Comparison of Indirect Calorimetry- and Accelerometry-Based Energy Expenditure During Children's Discrete Skill Performance.

: To compare children's energy expenditure (EE) levels during object projection skill performance (OPSP; e.g., kicking, throwing, striking) as assessed by hip- and wrist-worn accelerometers. : Forty-two children (female = 20, age = 8.1 ± 0.8 years) performed three, nine-minute sessions of kicking, over-arm throwing, and striking at performance intervals of 6, 12, and 30 seconds. EE was estimated using indirect calorimetry (COSMED k4b2) and accelerometers (ActiGraph GT3X+) worn on three different locations (hip, dominant-wrist, and non-dominant-wrist) using four commonly used cut-points. Bland-Altman plots were used to analyze the agreement in EE estimations between accelerometry and indirect calorimetry (METS). Chi-square goodness of fit tests were used to examine the agreement between accelerometry and indirect calorimetry. : Hip- and wrist-worn accelerometers underestimated EE, compared to indirect calorimetry, during all performance conditions. Skill practice at a rate of two trials per minute resulted in the equivalent of moderate PA and five trials per minute resulted in vigorous PA (as measured by indirect calorimetry), yet was only categorized as light and/or moderate activity by all measured forms of accelerometry. : This is one of the first studies to evaluate the ability of hip- and wrist-worn accelerometers to predict PA intensity levels during OPSP in children. These data may significantly impact PA intervention measurement strategies by revealing the lack of validity in accelerometers to accurately predict PA levels during OPSP in children.