Physical activity assessment in children and adolescents

• Published in: Sports medicine (Auckland) Vol. 31; no. 6; pp. 439 - 454
• Main Authors: SIRARD, John R, PATE, Russell R
• Format: Journal Article
• Language: English
• Published: Chester Adis International 2001; Hong Kong; Auckland
• Subjects: Adolescent; Biological and medical sciences; Body Water - diagnostic imaging; Calorimetry, Indirect - instrumentation; Cardiovascular Diseases - physiopathology; Cardiovascular Diseases - prevention & control; Child; Energy Metabolism - physiology; Evaluation Studies as Topic; Exercise - physiology; Fundamental and applied biological sciences. Psychology; Health Surveys; Heart Rate; Humans; Monitoring, Physiologic - instrumentation; Monitoring, Physiologic - methods; Monitoring, Physiologic - statistics & numerical data; Movement; Observation - methods; Observer Variation; Physical Education and Training - methods; Physical Education and Training - standards; Physical Fitness - physiology; Primary Prevention - instrumentation; Radionuclide Imaging; Reproducibility of Results; Surveys and Questionnaires; Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports; Walking; Human; Physical exercise; Methodology; Adolescent; Review; Child; Epidemiology; Public health; Life style
• ISSN: 0112-1642; 1179-2035
• DOI: 10.2165/00007256-200131060-00004

Chronic disease risk factors, including a sedentary lifestyle, may be present even in young children, suggesting that early prevention programmes may be critical to reducing the rates of chronic disease. Accurate assessment of physical activity in children is necessary to identify current levels of activity and to assess the effectiveness of intervention programmes designed to increase physical activity. This article summarises the strengths and limitations of the methods used to evaluate physical activity in children and adolescents. MEDLINE searches and journal article citations were used to locate 59 articles that validated physical activity measurement methods in children and adolescents. Only those methods that were validated against a more stringent measure were included in the review. Based on the definition of physical activity as any bodily movement resulting in energy expenditure (EE), direct observation of the individual's movement should be used as the gold standard for physical activity research. The doubly labelled water technique and indirect calorimetry can also be considered criterion measures for physical activity research, because they measure EE, a physiologic consequence closely associated with physical activity. Devices such as heart rate monitors, pedometers and accelerometers have become increasingly popular as measurement tools for physical activity. These devices reduce the subjectivity inherent in survey methods and can be used with large groups of individuals. Heart rate monitoring is sufficiently valid to use in creating broad physical activity categories (e.g. highly active, somewhat active, sedentary) but lacks the specificity needed to estimate physical activity in individuals. Laboratory and field validations of pedometers and accelerometers yield relatively high correlations using oxygen consumption (r = 0.62 to 0.93) or direct observation (r = 0.80 to 0.97) as criterion measures, although, they may not be able to capture all physical activity. Physical activity has traditionally been measured with surveys and recall instruments. These techniques must be used cautiously in a paediatric population that has difficulty recalling such information. Still, some studies have reported 73.4% to 86.3% agreement between these instruments and direct observation. Future investigations of physical activity instruments should validate the novel instrument against a higher standard. Additional studies are needed to investigate the possibility of improving the accuracy of measurement by combining 2 or more techniques. The accurate measurement of physical activity is critical for determining current levels of physical activity, monitoring compliance with physical activity guidelines, understanding the dose-response relationship between physical activity and health and determining the effectiveness of intervention programmes designed to improve physical activity.