Discrepancies in Accelerometer-Measured Physical Activity in Children Due to Cut-Point Non-Equivalence and Placement Site

This study examined dissonance in physical activity (PA) between two youth-specific hip-derived intensity cut-points for the Actiwatch (AW), and compared PA between hip and wrist placements using site-specific cut-points. Twenty-four children aged 11.2 ± 0.5 years wore the AW on the right hip and non-dominant wrist during a typical school day. Minutes of sedentary behaviour and vigorous activity were greater using Puyau et al. (2002) cut-points, but light, moderate, and moderate-to-vigorous (MVPA) were greater when derived using Puyau et al. (2004) cut-points (P < 0.01). Total hip activity counts were lower than wrist. Sedentary minutes were greater at the hip, but minutes of light, vigorous and MVPA were lower (P < 0.01). Moderate minutes were greater at the hip, but differed only when applying the Puyau et al. (2004) cut-points (P < 0.01). In conclusion, data comparisons between two hip derived AW cut-points and between hip and wrist data are inappropriate. Future researchers using the AW at the hip should present data reduced using both published cut-points. As hip and wrist data differ, the wrist placement is preferable as it will likely increase children's compliance to monitoring protocols due to reduced obtrusiveness compared to the hip.