Use of actigraphy to measure real-world physical activities in manual wheelchair users

INTRODUCTION: The benefits of physical activity for manual wheelchair users are well-known. The purpose of this study was to validate actigraphy to objectively measure physical activity intensity among manual wheelchair users. METHOD: An experimental design was used. Adult manual wheelchair users wore a GT3X actigraph on their non-dominant arm while completing eight physical activities of low (reading), moderate (propelling -- flat) and high (propelling -- steep ramp) intensity. Heart rate and rating of perceived exertion were collected at the end of each physical activity. Distribution of data were examined and used to determine the type of repeated measures (parametric vs. non-parametric). A categorical principal component analysis was performed to determine the amount of variability explained by actigraphy, heart rate and rating of perceived exertion. Activity count cut-points were estimated using bootstrapping methods. RESULTS: Twenty-eight manual wheelchair users completed the study. Actigraphy, heart rate and rating of perceived exertion co-varied as physical activity intensity changed. Activity counts for low-intensity and medium-intensity physical activities were estimated to be 0 to 45 and 45 to 100 activity counts per second, respectively. Activity counts' ranges for high-intensity physical activities were not clear. CONCLUSION: Combining actigraphy and rating of perceived exertion could be an easy and reliable method to measure the intensity of real-world activities. Further research is needed confirm cut-points for physical activity intensity.