Accelerometer output and its association with energy expenditure in persons with mild-to-moderate Parkinson’s disease

OBJECTIVE: This study examined the association between ActiGraph accelerometer output and energy expenditure across different speeds of walking in persons with Parkinson’s disease (PD), and further generated cut-points that represent a metric for quantifying time spent in moderate-to-vigorous physical activity (MVPA) among persons with PD. METHODS: The sample included 30 persons with mild-to-moderate PD (Hoehn and Yahr stages 2–3) and 30 adults without PD matched by sex and age. All participants completed 5 minutes of quiet, seated rest and then underwent three, 6-minute bouts of walking on a treadmill at three different speeds relative to the individual’s self-selected pace. Activity counts were measured using an ActiGraph accelerometer worn at the waist level on the least affected side for persons with PD and the dominant side for controls. The rate of oxygen consumption, or energy expenditure, was measured using a portable, open-circuit spirometry system. RESULTS: Our results indicated a strong association between activity counts and energy expenditure for persons with PD (R(2) = 0.87) and controls (R(2) = 0.89). However, the significant difference in slopes resulted in a lower cut-point of 1,354 counts·min(-1) for persons with PD than the cut-point of 2,010 counts·min(-1) for controls. CONCLUSION: Our results support the application of the disease-specific cut-point for quantifying the amount of time spent in MVPA using ActiGraph accelerometers among persons with mild-to-moderate PD. Such an application may provide accurate estimates of MVPA in this population, and better inform future research examining the possible determinants and consequences of physical activity as well as testing of interventions for changing MVPA in PD.