| 1. |
- Arvidsson, Daniel, 1974, et al.
(författare)
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Measurement of physical activity in clinical practice using accelerometers.
- 2019
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Ingår i: Journal of internal medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 286:2, s. 137-153
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Forskningsöversikt (refereegranskat)abstract
- Accelerometers are commonly used in clinical and epidemiological research for more detailed measures of physical activity and to target the limitations of self-report methods. Sensors are attached at the hip, wrist and thigh, and the acceleration data are processed and calibrated in different waysto determine activity intensity, body position and/or activity type. Simple linear modelling can be used to assess activity intensity from hip andthighdata, whilst more advanced machine-learning modelling is to prefer for the wrist. The thigh position is most optimal to assess body position and activity type using machine-learning modelling. Frequency filtering and measurement resolution needs to be considered for correct assessment of activity intensity. Simple physical activity measures and statistical methods are mostly used to investigate relationship with health, but do not take advantage of all information provided by accelerometers and do not consider all components of the physical activity behaviour and their interrelationships. More advanced statistical methods are suggested that analyse patterns of multiple measures of physical activity to demonstrate stronger and more specific relationships with health. However, evaluations of accelerometer methods show considerable measurement errors, especially at individual level, which interferes with their use in clinical research and practice. Therefore, better objective methods are needed with improved data processing andcalibration techniques, exploring both simple linear and machine-learning alternatives. Development and implementation of accelerometer methods into clinical research and practice requires interdisciplinary collaboration to cover all aspects contributing to useful and accurate measures of physical activity behaviours related to health.
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| 2. |
- Arvidsson, Daniel, 1974, et al.
(författare)
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Re-examination of accelerometer data processing and calibration for the assessment of physical activity intensity.
- 2019
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : John Wiley & Sons. - 0905-7188 .- 1600-0838. ; 29:10, s. 1442-1452
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Tidskriftsartikel (refereegranskat)abstract
- This review reexamines use of accelerometer and oxygen uptake data for assessment of activity intensity. Accelerometers capture mechanical work, while oxygen uptake captures the energy cost of this work. Frequency filtering needs to be considered when processing acceleration data. A too restrictive filter attenuates the acceleration signal for walking and, to a higher degree, for running. This measurement error affects shorter (children) more than taller (adults) individuals due to their higher movement frequency. Less restrictive filtering includes more movement related signals and provide measures that better capture mechanical work, but may include more noise. An optimal filter cut-point is determined where most relevant acceleration signals are included. Further, accelerometer placement affects what part of mechanical work being captured. While the waist placement captures total mechanical work and therefore contributes to measures of activity intensity equivalent by age and stature, the thigh and wrist placements capture more internal work and do not provide equivalent measures. Value calibration of accelerometer measures is usually performed using measured oxygen uptake with the metabolic equivalent of task (MET) as reference measure of activity intensity. However, the use of MET is not stringent and is not a measure of activity intensity equivalent by age and stature. A candidate measure is the mass-specific net oxygen uptake, VO2 net (VO2 tot - VO2 stand). To improve measurement of physical activity intensity using accelerometers, research developments are suggested concerning processing of accelerometer data, use of energy expenditure as reference for activity intensity, and calibration procedure with absolute versus relative intensity. This article is protected by copyright. All rights reserved.
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| 3. |
- Arvidsson, Daniel, 1974, et al.
(författare)
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Reexamination of Accelerometer Calibration with Energy Expenditure as Criterion: VO2net Instead of MET for Age-Equivalent Physical Activity Intensity
- 2019
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Ingår i: Sensors. - : MDPI AG. - 1424-8220. ; 19:15
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Tidskriftsartikel (refereegranskat)abstract
- Accelerometer calibration for physical activity (PA) intensity is commonly performed using Metabolic Equivalent of Task (MET) as criterion. However, MET is not an age-equivalent measure of PA intensity, which limits the use of MET-calibrated accelerometers for age-related PA investigations. We investigated calibration using VO2net (VO2gross - VO2stand; mL.min(-1).kg(-1)) as criterion compared to MET (VO2gross/VO2rest) and the effect on assessment of free-living PA in children, adolescents and adults. Oxygen consumption and hip/thigh accelerometer data were collected during rest, stand and treadmill walk and run. Equivalent speed (Speed(eq)) was used as indicator of the absolute speed (Speed(abs)) performed with the same effort in individuals of different body size/age. The results showed that VO2net was higher in younger age-groups for Speedabs, but was similar in the three age-groups for Speed(eq). MET was lower in younger age-groups for both Speed(abs) and Speed(eq). The same VO2net-values respective MET-values were applied to all age-groups to develop accelerometer PA intensity cut-points. Free-living moderate-and-vigorous PA was 216, 115, 74 and 71 min/d in children, adolescents, younger and older adults with VO2net-calibration, but 140, 83, 74 and 41 min/d with MET-calibration, respectively. In conclusion, VO2net calibration of accelerometers may provide age-equivalent measures of PA intensity/effort for more accurate age-related investigations of PA in epidemiological research.
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| 4. |
- Bornhöft, Lena, et al.
(författare)
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Development and feasibility of a function-based preventive intervention for lifestyle-related disorders
- 2024
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Ingår i: BMC PUBLIC HEALTH. - 1471-2458. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe enormous effect of lifestyle-related disorders on health of the global population warrants the development of preventive interventions. Focusing on musculoskeletal health and physical activity may be a way to encourage necessary lifestyle changes by making them more concrete and understandable. The aims of the current study were to develop a function-based preventive intervention aimed at lifestyle-related disorders in physically inactive 40-year-old people and to investigate the feasibility of the intervention. The feasibility study aimed to solve practical and logistical challenges and to develop the intervention based on the experiences of participants and involved clinical personnel according to defined criteria.MethodsDevelopment of the standardised functional examination was based on literature-validated tests and clinical reasoning. Development of a risk profile was based on the functional examination and similar profiles which have already proved feasible. The feasibility of the functional examination and risk profile, together with function-based lifestyle counselling was tested on 27 participants in a pilot study with two physiotherapist examinations over a four-month period. Practical results and feedback from participants and collaborating personnel were examined.ResultsThe functional examination consists of 20 established tests not requiring specialised equipment or training which were deemed relevant for a middle-aged population and a sub-maximal ergometer test. The risk profile consists of seven functional dimensions: cardiovascular fitness, strength in upper extremity, lower extremity and trunk, mobility, balance and posture, and three non-functional dimensions: weight, self-assessed physical activity and pain. Each dimension contains at least two measures. The participants appreciated the intervention and found it motivating for making lifestyle changes. They found the tests and risk profile understandable and could see them as tools to help achieve concrete goals. The examination required 60-75 min for one physiotherapist. The recruitment rate was low and recruited participants were highly motivated to making lifestyle changes.ConclusionThis project developed a functional test battery and risk profile aimed at inactive 40-year-olds which fulfilled our feasibility criteria. Functional screening and lifestyle counselling were found to be of value to a sub-group of inactive 40-year-olds who were already motivated to improve their health situations.
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| 5. |
- Dahlstrand, Johan, et al.
(författare)
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Move for Your Heart, Break a Sweat for Your Mind: Providing Precision in Adolescent Health and Physical Activity Behaviour Pattern.
- 2023
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Ingår i: The Journal of adolescent health : official publication of the Society for Adolescent Medicine. - 1879-1972. ; 73:1, s. 29-36
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Tidskriftsartikel (refereegranskat)abstract
- Adolescent health benefits of different physical activity (PA) intensities, especially of lower intensities, are debated due to challenges in accelerometer data processing and analyses. Using a new accelerometer data processing method and multivariate pattern analysis, this study investigated the association of PA intensities with indicators of cardiovascular and mental health.Adolescents (n= 1,235, mean age 13.6years, 41% males) were examined for cardiovascular health: body mass index (BMI) z-score, waist circumference (WC), resting heart rate and blood pressure, white blood cell count (WBC), pulse wave velocity (PWV), and answered questionnaires assessing stress and psychosomatic symptoms. Sex, age, and socioeconomic status were confounders. Hip-worn accelerometer data were processed with 10Hz frequency extended method and a spectrum of 22 PA intensity categories was analyzed for association with health using partial least squares regression.Total explained variances for BMI z-score, WC, resting heart rate, stress, and psychosomatic symptoms were higher (3.3%-8.7%) compared to diastolic blood pressure, WBC, and PWV (0.9%-1.4%). We found positive associations of high-end moderate PA and vigorous PA with cardiovascular and mental health indicators. More sedentary time and lower level of light PA were associated with higher BMI z-score, WC, resting heart rate, diastolic blood pressure, WBC, and PWV, but not with mental health indicators. Very vigorous PA was negatively associated with resting heart rate, stress, and psychosomatic symptoms.In adolescents, PA of varying intensities were generally found to be positively associated with better cardiovascular health, but only higher intensity PA was associated with better mental health.
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| 6. |
- Dahlstrand, Johan, et al.
(författare)
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The use of coping strategies “shift-persist” mediates associations between physical activity and mental health problems in adolescents: a cross-sectional study
- 2021
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Self-perceived mental health problems among adolescents has had an upward trend. Concurrently, adolescents’ physical activity (PA) has been falling whilst sedentary time (SED) has increased. There is a lack of research using accelerometer measured PA and SED to study their relationships to perceived stress and psychosomatic symptoms, both frequently observed mental health problems among adolescents. Whether coping strategies is one of the mechanisms underlying such relationship is less clear. Methods: A total of 2283 13-year olds were enrolled in the baseline examination of the STARS (STudy of Adolescence Resilience and Stress) study in Western Sweden. Light-, moderate-, vigorous-intensity PA (LPA, MPA and VPA) and SED were measured using hip-worn ActiGraph GT3X+ accelerometer. A total of 1284 adolescents provided valid accelerometer data (at least 4 days with ≥10 h per day). PA and SED during school-time and leisure-time were analysed separately. Surveys were utilized to monitor perceived stress, psychosomatic symptoms and the use of coping strategies “shift-persist”. Logistic regression and mediation analyses were performed adjusting for gender, ethnicity, socioeconomic status and puberty development. Results: We observed that more time spent in PA was associated with less stress in adolescents. The associations were observed for LPA (Odds ratio for LPA per 60 min: 0.557 (95% CI 0.399–0.776), VPA (Odds ratio for VPA per 15 min: 0.688 (95% CI 0.588–0.806) and MVPA (Odds ratio for MVPA per 15 min: 0.795 (95%CI 0.718–0.879) during leisure time, but not during school time. Similar associations were observed between leisure time PA and psychosomatic symptoms. The associations remained statistically significant even after adjusting for the confounders. Further, our data showed that adolescents who engaged more time in PA during leisure time were more likely to adopt the coping strategies of “shift-persist”. Mediation analysis showed that the use of “shift-persist” mediated the associations between leisure time PA and stress/psychosomatic symptoms. Conclusions: Leisure time physical activity, irrespective of intensity, may facilitate successful coping with stress and stress-related mental health problems in adolescents. © 2021, The Author(s).
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| 7. |
- Fridolfsson, Jonatan, 1992, et al.
(författare)
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A Biomechanical Re-Examination of Physical Activity Measurement with Accelerometers
- 2018
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Ingår i: Sensors (Basel). - : MDPI AG. - 1424-8220. ; 18:10
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Tidskriftsartikel (refereegranskat)abstract
- ActiGraph is the most common accelerometer in physical activity research, but it has measurement errors due to restrictive frequency filtering. This study investigated biomechanically how different frequency filtering of accelerometer data affects assessment of activity intensity and age-group differences when measuring physical activity. Data from accelerometer at the hip and motion capture system was recorded during treadmill walking and running from 30 subjects in three different age groups: 10, 15, and >20 years old. Acceleration data was processed to ActiGraph counts with original band-pass filter at 1.66 Hz, to counts with wider filter at either 4 or 10 Hz, and to unfiltered acceleration according to "Euclidian norm minus one" (ENMO). Internal and external power, step frequency, and vertical displacement of center of mass (VD) were estimated from the motion capture data. Widening the frequency filter improved the relationship between higher locomotion speed and counts. It also removed age-group differences and decreased within-group variation. While ActiGraph counts were almost exclusively explained by VD, the counts from the 10 Hz filter were explained by VD and step frequency to an equal degree. In conclusion, a wider frequency filter improves assessment of physical activity intensity by more accurately capturing individual gait patterns.
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| 8. |
- Fridolfsson, Jonatan, 1992, et al.
(författare)
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Accelerometer-measured absolute versus relative physical activity intensity : cross-sectional associations with cardiometabolic health in midlife.
- 2023
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Observational studies investigating the association between accelerometer-measured physical activity and health all use absolute measures of physical activity intensity. However, intervention studies suggest that the physical activity intensity required to improve health is relative to individual fitness. The aim of this study was to investigate the associations between accelerometer-measured absolute and relative physical activity intensity and cardiometabolic health, and what implications these associations may have on the interpretation of health-associated physical activity.METHODS: A sample of the cross-sectional Swedish CArdioPulmonary bioImage Study (SCAPIS) consisting of 4,234 men and women aged 55-64 years was studied. Physical activity intensity was measured by accelerometry and expressed as absolute (e.g., metabolic equivalents of task) or relative (percentage of maximal oxygen consumption). Fitness was estimated by the submaximal Ekblom-Bak test. A composite ('metabolic syndrome') score combined measures of waist circumference, systolic blood pressure, high-density lipoprotein, triglycerides, and glycated hemoglobin. Associations of absolute and relative physical activity intensity with the health indicators (i.e., fitness and metabolic syndrome score) were studied by partial least squares regression. Analyses were stratified by fitness level.RESULTS: Both absolute and relative physical activity intensity associated with the health indicators. However, the strongest associations for absolute intensity varied depending on fitness levels, whereas the associations for relative intensity were more synchronized across fitness groups. The dose-response relationship between moderate-to-vigorous intensity and the health indicators was stronger for relative than for absolute intensity. The absolute and relative moderate-to-vigorous intensity cut-offs intersected at the 5th fitness percentile, indicating that the absolute intensity cut-off is too low for 95% of individuals in this sample. While 99% of individuals fulfilled the general physical activity recommendations based on absolute intensity measures, only 21% fulfilled the recommendations based on relative intensity measures. In relation to a "sufficient" fitness level, 9% fulfilled the recommendations.CONCLUSIONS: Accelerometer-measured relative physical activity intensity represents the intensity related to health benefits regardless of fitness level. Traditional absolute moderate intensity accelerometer cut-offs are too low for most individuals and should be adapted to the fitness level in the sample studied. Absolute and relative physical activity intensity cannot be used interchangeably.
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| 9. |
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| 10. |
- Fridolfsson, Jonatan, 1992, et al.
(författare)
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Effects of Frequency Filtering on Intensity and Noise in Accelerometer-Based Physical Activity Measurements.
- 2019
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Ingår i: Sensors. - : MDPI. - 1424-8220. ; 19:9
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Tidskriftsartikel (refereegranskat)abstract
- In objective physical activity (PA) measurements, applying wider frequency filters than the most commonly used ActiGraph (AG) filter may be beneficial when processing accelerometry data. However, the vulnerability of wider filters to noise has not been investigated previously. This study explored the effect of wider frequency filters on measurements of PA, sedentary behavior (SED), and capturing of noise. Apart from the standard AG band-pass filter (0.29-1.63 Hz), modified filters with low-pass component cutoffs at 4 Hz, 10 Hz, or removed were analyzed. Calibrations against energy expenditure were performed with lab data from children and adults to generate filter-specific intensity cut-points. Free-living accelerometer data from children and adults were processed using the different filters and intensity cut-points. There was a contribution of acceleration related to PA at frequencies up to 10 Hz. The contribution was more pronounced at moderate and vigorous PA levels, although additional acceleration also occurred at SED. The classification discrepancy between AG and the wider filters was small at SED (1-2%) but very large at the highest intensities (>90%). The present study suggests an optimal low-pass frequency filter with a cutoff at 10 Hz to include all acceleration relevant to PA with minimal effect of noise.
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Fridolfsson, Jonatan, 1992, et al.
(författare)
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High-intensity activity is more strongly associated with metabolic health in children compared to sedentary time: a cross-sectional study of the I.Family cohort
- 2021
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Ingår i: International Journal of Behavioral Nutrition and Physical Activity. - : Springer Science and Business Media LLC. - 1479-5868. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Physical activity (PA) during childhood is important for preventing future metabolic syndrome (MetS). To examine the relationship between PA and MetS in more detail, accurate measures of PA are needed. Previous studies have only utilized a small part of the information available from accelerometer measured PA. This study investigated the association between measured PA and MetS in children with a new method for data processing and analyses that enable more detailed interpretation of PA intensity level. Methods The association between PA pattern and risk factors related to MetS was investigated in a cross- sectional sample of children (n = 2592, mean age 10.9 years, 49.4% male) participating in the European multicenter I. Family study. The risk factors examined include body mass index, blood pressure, high-density lipoprotein cholesterol, insulin resistance and a combined risk factor score (MetS score). PA was measured by triaxial accelerometers and raw data was processed using the 10 Hz frequency extended method (FEM). The PA output was divided into an intensity spectrum and the association with MetS risk factors was analyzed by partial least squares regression. Results PA patterns differed between the European countries investigated, with Swedish children being most active and Italian children least active. Moderate intensity physical activity was associated with lower insulin resistance (R-2 = 2.8%), while vigorous intensity physical activity was associated with lower body mass index (R-2 = 3.6%), MetS score (R-2 = 3.1%) and higher high-density lipoprotein cholesterol (R-2 = 2.3%). PA of all intensities was associated with lower systolic- and diastolic blood pressure, although the associations were weaker than for the other risk factors (R-2 = 1.5% and R-2 = 1.4%). However, the multivariate analysis implies that the entire PA pattern must be considered. The main difference in PA was observed between normal weight and overweight children. Conclusions The present study suggests a greater importance of more PA corresponding to an intensity of at least brisk walking with inclusion of high-intense exercise, rather than a limited time spent sedentary, in the association to metabolic health in children. The methods of data processing and statistical analysis enabled accurate analysis and interpretation of the health benefits of high intensity PA that have not been shown previously.
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| 15. |
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| 16. |
- Fridolfsson, Jonatan, 1992, et al.
(författare)
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Measurement of physical activity by shoe-based accelerometers—calibration and free-living validation
- 2021
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Ingår i: Sensors. - : MDPI AG. - 1424-8220. ; 21:7
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Tidskriftsartikel (refereegranskat)abstract
- There is conflicting evidence regarding the health implications of high occupational physical activity (PA). Shoe-based accelerometers could provide a feasible solution for PA measurement in workplace settings. This study aimed to develop calibration models for estimation of energy expenditure (EE) from shoe-based accelerometers, validate the performance in a workplace setting and compare it to the most commonly used accelerometer positions. Models for EE estimation were calibrated in a laboratory setting for the shoe, hip, thigh and wrist worn accelerometers. These models were validated in a free-living workplace setting. Furthermore, additional models were devel-oped from free-living data. All sensor positions performed well in the laboratory setting. When the calibration models derived from laboratory data were validated in free living, the shoe, hip and thigh sensors displayed higher correlation, but lower agreement, with measured EE compared to the wrist sensor. Using free-living data for calibration improved the agreement of the shoe, hip and thigh sensors. This study suggests that the performance of a shoe-based accelerometer is similar to the most commonly used sensor positions with regard to PA measurement. Furthermore, it high-lights limitations in using the relationship between accelerometer output and EE from a laboratory setting to estimate EE in a free-living setting.
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| 17. |
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| 18. |
- Fridolfsson, Jonatan, 1992, et al.
(författare)
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One size does not fit all - translating absolute accelerometry to relative individual physical activity intensity for health
- 2023
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Ingår i: European Journal of Preventive Cardiology, Volume 30, Issue Supplement_1. - : Oxford University Press.
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Konferensbidrag (refereegranskat)abstract
- Funding AcknowledgementsType of funding sources: Foundation. Main funding source(s): The main funding body of The Swedish CArdioPulmonary bioImage Study (SCAPIS) is the Swedish Heart-Lung Foundation. The study is also funded by the Knut and Alice Wallenberg Foundation, the Swedish Research Council and VINNOVA (Sweden’s Innovation agency) the University of Gothenburg and Sahlgrenska University Hospital, Karolinska Institutet and Stockholm county council, Linköping University and University Hospital, Lund University and Skåne University Hospital, Umeå University and University Hospital, Uppsala University and University Hospital.IntroductionPhysical activity intensity can be expressed in either absolute (e.g. brisk walking or metabolic equivalents) or relative terms (e.g. proportion of maximal oxygen consumption or perceived exertion) (1). Although intervention studies typically use relative intensity for exercise prescription, large scale observational studies measuring physical activity with accelerometers always use absolute intensity. The association between relative physical activity intensity and cardiometabolic risk factors has not been studied using accelerometry previously.PurposeTo compare absolute and relative measures of physical activity intensity in terms of physical activity level and associations with cardiovascular risk factors among individuals with different fitness level.MethodsA subsample of the Swedish CArdioPulmonary bioImage Study (SCAPIS), in total 4234 men and women aged 50-64, was analysed (2). Physical activity was measured by accelerometers and the raw data processed with the 10 Hz frequency extended method (FEM) to get a more accurate measure of physical activity intensity compared to previous methods (3). Maximal oxygen consumption (fitness) was estimated by a submaximal ergometer test. Waist to hip ratio, systolic blood pressure, glycated haemoglobin (HBA1c) and high-density lipoprotein to total cholesterol ratio were combined into a composite cardiometabolic risk factor score. Partial least squares regression was used to investigate the associations of absolute and relative physical activity intensity with fitness as well as the composite score. The sample was divided into tertiles of fitness for stratified analyses.ResultsOverall, there was an association between physical activity at absolute moderate intensity and above, and the health outcomes. Yet, the main associations were found in the absolute moderate intensity range for the low fitness group and in the absolute vigorous intensity range for the high fitness group. When considering relative intensity however, all the main associations started in the upper part of the moderate intensity range and peaked in the vigorous intensity range (Figure 1). In addition, when comparing absolute and relative cut-offs for moderate intensity, absolute moderate intensity was too low for 95% of individuals in the sample (Figure 2). When using absolute intensity, 99% of individuals reached the general guidelines of 150 minutes of moderate-to-vigorous physical activity per week, while only 21% reached the guidelines based on relative intensity.ConclusionsHealth benefits of absolute intensity are misleading for most individuals in this sample and absolute measures of physical activity overestimate time spent at moderate intensity and above. Relative intensity should be used when interpreting accelerometer measured physical activity and when communicating health promoting physical activity.
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| 19. |
- Fridolfsson, Jonatan, 1992, et al.
(författare)
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Physical activity spectrum discriminant analysis—A method to compare detailed patterns between groups
- 2021
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 31:12, s. 2333-2342
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Tidskriftsartikel (refereegranskat)abstract
- Investigating physical activity (PA) patterns as a detailed intensity spectrum instead of crude intensity categories have improved the ability to analyze the relationship between measured PA and health variables. The aim of this methodological study was to introduce and investigate the utility of using detailed PA intensity spectrum compared to crude PA intensity categories for comparison of PA between groups and between repeated measures. The study sample consisted of two groups of children, where one group was scheduled for extended physical education (PE) by daily classes while the other group followed usual PE schedule. Accelerometer data was processed into traditional crude PA intensity categories and into detailed PA intensity spectrum. Multivariate partial least squares regression for discriminant analysis (PLS-DA) was applied for PA intensity spectrum group comparison and compared to traditional univariate statistical analysis. Repeated measures were investigated using independent PLS-DA as well as multilevel PLS-DA for paired analysis. While traditional analysis of crude PA intensity categories was unable to find any group differences, multivariate analysis of the PA intensity spectrum identified statistically significant differences. By the extension of multilevel PLS-DA for paired comparison, a clear difference in the PA intensity spectrum was demonstrated between repeated measures. In conclusion, analysis of detailed PA intensity spectrum demonstrates utility for comparing detailed PA data between groups and between repeated measures in interventional and observational research.
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| 20. |
- Fridolfsson, Jonatan, 1992
(författare)
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Statistical advancements in analyzing accelerometer-measured physical activity intensity
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Physical activity (PA) is widely recognized as an important factor in preventing and treating cardiometabolic diseases and reducing mortality. Yet, the health implications of specific PA intensities and the intricate role of fitness in the relationship between PA and health remain less clear. While accelerometers provide objective measurements of PA intensity, established methods for data processing and statistical analysis often underutilize this information. Recent advancements in accelerometer data processing and multivariate statistical methods promise enhanced detailed analyses of PA intensity. This doctoral thesis aimed to introduce and further develop multivariate statistical methods to analyze accelerometer-measured PA intensity. Data previously collected from four separate studies were re-analyzed using improved accelerometer data processing methods and multivariate statistical approaches. Specifically, data from the LIV 2013, SCAPIS, I.Family, and Bunkeflo studies were included. The improved accelerometer data processing method employed a 10 Hz frequency filter, instead of the common 1.63 Hz filter, facilitating the capture of moderate-to-vigorous intensity PA. All the multivariate statistical techniques employed were based on partial least squares regression (PLS). PLS was applied to explore the association between PA intensity and health. Extensions of the PLS model, including PLS discriminant analysis and PLS structural equation modeling, were used for group comparisons and mediation analysis, respectively. The results highlight the importance of detailed analyses of PA intensity. Using a wider frequency filter in the processing of raw accelerometer data resulted in stronger associations with health indicators and allowed for a more detailed interpretation of PA intensity. The patterns of PA intensity relating to health were different for different health indicators and different groups. Fitness level determined the PA intensity required for associations with health and can be considered an indicator of sufficient PA for health benefits. Analysis of PA patterns using multivariate statistical methods captures more detail in the accelerometer data and enables studying the complex role of PA intensity in different study designs.
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| 21. |
- Fridolfsson, Jonatan, 1992, et al.
(författare)
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Stronger association between high intensity physical activity and cardiometabolic health with improved assessment of the full intensity range using accelerometry
- 2020
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Ingår i: Sensors (Switzerland). - : MDPI AG. - 1424-8220. ; 20:4
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Tidskriftsartikel (refereegranskat)abstract
- © 2020 by the authors. Licensee MDPI, Basel, Switzerland. An improved method of physical activity accelerometer data processing, involving a wider frequency filter than the most commonly used ActiGraph filter, has been shown to better capture variations in physical activity intensity in a lab setting. The aim of the study was to investigate how this improved measure of physical activity affected the relationship with markers of cardiometabolic health. Accelerometer data and markers of cardiometabolic health from 725 adults from two samples, LIV 2013 and SCAPIS pilot, were analyzed. The accelerometer data was processed using both the original ActiGraph method with a low‐pass cut‐off at 1.6 Hz and the improved method with a low‐pass cut‐off at 10 Hz. The relationship between the physical activity intensity spectrum and a cardiometabolic health composite score was investigated using partial least squares regression. The strongest association between physical activity and cardiometabolic health was shifted towards higher intensities with the 10 Hz output compared to the ActiGraph method. In addition, the total explained variance was higher with the improved method. The 10 Hz output enables correctly measuring and interpreting high intensity physical activity and shows that physical activity at this intensity is stronger related to cardiometabolic health compared to the most commonly used ActiGraph method.
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| 22. |
- Fridolfsson, Jonatan, 1992, et al.
(författare)
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Workplace activity classification from shoebased movement sensors
- 2020
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Ingår i: BMC Biomedical Engineering. - : Springer Science and Business Media LLC. - 2524-4426. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Background: High occupational physical activity is associated with lower health. Shoe-based movement sensors can provide an objective measurement of occupational physical activity in a lab setting but the performance of such methods in a free-living environment have not been investigated. The aim of the current study was to investigate the feasibility and accuracy of shoe sensor-based activity classification in an industrial work setting. Results: An initial calibration part was performed with 35 subjects who performed different workplace activities in a structured lab setting while the movement was measured by a shoe-sensor. Three different machine-learning models (random forest (RF), support vector machine and k-nearest neighbour) were trained to classify activities using the collected lab data. In a second validation part, 29 industry workers were followed at work while an observer noted their activities and the movement was captured with a shoe-based movement sensor. The performance of the trained classification models were validated using the free-living workplace data. The RF classifier consistently outperformed the other models with a substantial difference in in the free-living validation. The accuracy of the initial RF classifier was 83% in the lab setting and 43% in the free-living validation. After combining activities that was difficult to discriminate the accuracy increased to 96 and 71% in the lab and freeliving setting respectively. In the free-living part, 99% of the collected samples either consisted of stationary activities or walking. Conclusions: Walking and stationary activities can be classified with high accuracy from a shoe-based movement sensor in a free-living occupational setting. The distribution of activities at the workplace should be considered when validating activity classification models in a free-living setting.
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| 23. |
- Holm, Ivar, et al.
(författare)
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Fourteen days free-living evaluation of an open-source algorithm for counting steps in healthy adults with a large variation in physical activity level.
- 2023
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Ingår i: BMC biomedical engineering. - 2524-4426. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- The number of steps by an individual, has traditionally been assessed with a pedometer, but increasingly with an accelerometer. The ActiLife software (AL) is the most common way to process accelerometer data to steps, but it is not open source which could aid understanding of measurement errors. The aim of this study was to compare assessment of steps from the open-source algorithm part of the GGIR package and two closed algorithms, AL normal (n) and low frequency extension (lfe) algorithms to Yamax pedometer, as reference. Free-living in healthy adults with a wide range of activity level was studied.A total 46 participants divided by activity level into a low-medium active group and a high active group, wore both an accelerometer and a pedometer for 14days. In total 614 complete days were analyzed. A significant correlation between Yamax and all three algorithms was shown but all comparisons were significantly different with paired t-tests except for ALn vs Yamax. The mean bias shows that ALn slightly overestimated steps in the low-medium active group and slightly underestimated steps in high active group. The mean percentage error (MAPE) was 17% and 9% respectively. The ALlfe overestimated steps by approximately 6700/day in both groups and the MAPE was 88% in the low-medium active group and 43% in the high active group. The open-source algorithm underestimated steps with a systematic error related to activity level. The MAPE was 28% in the low-medium active group and 48% in the high active group.The open-source algorithm captures steps fairly well in low-medium active individuals when comparing with Yamax pedometer, but did not show satisfactory results in more active individuals, indicating that it must be modified before implemented in population research. The AL algorithm without the low frequency extension measures similar number of steps as Yamax in free-living and is a useful alternative before a valid open-source algorithm is available.
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| 24. |
- Karczewska-Lindinger, Magdalena, 1986, et al.
(författare)
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Low physical activity in patients diagnosed with head and neck cancer
- 2021
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Ingår i: Laryngoscope Investigative Otolaryngology. - : Wiley. - 2378-8038. ; 6:4, s. 747-755
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Tidskriftsartikel (refereegranskat)abstract
- Background This pilot study aimed to describe physical activity (PA) and self-perceived function, health and quality of life (QoL) prior to oncological treatment in patients with head and neck cancer (HNC). Methods In a prospective study including 49 patients, self-perceived PA (Saltin-Grimby scale) and health-related QoL (European Organization for Research and Treatment of Cancer Quality of Life questionnaire Core 30 and EQ-5D) were assessed. Further, PA was also measured by an accelerometer attached to the thigh for eight consecutive days. The accelerometer PA was compared to the PA of a reference population assessed with the same method. Results presented are from data collected before start of oncological treatment. Results The patients (44-79 years, 65% males) spent most of their time in sedentary behavior: a median of 555 minutes/day in bed (39% of total) and 606 minutes/day sitting (41%). Only 129 minutes/day were spent moving/walking. Patients with higher education, reduced physical function and higher fatigue were less physically active (P <= .01). Further, the different PA measures demonstrated a pattern of being less physically active compared to the reference population. Conclusions Patients diagnosed for HNC may have low PA level. Assessment of PA from accelerometer data may be an important component of oncological treatment to identify patients in need for PA intervention that may enhance treatment outcome.
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| 25. |
- Kristiansson, Emilia, 1994, et al.
(författare)
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Validation of Oura ring energy expenditure and steps in laboratory and free-living
- 2023
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Ingår i: BMC Medical Research Methodology. - : Springer Science and Business Media LLC. - 1471-2288. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCommercial activity trackers are increasingly used in research and compared with research-based accelerometers are often less intrusive, cheaper, with improved storage and battery capacity, although typically less validated. The present study aimed to determine the validity of Oura Ring step-count and energy expenditure (EE) in both laboratory and free-living.MethodsOura Ring EE was compared against indirect calorimetry in the laboratory, followed by a 14-day free-living study with 32 participants wearing an Oura Ring and reference monitors (three accelerometers positioned at hip, thigh, and wrist, and pedometer) to evaluate Oura EE variables and step count.ResultsStrong correlations were shown for Oura versus indirect calorimetry in the laboratory (r = 0.93), and versus reference monitors for all variables in free-living (r >= 0.76). Significant (p < 0.05) mean differences for Oura versus reference methods were found for laboratory measured sitting (- 0.12 +/- 0.28 MET), standing (- 0.27 +/- 0.33 MET), fast walk (- 0.82 +/- 1.92 MET) and very fast run (- 3.49 +/- 3.94 MET), and for free-living step-count (2124 +/- 4256 steps) and EE variables (MET: - 0.34-0.26; TEE: 362-494 kcal; AEE: - 487-259 kcal). In the laboratory, Oura tended to underestimate EE with increasing discrepancy as intensity increased. The combined activities and slow running in the laboratory, and all MET placements, TEE hip and wrist, and step count in free-living had acceptable measurement errors (< 10% MAPE), whereas the remaining free-living variables showed close to (<= 13.2%) acceptable limits.ConclusionThis is the first study investigating the validity of Oura Ring EE against gold standard methods. Oura successfully identified major changes between activities and/or intensities but was less responsive to detailed deviations within activities. In free-living, Oura step-count and EE variables tightly correlated with reference monitors, though with systemic over- or underestimations indicating somewhat low intra-individual validity of the ring versus the reference monitors. However, the correlations between the devices were high, suggesting that the Oura can detect differences at group-level for active and total energy expenditure, as well as step count.
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| 26. |
- Larisch, Lisa-Marie, et al.
(författare)
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Effects of two randomized and controlled multi-component interventions focusing on 24-hour movement behavior among office workers: A compositional data analysis
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Intervention studies aiming at changing movement behavior have usually not accounted for the compositional nature of time-use data. Compositional data analysis (CoDA) has been sug-gested as a useful strategy for analyzing such data. The aim of this study was to examine the effects of two multi-component interventions on 24-h movement behavior (using CoDA) and on cardi-orespiratory fitness among office workers; one focusing on reducing sedentariness and the other on increasing physical activity. Office workers (n = 263) were cluster randomized into one of two 6-month intervention groups, or a control group. Time spent in sedentary behavior, light-intensity, moderate and vigorous physical activity, and time in bed were assessed using accelerometers and diaries, both for 24 h in total, and for work and leisure time separately. Cardiorespiratory fitness was estimated using a sub-maximal cycle ergometer test. Intervention effects were analyzed using linear mixed models. No intervention effects were found, either for 24-h behaviors in total, or for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Despite a thorough analysis of 24-h behaviors using CoDA, no intervention effects were found, nei-ther for behaviors in total, nor for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Although the design of the multi-component interventions was based on theoretical frameworks, and included cognitive behavioral therapy counselling, which has been proven effective in other populations, issues related to implementation of and compliance with some intervention components may have led to the observed lack of intervention effect.
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| 27. |
- Leviäkangas, Aleksi, et al.
(författare)
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Associations of accelerometer-estimated free-living daily activity impact intensities with 10-year probability of osteoporotic fractures in adults.
- 2024
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Ingår i: Gait & Posture. - 1879-2219. ; 112, s. 22-32
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Tidskriftsartikel (refereegranskat)abstract
- Accelerometers are used to objectively measure physical activity; however, the relationship between accelerometer-based activity parameters and bone health is not well understood. This study examines the association between accelerometer-estimated daily activity impact intensities and future risk estimates of major osteoporotic fractures in a large population-based cohort.Participants were 3165 adults 46 years of age from the Northern Finland Birth Cohort 1966 who agreed to wear a hip-worn accelerometer during all waking hours for 14 consecutive days. Raw accelerometer data were converted to resultant acceleration. Impact magnitude peaks were extracted and divided into 32 intensity bands, and the osteogenic index (OI) was calculated to assess the osteogenic effectiveness of various activities. Additionally, the impact peaks were categorized into three separate impact intensity categories (low, medium, and high). The 10-year probabilities of hip and all major osteoporotic fractures were estimated with FRAX-tool using clinical and questionnaire data in combination with body mass index collected at the age of 46 years. The associations of daily activity impact intensities with 10-year fracture probabilities were examined using three statistical approaches: multiple linear regression, partial correlation, and partial least squares (PLS) regression.On average, participants' various levels of impact were 8331 (SD = 3478) low; 2032 (1248) medium; and 1295 (1468) high impacts per day. All three statistical approaches found a significant positive association between the daily number of low-intensity impacts and 10-year probability of hip and all major osteoporotic fractures. In contrast, increased number of moderate to very high daily activity impacts was associated with a lower probability of future osteoporotic fractures. A higher OI was also associated with a lower probability of future major osteoporotic fractures.Low-intensity impacts might not be sufficient for reducing fracture risk in middle-aged adults, while high-intensity impacts could be beneficial for preventing major osteoporotic fractures.
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| 28. |
- Olofsson, Cecilia Kjellberg, et al.
(författare)
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Life satisfaction, health-related quality of life and physical activity after treatment for valvular aortic stenosis
- 2023
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Ingår i: Cardiology in the Young. - : Cambridge University Press (CUP). - 1047-9511 .- 1467-1107. ; 33:3, s. 403-409
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate health-related quality of life and life satisfaction in children and adolescents treated for isolated congenital valvular aortic stenosis compared to healthy peers. Our second aim was to investigate the relationship between objectively measured physical activity, health-related quality of life and life satisfaction in the same group. Methods: Forty-eight patients, 8-18 years of age, were recruited, as well as 43 healthy peers matched for age, gender and residential area. Health-related quality of life was assessed by the KIDSCREEN-52 self-report and parent proxy report, and life satisfaction was evaluated with the Satisfaction With Life Scale. Physical activity was measured with an accelerometer for 7 days. Sports participation was self-reported. Results: No differences in the health-related quality of life domains were found between patients and controls in the self-reports. In the proxy reports, parents of the adolescents rated their child's autonomy lower than did the parents of the healthy controls. A negative relationship was found between moderate to vigorous physical activity, sports participation, life satisfaction and the psychological well-being domain in adolescent patients. In children there was a positive relationship between moderate physical activity and the physical and psychological well-being domains. Conclusion: Overall, children and adolescents treated for valvular aortic stenosis reported similar life satisfaction and health-related quality of life as their healthy peers. The negative relationships between intense physical activity and sports participation with health-related quality of life and life satisfaction in adolescent patients might be explained by both physical and psychological factors in these teenagers with complex, lifelong heart disease.
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| 29. |
- Skovdahl, Pia, et al.
(författare)
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Children and Adolescents Treated for Valvular Aortic Stenosis Have Different Physical Activity Patterns Compared to Healthy Controls: A Methodological Study in a National Cohort
- 2021
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Ingår i: Pediatric Cardiology. - : Springer Science and Business Media LLC. - 0172-0643 .- 1432-1971. ; 42, s. 774-783
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Tidskriftsartikel (refereegranskat)abstract
- Previous research in children and adolescents with congenital heart defects presents contradictory findings concerning their physical activity (PA) level, due to methodological limitations in the PA assessment. The aim of the present cross-sectional study was to compare PA in children and adolescents treated for valvular aortic stenosis with healthy controls using an improved accelerometer method. Seven-day accelerometer data were collected from the hip in a national Swedish sample of 46 patients 6-18 years old treated for valvular aortic stenosis and 44 healthy controls matched for age, gender, geography, and measurement period. Sports participation was self-reported. Accelerometer data were processed with the new improved Frequency Extended Method and with the traditional ActiGraph method for comparison. A high-resolution PA intensity spectrum was investigated as well as traditional crude PA intensity categories. Children treated for aortic stenosis had a pattern of less PA in the highest intensity spectra and had more sedentary time, while the adolescent patients tended to be less physically active in higher intensities overall and with less sedentary time, compared to the controls. These patterns were evident using the Frequency Extended Method with the detailed PA intensity spectrum, but not to the same degree using the ActiGraph method and traditional crude PA intensity categories. Patients reported less sports participation than their controls in both age-groups. Specific differences in PA patterns were revealed using the Frequency Extended Method with the high-resolution PA intensity spectrum in Swedish children and adolescents treated for valvular aortic stenosis.
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| 30. |
- Tuomi, Lisa, 1985, et al.
(författare)
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A pilot study using pre-treatment physical activity level to predict long-term health-related quality of life in patients with head and neck cancer
- 2023
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Ingår i: Head and Neck-Journal for the Sciences and Specialties of the Head and Neck. - : Wiley. - 1043-3074 .- 1097-0347. ; 45:5, s. 1288-1298
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pre-treatment levels of physical activity (PA) in head and neck cancer (HNC) are rarely evaluated using accelerometry. This study aimed to investigate whether pre-treatment PA level in HNC predicts aspects of long-term health-related quality of life (HRQL) at 12 months after end of treatment. Methods: This pilot study included 48 patients diagnosed with HNC, 41 participants remaining at 12 months post-treatment. Pre-treatment PA was objectively assessed by an accelerometer. Self-perceived PA and HRQL were assessed pre-treatment and at 6- and 12-months post-treatment. Results: Patients with a higher pre-treatment PA level scored higher on physical function and role function and less fatigue and pain at the 12 months follow-up compared to patients with a lower pre-treatment PA. At 6 months the groups differed only on physical functioning. When comparing changes over time, there were statistically significant differences comparing high and low pre-treatment PA in the fatigue and pain domains between 6 and 12 months. Exploratory multiple regression analyses also indicated that higher pre-treatment PA levels were associated with greater favorable change in the four HRQL measures. ConclusionsHigher levels of PA assessed with accelerometer before oncologic treatment associated favorably with aspects of self-perceived HRQL and PA over time in patients with HNC.
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| 31. |
- Varkey, Emma, et al.
(författare)
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Physical activity, self-efficacy and quality of life in patients with chronic pain, assessed during and 1 year after physiotherapy rehabilitation - a prospective follow-up study
- 2022
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 44:22, s. 6730-6737
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The aim of this prospective cohort study was to evaluate the level of physical activity, self-efficacy and health-related quality of life in patients with chronic pain, at baseline and one year after physiotherapy rehabilitation at a specialist pain clinic. Materials and methods All patients who underwent rehabilitation at the physiotherapy unit at the Pain Centre at Sahlgrenska University Hospital/ostra in Gothenburg during a nine-month period were asked to participate in the study. The participants were evaluated regarding self-efficacy, health-related quality of life (HRQoL) and physical activity during physiotherapy treatment and one year later. Physical activity was measured both subjectively (self-reported physical activity) and objectively (accelerometer). Results Out of 42 patients who participated in the baseline evaluation, 28 (19 women and nine men) were included in the one-year follow-up. The patients had increased levels of vigorous physical activity at one-year follow-up, without deterioration of pain. There were no significant changes regarding self-efficacy and HRQoL. Levels of physical activity and perceived physical function may be associated to levels of physical activity 1 year after rehabilitation. Conclusion Patients with chronic pain can increase their level of vigorous physical activity after a period of rehabilitation without deterioration of pain.IMPLICATIONS FOR REHABILIATION Physical activity is an important part of rehabilitation for chronic pain patients, but many patients expect more pain after exercise, which they fear may affect performance and maintenance of physical activity. Patients with chronic pain at a specialist clinic increased their level of vigorous physical activity one year after physiotherapist led rehabilitation without deterioration of pain. Levels of physical activity and perceived physical function during rehabilitation may predict levels of physical activity 1 year after rehabilitation. Physiotherapist led rehabilitation seems to be beneficial for long-term improved physical activity in patients with chronic pain
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| 32. |
- Wang, Rui, et al.
(författare)
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The interrelationship between physical activity intensity, cardiorespiratory fitness, and executive function in middle-aged adults : An observational study of office workers.
- 2022
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous evidence supports a beneficial effect of physical activity on executive function across the whole lifespan. Yet, the interrelationships of the intensities of physical activity, cardiorespiratory fitness, and executive function require further investigation in adults.AIM: Using unfiltered accelerometry data and high-resolution intensity classification, we sought to estimate the associations of physical activity with cardiorespiratory fitness and executive function in adult office workers.METHODS: We included 343 full-time office workers (mean age: 42.41 years, range of age: 36-49 years). Executive function was assessed using Stroop, Trail making tests (part-B), and 2-back tests, and a composite score was produced to reflect the general executive function performance. Physical activity was assessed using the Actigraph GT3X+-monitor, worn by each participant for seven days at the hip. Raw accelerometry data were processed by the 10 Hz frequency extended method and divided into 22 intensity bins and sleep time. Cardiorespiratory fitness was estimated using the submaximal Ekblom-Bak cycle ergometer test. Data were analyzed using partial least squares regressions.RESULTS: In adults, cardiorespiratory fitness was closely correlated with a wide range of absolute physical activity intensity patterns. A higher level of executive function in adults was associated with both higher absolute physical activity intensities and cardiorespiratory fitness, which was independent of age, sex, and education levels. A very weak association between intensities, fitness, and executive function was observed in high-fit adults. Among low-fit adults, although a positive association started already toward the upper end of moderate intensity, there still appeared to be an association between intensities, cardiorespiratory fitness, and executive function. That is, cardiorespiratory fitness may mediate the association between absolute physical activity intensities and executive function up to a certain level.CONCLUSION: The maintenance of executive function in adulthood was related to both physical activity intensities and cardiorespiratory fitness, while their interrelationship was not equal across fitness levels. It is highly recommended to consider the cardiorespiratory fitness level in future studies that focus on executive functions in aging as well when designing individualized physical activity training programs.
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