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Cited by 81Physical Activity and HealthContext-Aware Activity Recognition SystemsErgonomics and Musculoskeletal Disorders

Validity of the ActivPAL monitor to distinguish postures: A systematic review

O’Brien, Myles W., Wu, Yanlin, Petterson, Jennifer L., Bray, Nick W., Kimmerly, Derek S.·2022·Gait & Posture
DOI 10.1016/j.gaitpost.2022.03.002
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Abstract

Background Posture has been recently integrated into activity guidelines, advising people to limit their sedentary time and break up sedentary postures with standing/stepping as much as possible. The thigh-worn activPAL is a frequently used objective measure of posture, but its validity has only been investigated by individual studies and has not been systematically reviewed.Research question Can the activPAL accurately characterize different postures?Methods A rigorous systematic review protocol was conducted, including multiple study screeners and determiners of study quality. To be included, validation studies had to examine the accuracy of an activPAL posture outcome relative to a criterion measure (e.g., direct observation) in adults (>18 years). Citations were not restricted to language or date of publication. Sources were searched on May 16, 2021 and included Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier. The study was pre-registered in Prospero (ID# CRD42021248240). Study quality was determined using a modified Hagströmer Bowles checklist. The results are presented narratively.Results Twenty-four studies (18 semi-structured laboratory arms, 8 uncontrolled protocol arms; 476 participants) met the inclusion criteria. Some studies (5/24) incorporated dual-monitor (trunk: 4/5; shin: 1/5) configurations. While heterogenous statistical procedures were implemented, most studies (n = 22/24) demonstrated a high validity (e.g., percent agreement >90%, no fixed bias, etc.) of the activPAL to measure sedentary and/or upright postures across semi-structured (17/18 arms) and uncontrolled study designs (7/8 arms). Specific experimental protocol factors (i.e., seat height, fidgeting, non-direct observation criterion comparator) likely explain the divergent reports that observed valid versus invalid findings. The study quality was 11.3 (standard deviation: 2.3) out of 19.Conclusion Despite heterogeneous methodological and statistical approaches, the included studies generally provide supporting evidence that the activPAL can accurately distinguish between sedentary and standing postures. Multiple activPAL monitor configurations (e.g., thigh and torso) are needed to better characterize sitting versus lying postures.

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Authors
O’Brien, M. W., Wu, Y., Petterson, J. L., Bray, N. W., & Kimmerly, D. S.
Affiliations
  • Dalhousie University (CA)
  • Acadia University (CA)
ORCID
Venue
Gait & Posture
Publisher
Elsevier BV
Published
2022-05
Volume
94
Pages
107-113
ISSN
0966-6362 (ISSN-L)
DOI
10.1016/j.gaitpost.2022.03.002
OpenAlex
W4220673832
Cited by
81
References
41
Citations by year
2026: 17 · 2025: 18 · 2024: 27 · 2023: 16 · 2022: 3
FWCI
2.20
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Gait & Posture (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
  • Social Sciences › Psychology › Social Psychology › Ergonomics and Musculoskeletal Disorders
Keywords
activPAL, posture monitoring, sedentary behavior, standing posture, lying posture, thigh-worn accelerometers, device validity, fidgeting
MeSH terms
Adult, Humans, Posture, Reproducibility of Results, Monitoring, Ambulatory, Sedentary Behavior, Torso, Accelerometry

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