Objective Measurement of 24-Hour Movement Behaviors in Preschool Children Using Wrist-Worn and Thigh-Worn Accelerometers

Abstract

In recent years, more attention has been paid towards the study of 24-h movement behaviors (including physical activity (PA), sedentary behavior (SB) and sleep) in preschoolers instead of studying these behaviors in isolation. This study aimed to evaluate the feasibility of using wrist- vs. thigh-worn accelerometers and to report accelerometer-derived metrics of 24-h movement behaviors in preschoolers. A convenience sample of 16 preschoolers (50.0% boys, 4.35 years) and one of their parents were recruited for this study. Preschoolers had to wear the ActivPAL accelerometer (attached to the upper thigh) and Axivity accelerometer (using a wrist band) simultaneously for 7 consecutive days and for 24 h a day. Parents completed an acceptability survey. In total, 16 preschoolers (100.0%) had a minimum of 6 days of valid wrist-worn data, while only 10 preschoolers (62.5%) had a minimum of 6 days of valid thigh-worn data (p = 0.002). When looking at the acceptability, 81.3% of parents indicated that it was easy for their child to wear the Axivity for 7 consecutive days, and 93.8% of parents indicated so for the ActivPAL (p = 0.88). However, some parents stated that the wristband of the Axivity accelerometer was big, which might have affected data collection. Significant differences were found for the measurement of total volume of PA, SB and sleep across 24 h. Total PA was 464.44 min/day (±64.00) with the ActivPAL compared with 354.94 min/day (±57.46) with the Axivity (p < 0.001). The volume of SB was 290.94 min/day (±55.05) with the ActivPAL compared with 440.50 min/day (±50.01) with the Axivity (p < 0.001). The total volume of sleep was also significantly different between both devices (p = 0.001; ActivPAL: 684.63 min/day ± 51.96; Axivity: 645.69 min/day ± 46.78). Overall, parents perceived both devices to be feasible to use for preschoolers. However, future studies are required to validate both devices for the measurement of preschoolers’ 24-h movement behaviors since significant differences in the classification of PA, SB and sleep were found in this small sample.

Parental Views on the Acceptability and Feasibility of Measurement Tools Used to Assess Movement Behaviour of Pre-School Children: A Qualitative Study

“…Similar concerns have been raised with the use of the activPAL due to skin irritation in previous research [ 53 ]. However, further studies have reported that the activPAL was generally accepted [ 24 , 28 ], with minimal reports of removal of the device due to the dressing of the device being uncomfortable for the child [ 24 ]. Despite this, in some research studies it may be that, for accuracy reasons, devices must be attached to the skin.…”

“…There are currently no practical recommendations for the measurement of movement behaviours of pre-school children and limited research exploring the acceptability and feasibility of tools used for this purpose [ 22 , 23 ]. Studies examining acceptability have primarily used survey based research, whereby parents or researchers rate sentences such as ‘ the device was uncomfortable to wear ’ [ 24 , 25 , 26 , 27 , 28 ] or through researcher observation [ 29 ]. Whilst these studies are informative in inferring the practical acceptability of devices, there is a need for more qualitative research to understand how different tools are perceived and accepted in the target population to ensure they are appropriate and accessible prior to use [ 30 , 31 , 32 , 33 ].…”

The Associations between 24-Hour Movement Behaviours and Quality of Life in Preschoolers: A Compositional Analysis of Cross-Sectional Data from 2018–2021

“…It is not known if there are temporal variabilities in PA, SB, and SL of preschoolers’ issues that remain unaddressed and await future research. Nonetheless, future research on the 24-h behaviours of PA, SB, and SL should employ a combination of subjective (appropriately developed questionnaires) and objective (such as accelerometers) methods [ 72 , 73 ] for a more complete understanding of 24-h movement behaviours in preschoolers.…”

Levels and Correlates of Objectively Measured Sedentary Behavior in Young Children: SUNRISE Study Results from 19 Countries

“…Although the validity remains unclear, these algorithms have been used in other studies. Little evidence is currently available regarding the validity of these algorithms for this age-group, they are being used in similar research ( 24 ), and validation in youth and adults is promising ( 25 ).…”