Impact of walking aids on estimating physical activity using a tri-axial accelerometer in frail older adults

Yuki Nishida; Shigeho Tanaka; Yoichi Hatamoto; Mana Hatanaka; Kazuko Ishikawa-Takata; Takayuki Abe; Yasuki Higaki; Fuminori Katsukawa

doi:10.1136/bmjsem-2020-001014

Impact of walking aids on estimating physical activity using a tri-axial accelerometer in frail older adults

BMJ Open Sport Exerc Med. 2021 Jun 25;7(2):e001014. doi: 10.1136/bmjsem-2020-001014. eCollection 2021.

Authors

Yuki Nishida^{1

2}, Shigeho Tanaka^{1

3}, Yoichi Hatamoto¹, Mana Hatanaka¹, Kazuko Ishikawa-Takata⁴, Takayuki Abe⁵, Yasuki Higaki⁶, Fuminori Katsukawa²

Affiliations

¹ National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
² Keio University, Yokohama, Japan.
³ Kagawa Nutrition University, Sakado, Japan.
⁴ Tokyo University of Agriculture, Tokyo, Japan.
⁵ Yokohama City University, Yokohama, Japan.
⁶ Fukuoka University, Fukuoka, Japan.

Abstract

Objectives: This study aimed to compare the estimation error of physical activity level (PAL) estimated using a tri-axial accelerometer between an independent walking group and an assisted walking group with walking aids.

Methods: Subjects were 6 older adults who could walk independently and 10 older adults requiring walking assistance during gait. Total energy expenditure (TEE) was measured using the doubly labelled water (DLW) method over 2 weeks and PAL was calculated as the measured TEE divided by the basal metabolic rate measured using indirect calorimetry (PAL_DLW). The participants wore a tri-axial accelerometer (Active style Pro HJA-750C) on the waist simultaneously as the DLW period, and the estimated PAL was derived from it (PAL_ACC).

Results: The median PAL estimation error in the assisted walking group was -0.30 kcal/day (range: -0.77 to -0.01 kcal/day) and more underestimated than that in the independent walking group (p=0.02). The estimation error of PAL_ACC was significantly correlated with PAL_DLW (r=-0.80, p<0.01).

Conclusions: Using the accelerometer, PAL was underestimated for older adults who used walking aids but not for those who walked independently under free-living conditions.

Keywords: accelerometer; elderly people; energy expenditure.