Validating hip- and wrist-ActiGraph accelerometer cut-points for physical activity intensities in people living with coronary heart disease.
N, F., B, C., M, B., T, N., K, P., A, R., TH, W., S, J., A, K., & R, D. (2026). Validating hip- and wrist-ActiGraph accelerometer cut-points for physical activity intensities in people living with coronary heart disease.. PloS one. https://doi.org/10.1371/journal.pone.0349618
N F, B C, M B, T N, K P, A R, et al. Validating hip- and wrist-ActiGraph accelerometer cut-points for physical activity intensities in people living with coronary heart disease.. PloS one. 2026; doi: 10.1371/journal.pone.0349618
N F, B C, M B, et al. Validating hip- and wrist-ActiGraph accelerometer cut-points for physical activity intensities in people living with coronary heart disease.[J]. PloS one. 2026. DOI: 10.1371/journal.pone.0349618.
@article{n2026,
author = {Freene N and Clark B and Bäck M and Niyonsenga T and Pumpa K and Rangaraj A and Wong TH and Joseph S and Khan A and Davey R},
title = {Validating hip- and wrist-ActiGraph accelerometer cut-points for physical activity intensities in people living with coronary heart disease.},
journal = {PloS one},
year = {2026},
doi = {10.1371/journal.pone.0349618},
note = {PMID: 42207777},
}
TY - JOUR AU - Freene N AU - Clark B AU - Bäck M AU - Niyonsenga T AU - Pumpa K AU - Rangaraj A AU - Wong TH AU - Joseph S AU - Khan A AU - Davey R TI - Validating hip- and wrist-ActiGraph accelerometer cut-points for physical activity intensities in people living with coronary heart disease. T2 - PloS one PY - 2026 DO - 10.1371/journal.pone.0349618 AN - PMID:42207777 ER -
People with coronary heart disease (CHD) are encouraged to meet the public health moderate-to-vigorous aerobic physical activity (MVPA) guidelines for secondary prevention of cardiovascular disease. However, no accelerometer aerobic intensity cut-points are currently available to classify MVPA in this population. This study aimed to establish absolute and relative aerobic physical activity intensity accelerometer cut-points in people with CHD and compare the new with existing cut-points in an international cohort. Eighty-six participants with CHD performed a resting-metabolic-rate (RMR) assessment, activities-of-daily-living (ADLs) and a peak treadmill test with mixed-chamber gas analysis while wearing two ActiGraph GT3X accelerometers (hip and wrist). The average RMR was 2.8 ml.kg-1.min-1, 20% less than the commonly used 1 Metabolic Equivalent of Task (3.5 ml.kg-1.min-1). The study sample was randomly split into a training and independent validation set (2:1) allowing for cross validation. In the training set, there were significant positive correlations between accelerometer counts.min-1 (y-axis, vector-magnitude (VM)) and intensity (relative and absolute) across both accelerometer hip- and wrist-placements for all activities (p < 0.001). Using Generalized Estimating Equation modelling, there was a strong linear relationship between accelerometer counts and absolute intensity for hip-placement (R2 = 0.62-0.71), and weaker relationships for hip relative intensity (R2 = 0.40-0.47) and wrist-placement (R2 = 0.09-0.25). In the validation set, Bland-Altman plots found that the mean differences between predicted and actual absolute and relative intensity measures were negligible for all accelerometer counts.min-1 (y-axis, VM) and placements (hip, wrist), although the dispersion of the differences (95% limits of agreement) were wide. Hip VM counts.min-1 cut-points were found to best identify absolute and relative MVPA. In the international comparison (n = 176), participants completed significantly more MVPA using the new cut-points (p < 0.001). Thus, accelerometer cut-points developed in healthy individuals appear to under-estimate physical activity intensity in this population and cut-points specific to people with CHD should be used. Australian New Zealand Clinical Trials Registry: ACTRN12623000605695.