Assessing the Accuracy of Activity Classification Using Thigh-Worn Accelerometry: A Validation Study of ActiPASS in School-Aged Children.

Background: The ActiPASS software was developed from the open-source Acti4 activity classification algorithm for thigh-worn accelerometry. However, the original algorithm has not been validated in children or compared with a child-specific set of algorithm thresholds. This study aims to evaluate the accuracy of ActiPASS in classifying activity types in children using 2 published sets of Acti4 thresholds.

Methods: Laboratory and free-living data from 2 previous studies were used. The laboratory condition included 41 school-aged children (11.0 [4.8] y; 46.5% male), and the free-living condition included 15 children (10.0 [2.6] y; 66.6% male). Participants wore a single accelerometer on the dominant thigh, and annotated video recordings were used as a reference. Postures and activity types were classified with ActiPASS using the original adult thresholds and a child-specific set of thresholds.

Results: Using the original adult thresholds, the mean balanced accuracy (95% CI) for the laboratory condition ranged from 0.62 (0.56-0.67) for lying to 0.97 (0.94-0.99) for running. For the free-living condition, accuracy ranged from 0.61 (0.48-0.75) for lying to 0.96 (0.92-0.99) for cycling. Mean balanced accuracy for overall sedentary behavior (sitting and lying) was ≥0.97 (0.95-0.99) across all thresholds and conditions. No meaningful differences were found between the 2 sets of thresholds, except for superior balanced accuracy of the adult thresholds for walking under laboratory conditions.

Conclusions: The results indicate that ActiPASS can accurately classify different basic types of physical activity and sedentary behavior in children using thigh-worn accelerometer data.