Objective: This study aimed to examine whether, on the basis of the relationship between sensors attached on the upper limbs and energy expenditure (EE) at the time of wheelchair propulsion, there are differences in the measurement of EE depending on the sensor attachment site and whether addition of the angular velocity information to the acceleration value is advantageous. We also aimed to clarify the variables used to estimate EE as well as the estimated error. Setting: Laboratory of the National Hospital Organization Murayama Medical Center, Japan. Methods: Six male subjects with spinal cord injuries participated in the study. Each wore sensors at the wrist and the middle upper arm on both sides while driving a wheelchair on a treadmill at three levels: very, very light; very light; and fairly light. Triaxial acceleration, triaxial angular velocity and EE were measured during driving. We analyzed the correlation between EE and acceleration, angular velocity and synthesized values of acceleration and angular velocity at each location using regression, multiple regression and Bland-Altman analyses.
INTRODUCTIONIndividuals with spinal cord injury (SCI) are prone to disuse syndrome due to their injury and limited movement. Compared with healthy people, people with SCI are at higher risk for lifestylerelated diseases and metabolic syndrome. 1 Thus, to improve and maintain health, a plan for managing physical activity is necessary. 2,3 A recent prospective cohort study showed that an increased physical activity level is associated with both improved physical fitness and a reduced risk of developing cardiovascular diseases. 3 Devices are needed to assess physical activity and evaluate the efficacy of health-promotion interventions.It is difficult to assess daily physical activity in community-dwelling people according to measurements of energy expenditure (EE) using criterion methods such as calorimetry or doubly labeled water techniques. Therefore, the development and validation of wearable monitors such as pedometers, load transducers/foot-contact monitors, accelerometers, heart rate monitors, combined accelerometer and heart rate monitors and multiple sensor systems that enable the evaluation of physical activity in healthy individuals are in progress. 4