Assessment of 24-hour physical behaviour in children and adolescents via wearables: a systematic review of free-living validation studies

Marco Giurgiu; Simon Kolb; Carina Nigg; Alexander Burchartz; Irina Timm; Marlissa Becker; Ellen Rulf; Ann-Kathrin Doster; Elena Koch; Johannes B J Bussmann; Claudio Nigg; Ulrich W Ebner-Priemer; Alexander Woll

doi:10.1136/bmjsem-2021-001267

Assessment of 24-hour physical behaviour in children and adolescents via wearables: a systematic review of free-living validation studies

Marco Giurgiu
, Simon Kolb
, Carina Nigg
, Alexander Burchartz
, Irina Timm
, Marlissa Becker
, Ellen Rulf
, Ann-Kathrin Doster
, Elena Koch
, Johannes B J Bussmann
, Claudio Nigg
, Ulrich W Ebner-Priemer
, Alexander Woll

Orthopedics and Sports Medicine

Research output: Contribution to journal › Article › Academic › peer-review

15 Citations (Web of Science)

11 Downloads (Pure)

Abstract

OBJECTIVES: Studies that assess all three dimensions of the integrative 24-hour physical behaviour (PB) construct, namely, intensity, posture/activity type and biological state, are on the rise. However, reviews on validation studies that cover intensity, posture/activity type and biological state assessed via wearables are missing.

DESIGN: Systematic review. The risk of bias was evaluated by using the QUADAS-2 tool with nine signalling questions separated into four domains (ie, patient selection/study design, index measure, criterion measure, flow and time).

DATA SOURCES: Peer-reviewed validation studies from electronic databases as well as backward and forward citation searches (1970-July 2021).

ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Wearable validation studies with children and adolescents (age <18 years). Required indicators: (1) study protocol must include real-life conditions; (2) validated device outcome must belong to one dimension of the 24-hour PB construct; (3) the study protocol must include a criterion measure; (4) study results must be published in peer-reviewed English language journals.

RESULTS: Out of 13 285 unique search results, 76 articles with 51 different wearables were included and reviewed. Most studies (68.4%) validated an intensity measure outcome such as energy expenditure, but only 15.9% of studies validated biological state outcomes, while 15.8% of studies validated posture/activity type outcomes. We identified six wearables that had been used to validate outcomes from two different dimensions and only two wearables (ie, ActiGraph GT1M and ActiGraph GT3X+) that validated outcomes from all three dimensions. The percentage of studies meeting a given quality criterion ranged from 44.7% to 92.1%. Only 18 studies were classified as 'low risk' or 'some concerns'.

SUMMARY: Validation studies on biological state and posture/activity outcomes are rare in children and adolescents. Most studies did not meet published quality principles. Standardised protocols embedded in a validation framework are needed.

PROSPERO REGISTRATION NUMBER: CRD42021230894.

Original language	English
Article number	e001267
Pages (from-to)	e001267
Journal	BMJ open sport & exercise medicine
Volume	8
Issue number	2
DOIs	https://doi.org/10.1136/bmjsem-2021-001267
Publication status	Published - 2022

Bibliographical note

Access to Document

10.1136/bmjsem-2021-001267Licence: CC BY-NC

Assessment of 24-hour physical behaviour in children and adolescents via wearablesLicence: CC BY-NC

Cite this

Giurgiu, M., Kolb, S., Nigg, C., Burchartz, A., Timm, I., Becker, M., Rulf, E., Doster, A.-K., Koch, E., Bussmann, J. B. J., Nigg, C., Ebner-Priemer, U. W., & Woll, A. (2022). Assessment of 24-hour physical behaviour in children and adolescents via wearables: a systematic review of free-living validation studies. BMJ open sport & exercise medicine, 8(2), e001267. Article e001267. https://doi.org/10.1136/bmjsem-2021-001267

@article{6416b17d0ad14d8d9dc4973d666d466a,

title = "Assessment of 24-hour physical behaviour in children and adolescents via wearables: a systematic review of free-living validation studies",

abstract = "OBJECTIVES: Studies that assess all three dimensions of the integrative 24-hour physical behaviour (PB) construct, namely, intensity, posture/activity type and biological state, are on the rise. However, reviews on validation studies that cover intensity, posture/activity type and biological state assessed via wearables are missing.DESIGN: Systematic review. The risk of bias was evaluated by using the QUADAS-2 tool with nine signalling questions separated into four domains (ie, patient selection/study design, index measure, criterion measure, flow and time).DATA SOURCES: Peer-reviewed validation studies from electronic databases as well as backward and forward citation searches (1970-July 2021).ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Wearable validation studies with children and adolescents (age <18 years). Required indicators: (1) study protocol must include real-life conditions; (2) validated device outcome must belong to one dimension of the 24-hour PB construct; (3) the study protocol must include a criterion measure; (4) study results must be published in peer-reviewed English language journals.RESULTS: Out of 13 285 unique search results, 76 articles with 51 different wearables were included and reviewed. Most studies (68.4\%) validated an intensity measure outcome such as energy expenditure, but only 15.9\% of studies validated biological state outcomes, while 15.8\% of studies validated posture/activity type outcomes. We identified six wearables that had been used to validate outcomes from two different dimensions and only two wearables (ie, ActiGraph GT1M and ActiGraph GT3X+) that validated outcomes from all three dimensions. The percentage of studies meeting a given quality criterion ranged from 44.7\% to 92.1\%. Only 18 studies were classified as 'low risk' or 'some concerns'.SUMMARY: Validation studies on biological state and posture/activity outcomes are rare in children and adolescents. Most studies did not meet published quality principles. Standardised protocols embedded in a validation framework are needed.PROSPERO REGISTRATION NUMBER: CRD42021230894.",

author = "Marco Giurgiu and Simon Kolb and Carina Nigg and Alexander Burchartz and Irina Timm and Marlissa Becker and Ellen Rulf and Ann-Kathrin Doster and Elena Koch and Bussmann, \{Johannes B J\} and Claudio Nigg and Ebner-Priemer, \{Ulrich W\} and Alexander Woll",

note = "{\textcopyright} Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2022",

doi = "10.1136/bmjsem-2021-001267",

language = "English",

volume = "8",

pages = "e001267",

journal = "BMJ open sport \& exercise medicine",

issn = "2055-7647",

publisher = "BMJ Publishing Group",

number = "2",

}

Giurgiu, M, Kolb, S, Nigg, C, Burchartz, A, Timm, I, Becker, M, Rulf, E, Doster, A-K, Koch, E, Bussmann, JBJ, Nigg, C, Ebner-Priemer, UW & Woll, A 2022, 'Assessment of 24-hour physical behaviour in children and adolescents via wearables: a systematic review of free-living validation studies', BMJ open sport & exercise medicine, vol. 8, no. 2, e001267, pp. e001267. https://doi.org/10.1136/bmjsem-2021-001267

TY - JOUR

T1 - Assessment of 24-hour physical behaviour in children and adolescents via wearables

T2 - a systematic review of free-living validation studies

AU - Giurgiu, Marco

AU - Kolb, Simon

AU - Nigg, Carina

AU - Burchartz, Alexander

AU - Timm, Irina

AU - Becker, Marlissa

AU - Rulf, Ellen

AU - Doster, Ann-Kathrin

AU - Koch, Elena

AU - Bussmann, Johannes B J

AU - Nigg, Claudio

AU - Ebner-Priemer, Ulrich W

AU - Woll, Alexander

PY - 2022

Y1 - 2022

N2 - OBJECTIVES: Studies that assess all three dimensions of the integrative 24-hour physical behaviour (PB) construct, namely, intensity, posture/activity type and biological state, are on the rise. However, reviews on validation studies that cover intensity, posture/activity type and biological state assessed via wearables are missing.DESIGN: Systematic review. The risk of bias was evaluated by using the QUADAS-2 tool with nine signalling questions separated into four domains (ie, patient selection/study design, index measure, criterion measure, flow and time).DATA SOURCES: Peer-reviewed validation studies from electronic databases as well as backward and forward citation searches (1970-July 2021).ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Wearable validation studies with children and adolescents (age <18 years). Required indicators: (1) study protocol must include real-life conditions; (2) validated device outcome must belong to one dimension of the 24-hour PB construct; (3) the study protocol must include a criterion measure; (4) study results must be published in peer-reviewed English language journals.RESULTS: Out of 13 285 unique search results, 76 articles with 51 different wearables were included and reviewed. Most studies (68.4%) validated an intensity measure outcome such as energy expenditure, but only 15.9% of studies validated biological state outcomes, while 15.8% of studies validated posture/activity type outcomes. We identified six wearables that had been used to validate outcomes from two different dimensions and only two wearables (ie, ActiGraph GT1M and ActiGraph GT3X+) that validated outcomes from all three dimensions. The percentage of studies meeting a given quality criterion ranged from 44.7% to 92.1%. Only 18 studies were classified as 'low risk' or 'some concerns'.SUMMARY: Validation studies on biological state and posture/activity outcomes are rare in children and adolescents. Most studies did not meet published quality principles. Standardised protocols embedded in a validation framework are needed.PROSPERO REGISTRATION NUMBER: CRD42021230894.

AB - OBJECTIVES: Studies that assess all three dimensions of the integrative 24-hour physical behaviour (PB) construct, namely, intensity, posture/activity type and biological state, are on the rise. However, reviews on validation studies that cover intensity, posture/activity type and biological state assessed via wearables are missing.DESIGN: Systematic review. The risk of bias was evaluated by using the QUADAS-2 tool with nine signalling questions separated into four domains (ie, patient selection/study design, index measure, criterion measure, flow and time).DATA SOURCES: Peer-reviewed validation studies from electronic databases as well as backward and forward citation searches (1970-July 2021).ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Wearable validation studies with children and adolescents (age <18 years). Required indicators: (1) study protocol must include real-life conditions; (2) validated device outcome must belong to one dimension of the 24-hour PB construct; (3) the study protocol must include a criterion measure; (4) study results must be published in peer-reviewed English language journals.RESULTS: Out of 13 285 unique search results, 76 articles with 51 different wearables were included and reviewed. Most studies (68.4%) validated an intensity measure outcome such as energy expenditure, but only 15.9% of studies validated biological state outcomes, while 15.8% of studies validated posture/activity type outcomes. We identified six wearables that had been used to validate outcomes from two different dimensions and only two wearables (ie, ActiGraph GT1M and ActiGraph GT3X+) that validated outcomes from all three dimensions. The percentage of studies meeting a given quality criterion ranged from 44.7% to 92.1%. Only 18 studies were classified as 'low risk' or 'some concerns'.SUMMARY: Validation studies on biological state and posture/activity outcomes are rare in children and adolescents. Most studies did not meet published quality principles. Standardised protocols embedded in a validation framework are needed.PROSPERO REGISTRATION NUMBER: CRD42021230894.

U2 - 10.1136/bmjsem-2021-001267

DO - 10.1136/bmjsem-2021-001267

M3 - Article

C2 - 35646389

SN - 2055-7647

VL - 8

SP - e001267

JO - BMJ open sport & exercise medicine

JF - BMJ open sport & exercise medicine

IS - 2

M1 - e001267

ER -

Assessment of 24-hour physical behaviour in children and adolescents via wearables: a systematic review of free-living validation studies

Abstract

Bibliographical note

Access to Document

Fingerprint

Cite this