Validity and Reliability of the activPAL4(TM) for Measurement of Body Postures and Stepping Activity in 6–12-Year-Old Children

A link between inappropriate physical behaviour patterns (low physical activity and high sedentary behaviour) and poor health outcomes has been observed. To provide evidence to quantify this link, it is important to have valid and reliable assessment tools. This study aimed to assess the validity and reliability of the activPAL4(TM) monitor for distinguishing postures and measuring stepping activity of 6–12-year-old children. Thirteen children (8.5 ± 1.8 years) engaged in pre-determined standardised (12 min) and non-standardised (6 min) activities. Agreement, specificity and positive predictive value were assessed between the activPAL4(TM) and direct observation (DO) (nearest 0.1 s). Between-activPAL4(TM) (inter-device) and between-observer (inter-rater) reliability were determined. Detection of sitting and stepping time and forward purposeful step count were all within 5% of DO. Standing time was slightly overestimated (+10%) and fast walking/jogging steps underestimated (−20%). For non-standardised activities, activPAL4(TM) step count matched most closely to combined backward and forward purposeful steps; however, agreement varied widely. The activPAL4(TM) demonstrated high levels of reliability (ICC(1, 1) > 0.976), which were higher in some instances than could be achieved through direct observation (ICC(2, 1) > 0.851 for non-standardised activities). Overall, the activPAL4(TM) recorded standardised activities well. However, further work is required to establish the exact nature of steps counted by the activPAL4(TM).