Cadence (steps/min) and intensity during ambulation in 6-20 year olds: the CADENCE-kids study

Abstract

Background: Steps/day is widely utilized to estimate the total volume of ambulatory activity, but it does not directly reflect intensity, a central tenet of public health guidelines. Cadence (steps/min) represents an overlooked opportunity to describe the intensity of ambulatory activity. We sought to establish thresholds linking directly observed cadence with objectively measured intensity in 6-20 year olds.

Methods: One hundred twenty participants completed multiple 5-min bouts on a treadmill, from 13.4 m/min (0.80 km/h) to 134.0 m/min (8.04 km/h). The protocol was terminated when participants naturally transitioned to running, or if they chose to not continue. Steps were visually counted and intensity was objectively measured using a portable metabolic system. Youth metabolic equivalents (METy) were calculated for 6-17 year olds, with moderate intensity defined as ≥4 and < 6 METy, and vigorous intensity as ≥6 METy. Traditional METs were calculated for 18-20 year olds, with moderate intensity defined as ≥3 and < 6 METs, and vigorous intensity defined as ≥6 METs. Optimal cadence thresholds for moderate and vigorous intensity were identified using segmented random coefficients models and receiver operating characteristic (ROC) curves.

Result: Participants were on average (± SD) aged 13.1 ± 4.3 years, weighed 55.8 ± 22.3 kg, and had a BMI z-score of 0.58 ± 1.21. Moderate intensity thresholds (from regression and ROC analyses) ranged from 128.4 steps/min among 6-8 year olds to 87.3 steps/min among 18-20 year olds. Comparable values for vigorous intensity ranged from 157.7 steps/min among 6-8 year olds to 119.3 steps/min among 18-20 year olds. Considering both regression and ROC approaches, heuristic cadence thresholds (i.e., evidence-based, practical, rounded) ranged from 125 to 90 steps/min for moderate intensity, and 155 to 125 steps/min for vigorous intensity, with higher cadences for younger age groups. Sensitivities and specificities for these heuristic thresholds ranged from 77.8 to 99.0%, indicating fair to excellent classification accuracy.

Conclusions: These heuristic cadence thresholds may be used to prescribe physical activity intensity in public health recommendations. In the research and clinical context, these heuristic cadence thresholds have apparent value for accelerometer-based analytical approaches to determine the intensity of ambulatory activity.

Trial registration: ClinicalTrials.gov NCT01989104.

Keywords: Accelerometer; Exercise; Pedometer; Physical activity; Walking.

Conflict of interest statement

Ethics approval and consent to participate

All study procedures were reviewed and approved by the Pennington Biomedical Institutional Review Board. Before participating, informed parental consent and participant assent were obtained for children and adolescents 6–17 years of age. Participants between 18 and 20 years of age provided informed consent.

Consent for publication

Not applicable.

Competing interest

The authors declare that they have no competing interests.

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Figures

Fig. 1

Scatterplots of cadence and ln(METy) for 6–17 year olds, and cadence and ln(METs) for 18–20 year olds. Fitted regression lines and 4 and 6 METy or 3 and 6 METs intensity levels are superimposed. METy = youth metabolic equivalents calculated as mass-specific VO2 (mL·kg·min− 1) divided by resting mass-specific VO2 (estimated using the Schofield equation). METs = metabolic equivalents calculated as mass-specific VO2 [mL·kg·min− 1] divided by 3.5 mL·kg·min− 1