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Comparing Estimates of Physical Activity from Two Accelerometer Locations and Direct Observation during Equine-Assisted Therapy in Neurodivergent Children

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Abstract
Measuring physical activity (PA) in neurodivergent children during equine-assisted therapy (EAT) presents unique challenges. While accelerometers are commonly used to assess PA, their accuracy in this specific population and context remains unexplored. PURPOSE: This study aimed to compare PA estimates from wrist-worn and hip-worn accelerometers to direct observation during EAT sessions in neurodivergent children and adolescents. METHOD: Eight participants (mean age 8.7±2.2 years) wore ActiGraph GT3X+ accelerometers on the hip and non-dominant wrist during one-hour EAT sessions. Direct observation using the Movement Observation in Children and Adolescents (MOCA) system was also used to assess the participants’ PA and served as the criterion measure. Sedentary behavior, light PA (LPA), and moderate-to-vigorous PA (MVPA) were assessed. Agreement between methods was evaluated using Wilcoxon signed-rank tests, percent agreement, and Cohen's kappa. RESULTS: Both accelerometer locations significantly overestimated sedentary behavior and LPA while underestimating MVPA compared to direct observation (p<0.001). Overall agreement was poor between wrist and direct observation (kappa= -0.07), hip and direct observation (kappa= -0.04), and wrist and hip (kappa=0.25). Wrist accelerometer placement recorded less sedentary behavior (p<0.001) and more MVPA (p<0.001) compared to hip accelerometer placement. CONCLUSION: Current accelerometer algorithms demonstrated poor accuracy in measuring PA intensities during EAT in neurodivergent youth. Further research is needed to develop and validate PA measurement tools specifically for this population and setting. These findings highlight the importance of context-specific validation when assessing PA in unique therapeutic environments.
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Thesis (Open Access)
Date
2024-09
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Attribution 4.0 International
License
http://creativecommons.org/licenses/by/4.0/
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