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

Giurgiu, Marco; Kolb, Simon; Nigg, Carina; Burchartz, Alexander; Timm, Irina; Becker, Marlissa; Rulf, Ellen; Doster, Ann-Kathrin; Koch, Elena; Bussmann, Johannes B J; Nigg, Claudio; Ebner-Priemer, Ulrich W; Woll, Alexander (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. BMJ Publishing Group 10.1136/bmjsem-2021-001267

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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.

Interest & Impact

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24 since deposited on 02 Jun 2022
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Citations

5 Citations in Web of Science ®
6 Citations in Scopus

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