Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, SWITZERLAND.
Med Sci Sports Exerc. 2024 Feb 1;56(2):170-180. doi: 10.1249/MSS.0000000000003299. Epub 2023 Sep 12.
Accelerometer-assessed physical activity (PA) can be summarized using cut-point-free or population-specific cut-point-based outcomes. We aimed to 1) examine the interrelationship between cut-point-free (intensity gradient (IG) and average acceleration (AvAcc)) and cut-point-based accelerometer metrics, 2) compare the association between cardiorespiratory fitness (CRF) and cut-point-free metrics to that with cut-point-based metrics in healthy adults aged 20 to 89 yr and patients with heart failure, and 3) provide age-, sex-, and CRF-related reference values for healthy adults.
In the COmPLETE study, 463 healthy adults and 67 patients with heart failure wore GENEActiv accelerometers on their nondominant wrist and underwent cardiopulmonary exercise testing. Cut-point-free (IG: distribution of intensity of activity across the day; AvAcc: proxy of volume of activity) and traditional (moderate-to-vigorous and vigorous activity) metrics were generated. The "interpretablePA" R-package was developed to translate findings into clinical practice.
IG and AvAcc yield complementary information on PA with both IG ( P = 0.009) and AvAcc ( P < 0.001) independently associated with CRF in healthy individuals (adjusted R2 = 73.9%). Only IG was independently associated with CRF in patients with heart failure ( P = 0.043, adjusted R2 = 38.4%). The best cut-point-free and cut-point-based model had similar predictive value for CRF in both cohorts. We produced age- and sex-specific reference values and percentile curves for IG, AvAcc, moderate-to-vigorous PA, and vigorous PA for healthy adults.
IG and AvAcc are strongly associated with CRF and thus indirectly with the risk of noncommunicable diseases and mortality, in healthy adults and patients with heart failure. However, unlike cut-point-based metrics, IG and AvAcc are comparable across populations. Our reference values provide a healthy age- and sex-specific comparison that may enhance the translation and utility of cut-point-free metrics in clinical practice.
加速度计评估的身体活动（PA）可以使用无切点或基于人群特定切点的结果进行总结。我们旨在 1）检查无切点（强度梯度（IG）和平均加速度（AvAcc）和基于切点的加速度计指标之间的相互关系，2）比较健康成年人（年龄 20 至 89 岁）和心力衰竭患者的心肺功能（CRF）与无切点指标的关联与基于切点的指标，3）为健康成年人提供年龄、性别和 CRF 相关的参考值。
在 COmPLETE 研究中，463 名健康成年人和 67 名心力衰竭患者在非优势手腕上佩戴 GENEActiv 加速度计，并进行心肺运动测试。生成无切点（IG：活动强度在一天中的分布；AvAcc：活动量的代理）和传统（中等至剧烈和剧烈活动）指标。开发了“可解释的 PA”R 包将研究结果转化为临床实践。
IG 和 AvAcc 提供了关于 PA 的互补信息，IG（P=0.009）和 AvAcc（P<0.001）在健康个体中均与 CRF 独立相关（调整后的 R2=73.9%）。只有 IG 与心力衰竭患者的 CRF 独立相关（P=0.043，调整后的 R2=38.4%）。无切点和基于切点的最佳模型在两个队列中对 CRF 具有相似的预测价值。我们为健康成年人生成了 IG、AvAcc、中等至剧烈 PA 和剧烈 PA 的年龄和性别特异性参考值和百分位数曲线。
IG 和 AvAcc 与 CRF 密切相关，因此与非传染性疾病和死亡率的风险间接相关，在健康成年人和心力衰竭患者中。然而，与基于切点的指标不同，IG 和 AvAcc 在人群中是可比的。我们的参考值提供了健康的年龄和性别特异性比较，可能会增强无切点指标在临床实践中的转化和实用性。
