Reproducibility of objectively measured physical activity and sedentary time over two seasons in children; Comparing a day-by-day and a week-by-week approach

Eivind Aadland, Lars Bo Andersen, Turid Skrede, Ulf Ekelund, Sigmund Alfred Anderssen, Geir Kåre Resaland, Eivind Aadland, Lars Bo Andersen, Turid Skrede, Ulf Ekelund, Sigmund Alfred Anderssen, Geir Kåre Resaland

Abstract

Introduction: Knowledge of reproducibility of accelerometer-determined physical activity (PA) and sedentary time (SED) estimates are a prerequisite to conduct high-quality epidemiological studies. Yet, estimates of reproducibility might differ depending on the approach used to analyze the data. The aim of the present study was to determine the reproducibility of objectively measured PA and SED in children by directly comparing a day-by-day and a week-by-week approach to data collected over two weeks during two different seasons 3-4 months apart.

Methods: 676 11-year-old children from the Active Smarter Kids study conducted in Sogn og Fjordane county, Norway, performed 7 days of accelerometer monitoring (ActiGraph GT3X+) during January-February and April-May 2015. Reproducibility was calculated using a day-by-day and a week-by-week approach applying mixed effect modelling and the Spearman Brown prophecy formula, and reported using intra-class correlation (ICC), Bland Altman plots and 95% limits of agreement (LoA).

Results: Applying a week-by-week approach, no variables provided ICC estimates ≥ 0.70 for one week of measurement in any model (ICC = 0.29-0.66 not controlling for season; ICC = 0.49-0.67 when controlling for season). LoA for these models approximated a factor of 1.3-1.7 of the sample PA level standard deviations. Compared to the week-by-week approach, the day-by-day approach resulted in too optimistic reliability estimates (ICC = 0.62-0.77 not controlling for season; ICC = 0.64-0.77 when controlling for season).

Conclusions: Reliability is lower when analyzed over different seasons and when using a week-by-week approach, than when applying a day-by-day approach and the Spearman Brown prophecy formula to estimate reliability over a short monitoring period. We suggest a day-by-day approach and the Spearman Brown prophecy formula to determine reliability be used with caution.

Trial registration: The study is registered in Clinicaltrials.gov 7th April 2014 with identification number NCT02132494.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Bland Altman plots of agreement…
Fig 1. Bland Altman plots of agreement for different outcome variables over two weeks of measurement performed in the winter and spring, 3 to 4 months apart.
Bland Altman plots (the mean of two weeks of measurement on the x-axis versus the difference between them on the y-axis) for (a) overall physical activity (cpm), and minutes per day spent (b) sedentary (SED), (c) in light physical activity (LPA), (d) in moderate physical activity (MPA), (e) in vigorous physical activity (VPA), and (f) in moderate-to-vigorous physical activity (MVPA). Results are based on a ≥ 8 hours & ≥ 3 days wear time criterion (n = 615). The full line is the bias between weeks, whereas the dotted lines are 95% limits of agreement corrected for wear time and season.

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