Agreement and equivalence of estimated physical activity behaviours, using ENMO- and counts-based processing methods, for wrist-worn accelerometers in adolescents

The present study examined the agreement and equivalence between two physical activity processing methods. Data were obtained from 161 Hong-Kong adolescents (74 girls, age: 12.6 ± 1.7y). Participants wore an Actigraph GT3XBT on their non-dominant wrist for 7d. Time spent sedentary, and in light-(LPA), moderate-(MPA), vigorous-(VPA), and moderate-to-vigorous physical activity (MVPA) were calculated using different processing methods (proprietary counts and Euclidean Norm Minus One (ENMO)). Intraclass correlation coefficients (ICC) were used to examine absolute agreement (ICC2) and consistency (ICC3), and equivalence was assessed using pairwise equivalence tests. Using ENMO, sedentary time and VPA were higher, whereas all other behaviours were lower (compared to counts processing). Agreement ranged from poor (ICC2:0.42(Sedentary)) to moderate (ICC2:0.86(LPA)) and consistency ranged from moderate (ICC3:0.71(sedentary)) to good (ICC3:0.91(LPA)). Methods were not considered equivalent (all p > 0.05). Due to differences in the wear-time validation of processing methods, a sensitivity analyses (sub-sample with the same valid wear time for both methods (n = 56)), resulted in minimal change. Lack of agreement and equivalence between ENMO and counts processing methods suggests that the processing method significantly affects youth physical activity estimates. Copyright © 2023 The Author(s).