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.

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    • "The measurement of PA is a controversial issue, with evidence demonstrating positive and negative aspects of both subjective and objective methods of measurement[26]. Validated measurement methods of PA and energy expenditure (EE) in the RA population include the objective measures of the GT1M ActiGraph accelerometer, the SenseWear Armband[27]and the Yale Physical Activity Survey (YPAS)[28], which is a self-report questionnaire. "
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    • "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). "
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    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.
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    • "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]. "
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