 14 days using doubly labelled water as criterion for energy expenditure; V) children who have undergone surgery for congenital heart defects and healthy controls in the age-groups 9-11 and 14-16 years wore the ActiReg during 7 days, were interviewed about sports participation and performed a maximal exercise test with measured oxygen uptake for the assessment of aerobic fitness. Results: I) The ActiReg showed a mean (sd) accuracy of 99 (10) % in assessing energy expenditure in COPD patients; II-III) the accuracy of the SenseWear Armband and IDEEA in assessing energy expenditure varied between the different activities but showed an overall value of 81 (11) %/85 (8) % for the SenseWear Armband and 96 (10) % for the IDEEA; the SenseWear Armband showed increased underestimation with increasing intensity; the ActiReg algorithm overestimated moderate physical activity and the ActiReg had a limitation in registering vigorous physical activity; IV) the accuracy of the ActiReg with the new algorithm and the SenseWear Armband was 99 (11) % and 96 (10) %, both with increased underestimation with increasing intensity; V) children who have undergone surgery for congenital heart defects showed similar physical activity as the healthy controls but a tendency to lower amount of sports participation; in the older children, especially in boys, the patients had lower aerobic fitness; still, their amount of sports participation was considered high and their aerobic fitness moderate. Conclusions: The ActiReg, SenseWear Armband and IDEEA have to be improved to become accurate instruments in clinical settings. While children who have undergone surgery for congenital heart defects had a physical activity level comparable to healthy children, some of them may require support for their engagement in exercise and vigorous physical activity.