Assessment of physical activity - A review of methodologies with reference to epidemiological research: A report of the exercise physiology section of the European Association of Cardiovascular Prevention and Rehabilitation

MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
European journal of cardiovascular prevention and rehabilitation: official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology (Impact Factor: 3.69). 03/2010; 17(2):127-39. DOI: 10.1097/HJR.0b013e32832ed875
Source: PubMed


Physical activity has a fundamental role in the prevention and treatment of chronic disease. The precise measurement of physical activity is key to many surveillance and epidemiological studies investigating trends and associations with disease. Public health initiatives aimed at increasing physical activity rely on the measurement of physical activity to monitor their effectiveness. Physical activity is multidimensional, and a complex behaviour to measure; its various domains are often misunderstood. Inappropriate or crude measures of physical activity have serious implications, and are likely to lead to misleading results and underestimate effect size. In this review, key definitions and theoretical aspects, which underpin the measurement of physical activity, are briefly discussed. Methodologies particularly suited for use in epidemiological research are reviewed, with particular reference to their validity, primary outcome measure and considerations when using each in the field. It is acknowledged that the choice of method may be a compromise between accuracy level and feasibility, but the ultimate choice of tool must suit the stated aim of the research. A framework is presented to guide researchers on the selection of the most suitable tool for use in a specific study.

Download full-text


Available from: Ulf Ekelund,

Click to see the full-text of:

Article: Assessment of physical activity - A review of methodologies with reference to epidemiological research: A report of the exercise physiology section of the European Association of Cardiovascular Prevention and Rehabilitation

267.02 KB

See full-text
    • "Unfortunately the current review is not only theoretical speculation, but has practical relevance. Standard METs have been used in many original methodological publications of physical activity (Strath et al., 2001; Brage et al., 2004, 2005; Corder et al., 2005; Crouter et al., 2008), and these publications have been cited in reviews (Warren et al., 2010; Strath et al., 2013). Furthermore, body weight scaled METs have been used in recommendations for physical activity measurement in North America (US Department, 2008) and in global recommendations on physical activity by the World Health Organization (World Health Organization, 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Physical activity refers any bodily movements produced by skeletal muscles that expends energy. Hence the amount and the intensity of physical activity can be assessed by energy expenditure. Metabolic equivalents of task (MET) are multiplies of the resting metabolism reflecting metabolic rate during exercise. The standard MET is defined as 3.5 ml/min/kg. However, the expression of energy expenditure by body weight to normalize the size differences between subjects causes analytical hazards: scaling by body weight does not have a physiological, mathematical, or physical rationale. This review demonstrates by examples that false methodology may cause paradoxical observations if physical activity would be assessed by body weight scaled values such as standard METs. While standard METs are confounded by adiposity, lean mass proportional measures of energy expenditure would enable a more truthful choice to assess physical activity. While physical activity as a behavior and cardiorespiratory fitness or adiposity as a state represents major determinants of public health, specific measurements of health determinants must be understood to enable a truthful evaluation of the interactions and their independent role as a health predictor.
    Frontiers in Physiology 07/2015; 6. DOI:10.3389/fphys.2015.00226 · 3.53 Impact Factor
  • Source
    • "In the case of PA, objectively measured outcomes, e.g. motion sensors like pedometers and accelerometers would preferably be included [40]. To date, the OMERACT (Outcome Measures in Rheumatology) collaboration appears to have the longest history of developing such outcome sets [41]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Organised follow-up is a common feature of several strategies at the primary health care level to promote health behaviour change, e.g. to increase physical activity. In Norway, municipal 'healthy living' centres run by health care personnel are established to offer counselling and organised follow-up of health behaviour change during a 12-week programme. We report the results of a systematic review commissioned by the Norwegian Directorate of Health concerning organised follow-up to improve physical activity.
    BMC Family Practice 06/2014; 15(1):120. DOI:10.1186/1471-2296-15-120 · 1.67 Impact Factor
  • Source
    • "In addition, using self-reported LTPA is a potential source of recall and social desirability bias [32]. Although the questions were slightly modified to adapt to one’s perception of terms, uncertainty related to changes over time in the participants’ interpretation of the term LTPA remains to some degree [6,32]. However, currently no data are available from investigations of secular trends in LTPA using objective measurements in Norwegian adults. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Geographical differences in cardiovascular diseases (CVD) have been observed among Norwegian counties. Better long-term health status and higher physical activity (PA) levels have been documented in the county of Sogn & Fjordane compared with other counties. However, recent trends in CVD risk factors have not been documented. The aim of this study was to investigate the secular trends in leisure time physical activity (LTPA) and other CVD risk factors over a 35-year period in a rural population of 40- to 42-year-olds in western Norway and to compare these trends with national trends. Methods Data from eight cross-sectional studies from 1975–2010 (n = 375,682) were obtained from questionnaires and physical examinations and were analyzed using mixed model regression analyses. Results Decreasing trends were observed for sedentary behavior (for women), moderate PA, smoking, systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL-c) and total cholesterol (TC), whereas increasing trends were observed for body mass index (BMI), triglycerides (TG), light PA, vigorous PA and sedentary behavior for men. Compared to the national trends, the trends in the 40-42-year-olds from Sogn & Fjordane were more beneficial in terms of TG, HDL-c and BMI but less beneficial in terms of SBP and DBP. Conclusions Over a 35-year-period, this study indicates that the LTPA level has been relatively stable in the county of Sogn & Fjordane. Upward trends were observed in light and vigorous PA, whereas a downward trend was observed in moderate PA. For sedentary behavior, an upward trend was observed in men, whereas a downward trend was observed in women. For smoking, BP and cholesterol decreasing trends were found, but increasing trends were observed in BMI and TG. Compared with the national data, the trends in Sogn & Fjordane were more beneficial for TG, HDL-c and BMI but less beneficial for BP.
    BMC Public Health 06/2014; 14(1):569. DOI:10.1186/1471-2458-14-569 · 2.26 Impact Factor
Show more