Accelerometer Use in Physical Activity: Best

Practices and Research Recommendations

DIANNE S. WARD1, KELLY R. EVENSON1, AMBER VAUGHN1, ANNE BROWN RODGERS2, and
RICHARD P. TROIANO3
1
University of North Carolina, Chapel Hill, NC; 2Falls Church, VA; and 3National Cancer Institute, Bethesda, MD
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ABSTRACT
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WARD, D. S., K. R. EVENSON, A. VAUGHN, A. BROWN RODGERS, and R. P. TROIANO. Accelerometer Use in Physical
Activity: Best Practices and Research Recommendations. Med. Sci. Sports Exerc., Vol. 37, No. 11 (Suppl), pp. S582–S588, 2005.
Researchers are increasingly interested in the potential of accelerometers to improve our ability to measure and understand the health
impacts of physical activity. Although accelerometers have been available commercially for more than 25 yr, broad consensus about
how to use these tools has not been established. At a scientific conference in December 2004, a number of scientists were invited to
present papers, serve as reactors or moderators to papers, present posters of original research, or serve as members of an audience
knowledgeable about the use of accelerometers. During 2½ d, information about best practices of accelerometer use was presented and
suggestions for future research were made. From the collective experience of papers presented and discussions held, five areas of
accelerometer use were described. This paper summarizes the best practices and future research needs from those five areas: monitor
selection, quality, and dependability; monitor use protocols; monitor calibration; analysis of accelerometer data; and integration with
other data sources. Suggestions for reporting standards for journal articles also are presented. Key Words: ACCELEROMETRY,
PHYSICAL ACTIVITY, MEASUREMENT, BEST PRACTICES, RESEARCH

P
hysical activity has been shown to be an important
behavior related to a number of health outcomes (12).
The ability to measure physical activity behavior is
useful, not only to understand the association between phys-
ical activity and health, but also for many other reasons,
such as to monitor secular trends in behavior and to evaluate
the effectiveness of interventions and programs. Currently,
the most widely used research methods for measuring phys-
ical activity do not yield objective data. Researchers have
relied upon self-report measures, especially in large popu-
lation studies. Error associated with recall techniques, how-
ever, is estimated to be between 35 and 50%, with varying
error rates associated with age groups or disease conditions
(13). Factors related to recall ability and cognitive develop-
ment, along with a tendency to respond in socially desirable
ways, all contribute to the inaccuracy of the self-report
instrument (13). Thus, the need for an objective measure
capable of capturing a wide range of different movement
types is essential.
Although many researchers view accelerometry as the
preferred method for objective measurement of physical
activity, and some researchers even consider it a criterion
against which other measures of physical activity can be
Address for correspondence: Dianne S. Ward, Ed.D., Department of Nu-
trition, School of Public Health, University of North Carolina at Chapel
Hill, 4107 McGavran-Greenberg, CB #7461, Chapel Hill, NC 27599-7461;
E-mail: dsward@email.unc.edu.
0195-9131/05/3711(Suppl)-S582/0
MEDICINE & SCIENCE IN SPORTS & EXERCISE®
Copyright © 2005 by the American College of Sports Medicine
DOI: 10.1249/01.mss.0000185292.71933.91
S582
validated, accelerometer use is not without its challenges.
These challenges include a lack of understanding about
exactly how a monitor functions, how to select the most
appropriate instrument, standards of monitor wear and field
use, how to interpret accelerometer data, and how to ma-
nipulate and analyze the data produced by accelerometer
output. In addition to these challenges, advances in technol-
ogy, such as the use of multiple accelerometers or their
integration with other devices, such as heart rate (HR)
monitors or geographical location devices, improve our
ability to measure field-based energy expenditure (EE), but
demand a sophistication and complexity beyond many re-
searchers’ experience.
Gaps in our knowledge of accelerometry led to the cre-
ation of a conference designed to address these issues. In
December 2004, a scientific meeting titled, “Objective
Monitoring of Physical Activity: Closing the Gaps in the
Science of Accelerometry,” was held in Chapel Hill, North
Carolina. The conference was sponsored by Get Kids in
Action, a partnership between the University of North Caro-
lina at Chapel Hill and the Gatorade Company that is de-
signed to address issues associated with promoting physical
activity and obesity prevention among youths. Nine papers
were presented at this conference, each covering a specific
topic associated with using accelerometry to measure phys-
ical activity. The papers also suggested best practices for
accelerometer use and made recommendations for future
research. In addition, 10 posters on innovative assessment
devices or analytical approaches were presented. Each paper
is published in the current supplement to this journal.
Although a true consensus could not be reached about
procedures that should be applied in all areas when accel-
erometers are used to measure physical activity, meeting
 TABLE 1. Contribution of accelerometry papers to best practice and research recommendations.
Monitor
Selection,
Quality, and Monitor Use
Authors Dependability Protocol
Chen and Bassett (2) X X
Welk (14) X X
Matthews (5) X X
Freedson et al. (3)
Catellier et al. (1)
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Mâsse et al. (4)
Trost et al. (11) X X
Strath et al. (9) X X
Rodriguez et al. (8)
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participants were able to determine best practices for their
use in five specific areas: monitor selection, quality, and
dependability; monitor use protocols; monitor calibration;
analysis of accelerometer data; and integration of acceler-
ometry with other data sources. The contributions of each
paper to these topics can be seen in Table 1. Although not
meant to be comprehensive, this paper summarizes the best
practice recommendations and suggested future research
directions associated with each of these topics. It also pro-
vides several overarching observations about next steps in
the development of accelerometry as a method for objec-
tively measuring physical activity.
BEST PRACTICE GUIDELINES AND
RESEARCH RECOMMENDATIONS FOR THE
SPECIFIC THEMES
1. Monitor Selection, Quality, and Dependability
Although accelerometers to measure physical activity
have been commercially available for more than 25 yr, a
dramatic increase in their use has occurred more recently
(10). Contributing to this increase in use is the expansion of
different types of accelerometers and a greater variety of
applications for their use. With the advent of accelerometers
adapted for use in measuring movement, an objective mon-
itoring tool was added to the resources available to research-
ers interested in assessing physical activity behavior. Newer
and more sophisticated monitors continue to be developed,
and applications for their use realized. Although many ques-
tions on how best to use accelerometers to measure physical
activity remain unanswered, a considerable amount is
known about monitor selection, quality, and dependability.
Best Practice Recommendations
Selecting instruments. In general, no one monitor is
superior to another, and selection depends primarily upon
the research interest. Questions about product reliability,
availability of technical support, practicality, and cost must
be answered when monitors are selected (11,14). It is im-
portant that a monitor have sufficient data processing and
storage capacity to measure movement over time, be porta-
ble and compact for use in free-living (vs laboratory) ap-
plications, and be acceptable for wear by the participant (2).
ACCELEROMETER USE RECOMMENDATIONS
Analysis of Integration
Monitor Accelerometer with Other
Calibration Data Data Sources
X X
X
X
X
X
X
X
X
Assessing instrument quality and dependability.
Most accelerometers in use today are very dependable, with
studies reporting coefficient of variability (CV) measures of
approximately 3% for most models (2,14). It is important,
especially in descriptive studies that employ large number
of monitors, to assess the CV of the monitors used (14). The
CV can be determined by testing all monitors’ ability to
measure a standardized movement, such as attaching mon-
itors to a test tube shaker and shaking them for a period of
time. Monitor comparability should not be assumed, and
new monitors should be checked for accuracy against a
movement standard, even upon receipt from the factory. A
good approach for monitor control is to check the CV of
monitors before field use and upon return of the instruments
to the researcher. Because some monitors fail to function in
the field, the after-field check may help investigators inter-
pret questionable data when results are downloaded.
Guidelines should be established to detect monitors that
are not yielding counts within the expected level of error,
and some statistical correction should be employed to re-
move unwanted error due to monitor variability (14). For
example, numbering monitors and using that identification
number as a covariate to control for unit variation has been
recommended by some (14). It should be noted, however,
that other researchers continue to debate whether this degree
of control is necessary.
Future research recommendations
In the area of monitor selection, quality, and dependabil-
ity, additional work is needed to understand the character-
istics of accelerometers, such as how they function in dif-
ferent body locations and the mechanical characteristics of
different monitors. These factors influence accelerometer
output and, therefore, the validity and reliability of the data
obtained (14). For example, hip-mounted accelerometers
cannot capture certain highly static categories of activity or
complex movement patterns that combine dynamic and
static movements (5).
In addition, studies are needed to compare the validity
and interinstrument reliability of different makes and mod-
els of accelerometers. In particular, the reliability and va-
lidity of newly introduced monitors, especially those that
seek to combine different data collection devices, need to be
carefully examined. Research designs to assess this new
Medicine & Science in Sports & Exercise姞 S583
 instrumentation should be methodologically rigorous and
should be compared with indirect calorimetry or double-
labeled water (9).
Finally, the challenge for the next generation of physical
activity monitors—those that come closer to capturing a
person’s total physical activity—is to be able to calculate
total physical activity EE (PAEE). Single-plane accelerom-
eters display shortcomings for measuring PAEE, while mul-
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tiple monitors and the inclusion of HR monitoring create
burdens for the participant and challenges to the researcher,
even though they greatly improve the quality of the infor-
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mation collected. Advances in hardware and software tech-
nology should improve our measurement capability in this
area.
2. Monitor Use Protocols
With the proliferation of accelerometer use to measure
physical activity, a variety of different procedures have been
used. Standardized protocols do not exist for determining
the number of monitors that participants should wear, the
optimal placement on the body, the optimum number of
wearing days, or the procedures that will ensure participant
compliance. A number of papers addressed these practical
issues, and they also were an important component of work-
shop discussion sessions. Although some consensus is
emerging about best practices in this area, additional re-
search still is needed.
Best Practice Recommendations
Using multiple monitors. Strath and colleagues (9)
described the usefulness of multiple accelerometers to more
accurately measure EE. However, the additional measure of
accuracy provided may not outweigh the extra participant
burden from wearing multiple monitors (11). When mea-
suring physical activity in adults, especially in large popu-
lation studies, a single monitor generally will perform sat-
isfactorily for a multitude of research purposes (10).
Defining wearing days. For both children and adults,
the number of monitoring days will depend on the setting
(e.g., occupational or leisure time), the population under
study (e.g., young children, teenagers, adult males), the
study resources (e.g., low budget vs well funded), and the
research questions (e.g., the need for population-level vs
individual-level estimates of physical activity behaviors)
(11). Among adults, at least 3–5 d of monitoring are re-
quired to estimate habitual physical activity (11). With
children and adolescents, studies have shown that the num-
ber of monitoring days ranges between 4 and 9, making a
definitive recommendation difficult (11). Differences regu-
larly observed between weekday and weekend activities in
children and adults suggest that for most age groups, a
standard 7-d monitoring protocol is a sensible choice (11).
a. Determining monitor placement. One advantage
of the current accelerometer technology is its small, com-
pact size, making it wearable on many body locations (an-
kle, wrist, trunk). However, the trunk location (hip or lower
back) has become by far the most common placement for
S584 Official Journal of the American College of Sports Medicine
the monitors, and no calibration study (see next section) has
used sites other than the trunk to derive the equations for
interpreting accelerometer output. It makes little difference
whether the monitor is worn on the right or left side, but the
need for a standard protocol would suggest that one side be
used consistently. The right side may be most convenient
because most people are right-handed. Placement on the
wrist or ankle should be avoided (11).
b. Establishing field practices. Field-based prac-
tices are recommended for quality control and improved
accelerometer use, including quality control routines and
distribution and collection methods. Accelerometers de-
signed for measuring physical activity have been found to be
generally reliable, but observations of interunit variation and
variations at very low and very high frequencies suggest the
need for ongoing examination of unit function (checking
monitors for accurate data output before and after each use).
Face-to-face distribution and collection of monitors is gen-
erally best, but larger studies may require other techniques,
such as delivery and return by registered mail.
c. Ensuring compliance. Participant compliance in
wearing the monitor is critical for obtaining accurate phys-
ical activity measurement. Investigator-based strategies
(such as phoning participants to encourage wearing moni-
tors or providing incentives for monitor return) or partici-
pant-based strategies (such as keeping logs or placing re-
minders in prominent areas at home) have both been used
with some degree of success. It is recommended that re-
searchers consider the use of either investigator- or partic-
ipant-based compliance strategies (11).
Future research recommendations
In the area of monitor use, we need to identify a range of
methods that are acceptable for specific purposes and that
vary in cost and burden to participants and research staff (5).
Currently, no standard exists for determining which moni-
toring procedure, including instrument choice, protocol, and
approach, is appropriate under a given condition. For ex-
ample, we know that children’s physical activity, especially
that of younger children, occurs in relatively short bursts
(every few seconds), rather than long bouts (multiple min-
utes). This type of physical activity may require shorter
monitoring periods or epochs to record its intermittent be-
havior. Also, children engage in a variety of movement
forms, not just those that depend on locomotion; this pre-
sents measurement challenges for the more common single-
plane accelerometer. More research also is needed to deter-
mine whether more than one accelerometer is required to
measure the scope of children’s physical activity, especially
preschool children.
A prevailing standard for measuring physical activity
with accelerometry is needed. In other words, a “standard of
care” for accelerometry should be developed (14). In addi-
tion, the number of monitors required and the method for
their use, as well as specific strategies to promote participant
compliance must be further articulated (11).
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 3. Monitor Calibration
Although some research questions can be answered using
raw accelerometer counts (total counts), most studies re-
quire that the accelerometer information be converted into
more meaningful and interpretable units. This process,
called calibration, is achieved by comparing counts with
some known standard (typically, indirect calorimetry) that
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has been obtained from specific equations designed for this
purpose. The use of calibration equations can improve our
understanding of data obtained from accelerometry because
it permits investigators to determine the level of exertion
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represented by the accelerometer counts. Equations are de-
veloped using a representative sample of the population of
interest, in which participants wear accelerometers and an-
other device that can accurately measure EE (i.e., portable
calorimeters). The resulting equation is used to predict EE
(total kilocalories expended) or to provide interpretive count
cutoff levels. These cut points separate movement behavior
into level of exertion (sedentary, light, moderately, vigor-
ous, very vigorous). Although a number of calibration equa-
tions have been constructed for a variety of age groups,
using different physical activities, this area is still being
actively developed, and it was much a discussed and de-
bated issue at the workshop.
Best Practice Recommendations
Predicting EE. Several acceptable methods exist for
measuring EE, an important component of many research
studies. However, measuring EE outside a laboratory setting
has many challenges. For example, the cost is great for such
methods as using double-labeled water or the participant
burden is high, as is the case with calorimetry, even when
portable models are used. If an accurate EE assessment
could be estimated based on accelerometer counts, it could
be useful to researchers for a variety of purposes. However,
relationships between differing types of physical activity
and EE are not always linear (14). Therefore, when accel-
erometry is used to predict EE, and linear prediction equa-
tions are employed, the equations that are created based on
locomotion patterns (e.g., walking) tend to underestimate
EE, while equations based on lifestyle patterns (e.g., house-
hold or work chores) tend to overestimate EE (14). It may
be that equations that employ more complex mathematical
models (such as higher order equations) are necessary to
better predict values for activity at different intensity levels
(3). Current linear equations work only moderately well for
predicting an individual’s overall EE (3).
Using individual calibration equations. Calibration
equations, developed from a representative sample of indi-
viduals, can be used to give meaning to a group’s physical
activity behavior. However, use of these equations is not
suitable for studies where more precise measures are re-
quired. Individual physical activity that results from partic-
ipation in an intervention designed to measure baseline and
change, or from studies of a small number of individuals
followed over a period of time, can be measured using
accelerometry. However, in order to derive accurate and
ACCELEROMETER USE RECOMMENDATIONS
meaningful data, investigators should consider using per-
sonal calibration equations (14). In other words, the EE-
accelerometer relationship needs to be determined for each
person included in the study. However, this gain in accuracy
of the prediction equation may not be feasible for large-scale
trials due to the burden of determining calibration equations
for each participating individual (14).
Constructing group calibration equations. In
general, calibration equations are developed from a repre-
sentative sample of individuals and used to give meaning to
a group’s physical activity behavior. Although this approach
is not as precise as the use of personal calibration equations,
it is more practical and provides adequate interpretation of
accelerometer data. When selecting an existing equation or
developing a new one for a certain population, a number of
considerations should be made to ensure the most accurate
interpretation of the accelerometry data. Locomotor move-
ments are most accurately recorded by accelerometry, es-
pecially single plane or uniaxial accelerometers, and should
comprise most of the calibration activities (5). Calibration
equations should be based on data from a sample that is
representative of the population of interest (14). When the
equation is designed for use with a particular age group, a
range of body sizes should be included in the reference
group. Within the calibration analysis, the effects of age
(when multiple age groups are included), body fat, and body
size should be understood (14). Equations should be based
on activities common to the age of the participants in the
study (e.g., playing games for children, household chores or
leisure time physical activity for adults). The higher resting
metabolic rate (RMR) associated with children’s stages of
development also should be accounted for in that population
(14). Finally, if multiple equations for accelerometer inter-
pretation exist, investigators should explain their reasons for
selecting a particular equation (14).
Determining epoch length. Although not specifi-
cally related to the calibration function, the researcher also
must decide how frequently data will be collected. Measur-
ing physical activity by accelerometry employs rapid sam-
pling of accelerometer counts over a preset sampling period,
or epoch. Early accelerometry studies used 1-min epochs
almost exclusively. This practice was employed in most
cases to optimize the recording and storage capacity of the
monitors. However, with greater memory capacities, deci-
sions on epoch length should be based more on research
questions and measurement context, rather than equipment
limitations. Much of the research conducted with children
has used calibration equation cut points based on 1-min
epochs. Younger children, especially, engage in physical
activity in frequent bursts of short durations. This movement
characteristic suggests using shorter sampling periods or
epochs; use of the 1-min epoch may be inappropriate and
result in underestimation of moderate to vigorous physical
activity (11).
Analyzing data. When conducting calibration studies,
individual participants are asked to perform multiple bouts
of a number of different physical activities. Analysis of
these data requires the use of procedures that account for the
Medicine & Science in Sports & Exercise姞 S585
 lack of independence in the data, that is, repeated measures
are made of each study participant. Such approaches as
mixed modeling are necessary to control for the lack of
independence in the data structure (14).
Future research recommendations
There continues to be much work to accomplish in de-
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veloping calibration equations (5). First, and perhaps most
importantly, investigators need to describe the type and
intensity of the most prevalent physical activities of free-
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living humans (5). This will allow the development of a core
set of source activities to employ in future calibration re-
search that will permit results to be compared across differ-
ent age groups and among different monitoring devices (5).
Another high priority is developing prediction equations
and activity count thresholds (or cut points) for situations or
populations in which levels of physical activity include the
full range of intensities, from very light to very vigorous.
Calibration equations for specific population groups, such as
senior adults, need to be developed because their behavior
may vary from that of younger adults due to changes in gait
patterns that come with age.
In addition to measuring the intensity of an individual’s or
group’s physical activity, measurement of inactivity, or sed-
entary behavior, is of increasing interest to researchers.
Previous studies indicate that sedentary behavior is not
simply the absence of activity. Instead, sedentary behavior
is a purposeful use of time to engage in activities that are
sedentary in nature (such as watching TV, working on the
computer, or reading). However, other than a study with 3-
to 5-yr-old children (7), no standard calibration equation to
measure sedentary time has been developed (3,5). With the
increase in levels of obesity, especially in children, accel-
erometer cut points that indicate sedentary behaviors as well
as the full range of physical activity behaviors are needed.
4. Analysis of Accelerometer Data
In addition to determining how to calibrate monitor out-
put, data reduction and analysis must be undertaken. One of
the most challenging aspects of using accelerometers to
measure physical activity behavior is managing and under-
standing the vast amount of data collected. With recommen-
dations of multiple days of monitoring and with sampling
epochs that may be as low as 15 s, the volume of data
created from accelerometer measurement can be over-
whelming. Making decisions about how data will be
cleaned, collapsed, and analyzed even before data collection
begins, and stating these “decision rules” clearly in articles
will facilitate the analysis process and allow comparison
among studies once they are published.
Best Practice Recommendations
Defining a day. Among the most important “decision
rules” for accelerometry studies is determining what con-
stitutes a “day” (i.e., should it be the waking day, or a time
periods such as 12, 18, or 24 h) and what percentage of a day
S586 Official Journal of the American College of Sports Medicine
must be measured for an individual to have sufficient in-
formation to call this period a complete day. A day varies for
individuals in different age groups (young children, teens,
seniors) and also may vary depending on whether the phys-
ical activity is being measured on a weekday or a weekend
day (1,4). Further, monitor wear varies due to forgetfulness
or circumstances when monitor wear is not possible (e.g., in
certain activities such as swimming or competitive sports
situations where rules disallow wear). One approach to
determining a day is the 70/80 rule (1). A day can be defined
as the period during which at least 70% of the study pop-
ulation has recorded accelerometer data, and 80% of that
observed period constitutes a minimal day for inclusion in
data analysis (1).
Handling incomplete data. As noted above, a trou-
bling characteristic of accelerometer data is that activity is
not measured over a uniform period each day (1). Including
days in which only a few hours are measured is likely to
underestimate the real activity level, whereas eliminating
those days might cause an overestimation of physical activ-
ity. This creates a risky choice between selection bias, either
due to days dropped or days kept, both of which would
result in inaccurate representation of total physical activity
(1). In situations in which days have missing minutes of
activity, consideration should be given to imputation, a
procedure for replacing missing data. Imputation may work
better on weekdays than weekend days because there is a
lower percentage of missing records (at least for youths) and
a higher correlation among activity levels on weekdays (1).
Creating reporting standards. Researchers should
report the number of wearing interruptions (the length of
time that the monitor did not record any activity) observed
and should clearly specify decisions made about type of
inactivity and assumed nonwearing time, as well as average
wearing time (4). Due to variations in sleep patterns, espe-
cially among younger and older individuals, average waking
time for study participants should be reported, and the
percentage of waking time based on the group’s sleep pat-
tern should be indicated (4). However, it should be noted
that participants often remove the monitor near the time of
sleep, but remain awake for minutes or hours before they
actually fall asleep (4).
Information that should be included in research about
days monitored include the definition of wearing time, what
is the presumed nonwearing time, and what is the average
wearing time for the study sample (4). Researchers also are
encouraged to include the average number of valid days
used in their studies (4). The decision rules that are used to
process accelerometer data can have a significant impact on
the summary accelerometer values (4).
Determining bouts. Another important decision rule
concerns the role of “bouts,” or continuous sessions of
physical activity. For example, the Centers for Disease
Control and Prevention (CDC)/American College of Sports
Medicine (ACSM) joint statement recommends a minimum
of 30 min of moderate to vigorous daily physical activity,
but the physical activity can be accumulated over the course
of a day (6). Previous recommendations suggested that a
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 20-min bout of vigorous physical activity was needed, im-
plying that this was the minimum bout required for health
(12). Because the issue of minimum bout length has not
been settled, researchers should measure not only the total
duration of physical activity in a day, but also the number
and length of bouts in which the physical activity occurs.
When physical activity data are analyzed in bouts (typically
no shorter than 10 min), it is recommended that researchers
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use algorithms for bout analysis that allow for 1- or 2-min
interruptions anywhere in the bout (4). This would simulate
such real-life conditions as slowing a jog at a stop light or
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stopping for water when walking (4). When no interruption
in bouts is allowed, the number and duration of moderate to
vigorous physical activity bouts will decrease.
Handling spurious data. Care should be taken in
cleaning accelerometer data to attend to data points that are
outside the range of plausibility. Automated error checking
can be used to identify periods of brief accelerometer mal-
functioning or possible tampering with the instrument by the
participant (4). However, researchers should consider the
impact that setting these spurious data points to “missing”
will have on outcome variables (4).
Future research directions
Reporting standards for summary variables (e.g., average
minutes of physical activity in a weekday or weekend day)
to be included in accelerometer research need to be devel-
oped to allow comparison with other studies (4). In addition,
physical activity monitors that use pattern recognition soft-
ware (such as Markov Modeling) will improve the sophis-
tication and accuracy with which physical activity can be
measured. Such instruments may be useful as gold standards
against which accelerometers could be compared (14).
Future studies should be designed to answer such questions
as whether the use of 1 d of valid data (with imputation) is
sufficient to accurately describe a person’s physical activity
pattern and whether a minimum number of days should be
balanced between weekdays and weekend days (4).
Careful studies are necessary to elucidate the components
of raw accelerations that significantly contribute to accurate
PAEE prediction. Advances in this area could lead to major
improvements in determining optimum data processing al-
gorithms and optimum sensor placement. It may be possible
to combine parameters that represent high-frequency com-
ponents of the arms (for upper body movements), a postural
parameter from the chest to represent locomotion, and in-
tensity components extracted from leg movements to gen-
erate a significantly more accurate PAEE prediction (2).
5. Integration with Other Data Sources
Although the availability of objective physical activity
monitoring afforded by accelerometry has added tremen-
dously to the field of physical activity measurement, single-
or even multiplane activity monitors do not provide suffi-
cient information for all research studies. An exciting de-
velopment is the coupling of accelerometers with other
technologies. For example, the addition of HR monitoring to
ACCELEROMETER USE RECOMMENDATIONS
accelerometry may provide a more accurate assessment of
EE. Another example is the addition of global position
systems (GPS) to accelerometry to understand where phys-
ical activity is occurring. Investigators are considering cou-
pling a number of other approaches with accelerometry to
enhance the quality and scope of information collected. At
the conference, two scientific papers dealt with the integra-
tion of accelerometry with HR (9) and GPS (8).
Best Practice Recommendations
The addition of HR monitoring to accelerometry allows
increased precision in the measurement of PAEE, while the
addition of GPS allows the collection of information about
where outdoor activity is occurring. However, due to the
newness of these two integrative approaches, few specific
recommendations for best practices were offered by the
conference papers or in the ensuing discussions. Future
advances in technology, both hardware and software, should
enhance our ability to use, in new and creative ways, addi-
tional technologies in concert with accelerometry.
One of the recommendations that resulted from the con-
ference regarding integration of measuring devices is that
combining accelerometers with HR monitoring, irrespective
of modeling technique employed, can more accurately re-
flect PAEE levels when both individual and group level
equations are used (9). Improvements in the prediction of
EE of approximately 20% have been observed when HR
monitoring was added to accelerometry (9). The downside
of this finding is in the analysis of the data collected. Even
when a single integrated device is used, the analysis is
complex and requires sophisticated methodology. As the
availability of integrated monitors becomes more common-
place, other practice recommendations will be developed.
Future research directions
The rapid introduction of new technology creates exciting
possibilities for the measurement of physical activity. How-
ever, as opportunities to combine accelerometers with other
instrumentation such as HR monitors or GPS become com-
mercially available, measuring instrument reliability and
validity against a gold standard becomes increasingly im-
portant (9).
New devices that contain HR monitors and accelerome-
ters (e.g., Actiheart from Minimitter, www.minimitter.com)
show great promise in reliability and validity calculations
(9). However, further study is necessary to establish appro-
priate relationships between HR–PAEE and accelerometer–
PAEE (9). Because PAEE per unit of time is the primary
outcome from most physical activity monitoring devices,
standardizing such devices for body size is necessary. Better
knowledge of the relationships with PAEE in different con-
ditions in which each data source (accelerometer or HR) is
used should help create new modeling techniques (9). We
must seek study designs that allow us to apply, over the full
range of intensity, the validity of combined sensing of
physical activity in the laboratory to physical activity that
occurs during free-living conditions (9).
Medicine & Science in Sports & Exercise姞 S587
 The application of global information systems and GPS to
understand how the built environment affects physical activity
deserves additional research. Although GPS can add to our
information about physical activity location, additional re-
search about ways to support accelerometry with GPS data is
required. Testing relationships between type of activity and
location needs to occur in diverse populations and in various
urban contexts, with large numbers of participants (8).
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GENERAL RECOMMENDATIONS FOR THE
FUTURE
CX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdgGj2MwlZLeI= on 12/01/2023
In addition to the best practice and future research rec-
ommendations, a few general suggestions for further efforts
in physical activity measurement are provided.
Use of open source technology. At this point, we
are unable to compare findings between studies that use dif-
ferent commercial activity monitors (e.g., Actigraph in one and
Actical in the other) due to restrictions imposed by the respec-
tive manufacturers. Sampling rates and measurement standards
are considered proprietary and are not made public. Although
this practice may seem prudent for the company, the result is
confusion in the scientific community as to exactly what the
accelerometer counts compare. Continued collaboration be-
tween manufacturers and research teams is needed, and the
availability of more open-source technology should be encour-
aged to help standardize accelerometry use (14).
More affordable monitors. As researchers find more
applications for the use of accelerometers to measure physical
activity, cheaper alternatives are needed. In recent years, it
seems that research has shifted from using accelerometry only
in small lab- and field-based studies to using it in population-
based studies. The importance of physical activity in the lives
of individuals of all ages is well established, and studies con-
tinue to highlight the need for regular participation in such
activity. Thus, more research is needed to enable us to eco-
nomically monitor current activity levels in the general popu-
lation and to study the implications of different types of phys-
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ical activity among even greater numbers of population
subgroups. Collaboration between manufacturers and scientists
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and over a range of price points.
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SUMMARY
This conference included the presentation of nine scien-
tific papers by experienced scientists, formal responses by
knowledgeable and equally experienced experts in the mea-
surement of physical activity, and extensive discussion by
researchers and manufacturers. Although the result of this
comprehensive scientific event was a narrowing of the
knowledge gap in the use of accelerometry to measure
physical activity behavior, clear consensus was not reached.
Best practice recommendations were presented on five gen-
eral topics of accelerometer use, and suggestions were made
for the next generation of studies.
Use of accelerometry to measure physical activity offers
many improvements over self-report techniques. Although
this method is not without its challenges, the opportunities
afforded by the addition of an objective measure of physical
activity have added much to our knowledge base. Research-
ers should attempt to integrate these best practice recom-
mendations into their current use of accelerometers. As
recommended in these papers, future research should be
directed toward increasing our capacity to use accelerome-
ters and other devices to improve the quality of our under-
standing of physical activity.
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