Bianchim Mayara S, McNarry Melitta A, Larun Lillebeth, Mackintosh Kelly A
School of Sport and Exercise Sciences, Swansea University, Bay Campus, Fabian Way, SA1 8EN Swansea, Wales, United Kingdom.
Norwegian Institute of Public Health, Division of Health Services, PO Box 222, Skøyen N-0213, Oslo, Norway.
Prev Med Rep. 2019 Nov 6;16:101001. doi: 10.1016/j.pmedr.2019.101001. eCollection 2019 Dec.
A growing body of research calibrating and validating accelerometers to classify physical activity intensities has led to a range of cut-points. However, the applicability of current calibration protocols to clinical populations remains to be addressed. The aim of this review was to evaluate the accuracy of the methods for calibrating and validating of accelerometers to estimate physical activity intensity thresholds for clinical populations. Six databases were searched between March and July to 2017 using text words and subject headings. Studies developing moderate-to-vigorous intensity physical activity cut-points for adult clinical populations were included. The risk of bias was assessed using the health measurement instruments and a specific checklist for calibration studies. A total of 543,741 titles were found and 323 articles were selected for full-text assessment, with 11 meeting the inclusion criteria. Twenty-three different methods for calibration were identified using different models of ActiGraph and Actical accelerometers. Disease-specific cut-points ranged from 591 to 2717 counts·min and were identified for two main groups of clinical conditions: neuromusculoskeletal disorders and metabolic diseases. The heterogeneity in the available clinical protocols hinders the applicability and comparison of the developed cut-points. As such, a mixed protocol containing a controlled laboratory exercise test and activities of daily-life is suggested. It is recommended that this be combined with a statistical approach that allows for adjustments according to disease severity or the use of machine learning models. Finally, this review highlights the generalisation of cut-points developed on healthy populations to clinical populations is inappropriate.
越来越多校准和验证加速度计以对身体活动强度进行分类的研究产生了一系列切点。然而，当前校准方案在临床人群中的适用性仍有待解决。本综述的目的是评估校准和验证加速度计以估计临床人群身体活动强度阈值的方法的准确性。2017年3月至7月期间，使用文本词和主题词对六个数据库进行了检索。纳入了为成年临床人群制定中度至剧烈强度身体活动切点的研究。使用健康测量工具和校准研究的特定清单评估偏倚风险。共找到543741个标题，选择323篇文章进行全文评估，其中11篇符合纳入标准。使用不同型号的ActiGraph和Actical加速度计确定了23种不同的校准方法。特定疾病的切点范围为591至2717计数·分钟，确定了两大类临床病症的切点：神经肌肉骨骼疾病和代谢疾病。现有临床方案的异质性阻碍了所制定切点的适用性和比较。因此，建议采用包含受控实验室运动测试和日常生活活动的混合方案。建议将其与允许根据疾病严重程度进行调整的统计方法或机器学习模型的使用相结合。最后，本综述强调将在健康人群中制定的切点推广到临床人群是不合适的。
