Agreement of objectively measured physical activity and sedentary time in preschool children

• Measurement error is a challenge in epidemiology.
• Accelerometers are highly used to assess physical activity level.
• Agreement for such measurements has not been determined.
• Physical activity and sedentary time varies substantially over time in preschoolers.
• Good methodological considerations are essential to arrive at valid conclusions.

ObjectiveTo determine the intra-individual agreement for objectively measured physical activity (PA) and sedentary behavior (SED) over two subsequent weeks in preschool children.MethodNinety-one children aged 3 to 5 years (49% boys) from three preschools in Sogn og Fjordane, Norway, provided 14 consecutive days of accelerometer data (Actigraph GT3X +) during the autumn of 2014. Week-by-week reliability was assessed using intraclass correlation (ICC), Bland–Altman plots and 95% limits of agreement for different wear time criteria (≥ 6, 8 and 10 h/day and ≥ 3 and 5 days/week).ResultsThe week-by-week ICC was ≥ 0.75 for all variables across all wear criteria applied, except for absolute sedentary time (ICC 0.61–0.81). Using a ≥ 8 h/day and ≥ 3 days/week criterion (n = 78), limits of agreement were ± 209.5 cpm for overall PA, ± 68.6 min/day for SED, ± 43.8 min/day for light PA, ± 20.2 min/day for moderate-to-vigorous PA, and ± 55.9 min/day for light-to-vigorous PA, equaling 1.0–1.6 standard deviation units.ConclusionConsiderable week-by-week variability was found for all variables. Researchers need to be aware of substantial intra-individual variability in accelerometer-measurements and take necessary actions according to the hypothesis under study, as noise in any measurement will preclude researchers' ability to arrive at valid conclusions in epidemiology.