Assessing physical activity using wearable monitors: measures of physical activity.

BACKGROUND Physical activity may be defined broadly as "all bodily actions produced by the contraction of skeletal muscle that increase energy expenditure above basal level." Physical activity is a complex construct that can be classified into major categories qualitatively, quantitatively, or contextually. The quantitative assessment of physical activity using wearable monitors is grounded in the measurement of energy expenditure. Six main categories of wearable monitors are currently available to investigators: pedometers, load transducers/foot-contact monitors, accelerometers, HR monitors, combined accelerometer and HR monitors, and multiple sensor systems. BEST PRACTICES Currently available monitors are capable of measuring total physical activity as well as components of physical activity that play important roles in human health. The selection of wearable monitors for measuring physical activity will depend on the physical activity component of interest, study objectives, characteristics of the target population, and study feasibility in terms of cost and logistics. FUTURE DIRECTIONS Future development of sensors and analytical techniques for assessing physical activity should focus on the dynamic ranges of sensors, comparability for sensor output across manufacturers, and the application of advanced modeling techniques to predict energy expenditure and classify physical activities. New approaches for qualitatively classifying physical activity should be validated using direct observation or recording. New sensors and methods for quantitatively assessing physical activity should be validated in laboratory and free-living populations using criterion methods of calorimetry or doubly labeled water.