Sports Medicine

, Volume 31, Issue 2, pp 91–100 | Cite as

Challenges and Opportunities for Measuring Physical Activity in Sedentary Adults

  • Catrine E. Tudor-Locke
  • Anita M. Myers
Review Article

Abstract

Increasing the physical activity of typically sedentary adult populations is at the forefront of the public health agenda. This review addresses the challenges in defining and measuring physical activity in this target group, for a number of purposes, namely, scientific or academic inquiry, surveillance, clinical application and programme evaluation. First, we clarify the conceptual distinctions between the terms sedentarism, physical inactivity, physical activity and energy expenditure. Next, we review and compare the utility of different approaches for quantifying and expressing physical activity in these populations. Physical activity in typically sedentary populations is most likely a simple pattern of behaviour that has been largely obscured by existing measures and its expression as energy expenditure. Existing self-report methods are practical, but suffer from floor effects and recall bias. Walking, the most important activity to assess in this target group, is very difficult to measure through self-report methods. Motion sensors are more appropriate for quantifying physical activity behaviours in typically sedentary populations. Of the 2 types of motion sensors — the accelerometer and the pedometers — the latter is more appealing because it is both an affordable and a ‘good enough’ measure of physical activity, specifically ambulatory activity. Although a common measurement approach would greatly facilitate our understanding of physical activity behaviour patterns, the selection of an approach ultimately depends on the purpose of the study and to a great extent, its budget. Researchers, clinicians and practitioners interested in accurately capturing the lower end of the continuum of physical activity (that is characteristic of sedentary populations) must thoughtfully consider the relative advantages and disadvantages of the available approaches.

References

  1. 1.
    US Surgeon General. Surgeon General’s report on physical activity and health. JAMA 1996 Aug 21; 276 (7): 522CrossRefGoogle Scholar
  2. 2.
    Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995; 273 (5): 402–7PubMedCrossRefGoogle Scholar
  3. 3.
    Dunn AL, Anderson RE, Jakicic JM. Lifestyle physical activity interventions: History, short- and long-term effects, and recommendations. Am J Prev Med 1998; 15 (4): 398–412PubMedCrossRefGoogle Scholar
  4. 4.
    US Department of Health and Human Services. Healthy people 2000: midcourse review and 1995 revisions. Washington, DC: Department of Health and Human Services, 1995Google Scholar
  5. 5.
    Taylor WC, Baranowksi T, Young DR. Physical activity interventions in low-income, ethnic minority, and populations with disability. Am J Prev Med 1998; 15 (4): 334–43PubMedCrossRefGoogle Scholar
  6. 6.
    King AC, Rejeski J, Buchner DM. Physical activity interventions targeting older adults: a critical review and recommendations. Am J Prev Med 1998; 15 (4): 316–33PubMedCrossRefGoogle Scholar
  7. 7.
    Masse LC, Ainsworth BE, Tortolero S, et al. Measuring physical activity in midlife, older and minority women: issues from an expert panel. J Womens Health 1998; 7 (1): 57–67PubMedCrossRefGoogle Scholar
  8. 8.
    Sarkin JA, Nichols JF, Sallis JF, et al. Self-report measures and scoring protocols affect prevalence of estimates of meeting physical activity guidelines. Med Sci Sports Exerc 2000; 32 (1): 149–56PubMedGoogle Scholar
  9. 9.
    Bernstein MS, Morabia A, Sloutskis D. Definition and prevalence of sedentarism in an urban population. Am J Public Health 1999; 89 (6): 862–7PubMedCrossRefGoogle Scholar
  10. 10.
    Weyer C, Linkeschowa R, Heise T, et al. Implications of the traditional and the new ACSM Physical Activity Recommendations on weight reduction in dietary treated obese subjects. Int J Obes 1998; 22: 1071–8CrossRefGoogle Scholar
  11. 11.
    Webster’s new world dictionary and thesaurus. New York (NY): Macmillan, Inc., 1996Google Scholar
  12. 12.
    Dietz WH. The role of lifestyle in health: the epidemiology and consequences of inactivity. Proc Nutr Soc 1996; 55: 829–40PubMedCrossRefGoogle Scholar
  13. 13.
    Ainsworth BA, Haskell WL, Leon AS, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 1993; 25: 71–80PubMedCrossRefGoogle Scholar
  14. 14.
    Sidney S, Sternfeld B, Haskell WL, et al. Television viewing and cardiovascular risk factors in young adults: the CARDIA study. Ann Epidemiol 1996 Mar; 6 (2): 154–9PubMedCrossRefGoogle Scholar
  15. 15.
    Tucker LA, Friedman GM. Television viewing and obesity in adult males. Am J Public Health 1989; 79 (4): 516–8PubMedCrossRefGoogle Scholar
  16. 16.
    Tucker LA. Television viewing and physical fitness in adults. Res Q Exerc Sport 1990; 61 (4): 315–20PubMedGoogle Scholar
  17. 17.
    Tucker LA, Bagwell M. Television viewing and obesity in adult females. Am J Public Health 1991;81(7):908–11PubMedCrossRefGoogle Scholar
  18. 18.
    Jeffery RW, French SA. Epidemic obesity in the United States: are fast foods and television viewing contributing? Am J Public Health 1998; 88 (2): 277–80PubMedCrossRefGoogle Scholar
  19. 19.
    Fitzgerald SJ, Kriska AM, Pereira MA, et al. Associations among physical activity, television watching, and obesity in adult Pima Indians. Med Sci Sports Exerc 1997; 29 (7): 910–5PubMedCrossRefGoogle Scholar
  20. 20.
    Gortmaker SL, Dietz WH, Cheung LWY. Inactivity, diet, and the fattening of America. J Am Diet Assoc 1990;90(9):1247–55PubMedGoogle Scholar
  21. 21.
    Ching P, Willett WC, Rimm EB, et al. Activity level and risk of overweight in male health professionals. Am J Public Health 1996; 86 (1): 25–30PubMedCrossRefGoogle Scholar
  22. 22.
    Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985; 100 (2): 126–30PubMedGoogle Scholar
  23. 23.
    Rowlands AV, Eston RG, Ingledew EK. Measurement of physical activity in children with particular reference to the use of heart rate and pedometry. Sports Med 1997; 24 (4): 258–72PubMedCrossRefGoogle Scholar
  24. 24.
    Bursztain S, Elwyn DH, Askanazi J, et al. The theoretical framework of indirect calorimetry and energy balance. In: Bursztein S, Elwyn DH, Askanazi J, et al. Energy metabolism and indirect calorimetry. Baltimore (MD): Williams and Wilkins, 1989Google Scholar
  25. 25.
    Westerkerp KR. Assessment of physical activity level in relation to obesity: current evidence and research issues. Med Sci Sports Exerc 1999; 31 (Suppl. 11): S522–5Google Scholar
  26. 26.
    Starling RD, Matthews DE, Ades PA, et al. Assessment of physical activity in older individuals: a doubly labelled water study. J App Physiol 1999; 86 (6): 2090–6Google Scholar
  27. 27.
    Ainsworth BE, Sternfeld B, Slattery ML, et al. Physical activity and breast cancer: evaluation of physical activity assessment methods. Cancer 1998; 83 (3): 611–20PubMedCrossRefGoogle Scholar
  28. 28.
    Dishman RK. The measurement conundrum in exercise adherence research. Med Sci Sports Exerc 1994; 26: 1382–90PubMedGoogle Scholar
  29. 29.
    Blair SN. How to assess exercise habits and physical fitness. In: Matarazzo JD, Weiss SM, Herd JA, et al., editors. Behavioral health: a handbook of health enhancement and disease prevention. New York (NY): Wiley, 1984: 424–47Google Scholar
  30. 30.
    Kriska AM, Caspersen CJ. A collection of physical activity questionnaires for health-related research. Med Sci Sports Exerc 1997; 29 (Suppl. 6): S1–205Google Scholar
  31. 31.
    Jacobs DR, Ainsworth BE, Hartman TJ, et al. A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc 1992; 25 (1): 81–91Google Scholar
  32. 32.
    Blair SN, Haskell WL, Ho P, et al. Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments. Am J Epidemiol 1985; 122 (5):794–804PubMedGoogle Scholar
  33. 33.
    Hays LM, Clark DO. Correlates of physical activity in a sample of older adults with type 2 diabetes. Diabetes Care 1999; 22 (5): 706–12PubMedCrossRefGoogle Scholar
  34. 34.
    Kriska AM, Knowler WC, LaPorte RE, et al. Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care 1990; 13 (4): 401–11PubMedCrossRefGoogle Scholar
  35. 35.
    Ainsworth BE, Leon AS, Richardson MT, et al. Accuracy of the college alumnus physical activity questionnaire. J Clin Epidemiol 1993; 46: 1403–11PubMedCrossRefGoogle Scholar
  36. 36.
    Richardson MT, Leon AS, Jacobs DR, et al. Comprehensive evaluation of the Minnesota Leisure Time Physical Activity Questionnaire. J Clin Epidemiol 1993; 47: 271–81CrossRefGoogle Scholar
  37. 37.
    Siegal PZ, Brackbill RM, Health GW. The epidemiology of walking for exercise: implications for promoting activity among sedentary groups. Am J Public Health 1995; 85 (5): 706–10CrossRefGoogle Scholar
  38. 38.
    Durante R, Ainsworth BE. The recall of physical activity: using a cognitive model of the question-answering process. Med Sci Sports Exerc 1996; 28 (10): 1282–91PubMedCrossRefGoogle Scholar
  39. 39.
    Meijer GAL, Westerterp KR, Verhoeven FMH, et al. Methods to assess physical activity with special reference to motion sensors and accelerometers. IEEE Trans Biomed Eng 1991; 38 (3): 221–9PubMedCrossRefGoogle Scholar
  40. 40.
    Westerkerp KR. Physical activity assessment with accelerometers. Int J Obes Relat Metab Disord 1999; 23 (Supp1.3): S45–9CrossRefGoogle Scholar
  41. 41.
    Prentice AM, Goldberg GR, Murgatroyd PR, et al. Physical activity and obesity: problems in correcting expenditure for body size. Int J Obes Relat Metab Disord 1996; 20: 688–91PubMedGoogle Scholar
  42. 42.
    Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science Applications, Inc. accelerometer. Med Sci Sports Exere 1998; 30 (5): 777–81CrossRefGoogle Scholar
  43. 43.
    Johnson RK, Russ J, Goran MI. Physical activity related energy expenditure in children by doubly labelled water as compared with the Caltrac accelerometer. Int J Obes Relat Metab Disord 1998; 22: 1046–52PubMedCrossRefGoogle Scholar
  44. 44.
    Bray MS, Wong WW, Morrow JR, et al. Caltrac versus calorimeter determination of 24-h energy expenditure in female children and adolescents. Med Sci Sports Exerc 1994; 26 (12): 1524–30PubMedGoogle Scholar
  45. 45.
    Chen KY, Sun M. Improving energy expenditure estimation by using a triaxial accelerometer. J App Physiol 1997; 83 (6): 2112–22Google Scholar
  46. 46.
    Tryon WW, Pinto LP, Morrison DF. Reliability assessment of pedometer activity measurements. J Psychopathol Behav Assess 1991; 13 (1): 27–44CrossRefGoogle Scholar
  47. 47.
    Bassett DR, Ainsworth BE, Leggett SR, et al. Accuracy of five electronic pedometers for measuring distance walked. Med Sci Sports Exerc 1996; 28 (8): 1071–7PubMedCrossRefGoogle Scholar
  48. 48.
    Tryon WW, editor. Behavioral assessment in behavioral medicine. New York (NY): Springer Publishing Company, Inc., 1985Google Scholar
  49. 49.
    Montoye HJ, Kemper HCG, Saris WHM, et al. Measuring physical activity and energy expenditure. Champaign (IL): Human Kinetics, 1996Google Scholar
  50. 50.
    Shepherd EF, Toloza E, McClung CD, et al. Step activity monitor: increased accuracy in quantifying ambulatory activity. J Orthop Res 1999; 17 (5): 703–8PubMedCrossRefGoogle Scholar
  51. 51.
    Hatano Y. Use of the pedometer for promoting daily walking exercise. Int Council Health Phys Educ Rec 1993; 29: 4–8Google Scholar
  52. 52.
    Lee CJ, Lawler GS, Panemangalore M, et al. Nutritional status of middle-aged and elderly females in Kentucky in two seasons. Part I: body weight and related factors. J Am Coll Nutr 1987 Jun; 6 (3): 209–15PubMedGoogle Scholar
  53. 53.
    Bassett DR, Cureton AL, Ainsworth BE. Measurement of daily walking distance: questionnaire versus pedometer. Med Sci Sports Exerc 2000; 32 (5): 1018–23PubMedGoogle Scholar
  54. 54.
    Shephard RJ. Assessment of physical activity and energy needs. Am J Clin Nutr 1989; 50: 1195–200PubMedGoogle Scholar
  55. 55.
    Bassey EJ, Dallosso HM, Fentem PH, et al. Validation of a simple walking mechanical accelerometer (pedometer) for the estimation of walking activity. Eur J Appl Physiol 1987; 56: 323–30CrossRefGoogle Scholar
  56. 56.
    Kashiwazaki H, Inaoka T, Suzuki T, et al. Correlations of pedometer readings with energy expenditure in workers during free-living daily activities. Eur J Appl Physiol 1986; 54: 585–90CrossRefGoogle Scholar
  57. 57.
    Saris WHM, Binkhorst RA. The use of pedometer and actometer in studying daily physical activity in man. Part II: validity of pedometer and actometer measuring the daily physical activity. Eur J Appl Physiol Occup Physiol 1977; 37: 229–35PubMedCrossRefGoogle Scholar
  58. 58.
    Bassey EJ, Bendall MJ, Pearson M. Muscle strength in the triceps surae and objectively measured customary walking activity in men and women over 65 years of age. Clin Sci (Colch) 1988; 74 (1): 85–9Google Scholar
  59. 59.
    Voorrips LE, Ravelli ACJ, Dongelmans PCA, et al. A physical activity questionnaire for the elderly. Med Sci Sports Exerc 1991; 23 (8): 974–9PubMedGoogle Scholar
  60. 60.
    Sequeira MM, Rickenbach M, Wietlisbach V, et al. Physical activity assessment using a pedometer and its comparison with a questionnaire in a large population study. Am J Epidemiol 1995; 142 (9): 989–99PubMedGoogle Scholar
  61. 61.
    Ichihara Y, Hattori R, Anno T, et al. Oxygen uptake and its relation to physical activity and other coronary risk factors in asymptomatic middle-aged Japanese. J Cardiopulm Rehabil 1996; 16: 378–85PubMedCrossRefGoogle Scholar
  62. 62.
    Cowley AJ, Fullwood L, Stainer K, et al. Exercise tolerance in patients with heart failure: how should it be measured? Eur Heart J 1991; 12: 50–4PubMedGoogle Scholar
  63. 63.
    Walsh JT, Charlesworth A, Andrews R, et al. Relation of daily activity levels in patients with chronic heart failure to long-term prognosis. Am J Cardiol 1997; 79: 1364–9PubMedCrossRefGoogle Scholar
  64. 64.
    Gardner AW, Sieminski DJ, Killewich LA. The effect of cigarette smoking on free-living daily physical activity in older claudication patients. Angiology 1997; 48 (11): 947–55PubMedCrossRefGoogle Scholar
  65. 65.
    Schmalzried TP, Szuszczewicz ES, Northfield MR, et al. Quantitative assessment of walking activity after total hip or knee replacement. J Bone Joint Surg Am 1998; 80 (1): 54–9PubMedCrossRefGoogle Scholar
  66. 66.
    Sieminski DJ, Cowell LL, Montgomery PS. Physical activity monitoring in patients with peripheral arterial occlusive disease. J Cardiopulm Rehabil 1997; 17: 43–7PubMedCrossRefGoogle Scholar
  67. 67.
    Tryon WW, Goldberg JL, Morrison DF. Activity decreases as percentage of overweight increases. Int J Obes 1992; 16: 591–5Google Scholar
  68. 68.
    Bassey EJ, Patrick JM, Irving JM, et al. An unsupervised ‘aerobics’ physical training programme in middle-aged factory workers: feasibility, validation, and response. Eur J Appl Physiol 1983; 52: 120–5CrossRefGoogle Scholar
  69. 69.
    Yamanouchi K, Takashi T, Chikada K, et al. Daily walking combined with diet therapy is a useful means for obese NIDDM patients not only to reduce body weight but also to improve insulin sensitivity. Diabetes Care 1995; 18 (6): 775–8PubMedCrossRefGoogle Scholar
  70. 70.
    Meshkinpour H, Selod S, Movahedi H, et al. Effects of regular exercise in management of chronic idiopathic constipation. Dig Dis Sci 1998; 43 (11): 2379–83PubMedCrossRefGoogle Scholar
  71. 71.
    Fogelholm M, Kukkonen-Harjula K, Oja P. Eating control and physical activity as determinants of short-term weight maintenance after a very-low-calorie diet among obese women. Int J Obes Relat Metab Disord 1998; 23: 203–10CrossRefGoogle Scholar
  72. 72.
    Saris WHM, Binkhorst RA. The use of pedometer and actometer in studying daily physical activity in man. Part I: reliability of pedometer and actometer. Eur J Appl Physiol Occupa Physiol 1977; 37: 219–28CrossRefGoogle Scholar
  73. 73.
    Myers AM. Program evaluation for exercise leaders. Champaign (IL): Human Kinetics, 1999Google Scholar

Copyright information

© Adis International Limited 2001

Authors and Affiliations

  • Catrine E. Tudor-Locke
    • 1
    • 2
  • Anita M. Myers
    • 1
    • 2
  1. 1.Department of Health Studies and GerontologyThe University of WaterlooWaterlooCanada
  2. 2.The Centre for Activity and AgeingThe University of Western Ontario and St. Joseph’s Health CentreLondonCanada
  3. 3.Prevention Research Center, Nonnan J. Arnold School of Public HealthUniversity of South CarolinaColumbiaUSA

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