Abstract
<title>Abstract</title> <p>BACKGROUND There has been an explosion in the usage of wearable devices to self-monitor physical activity in clinical population groups and the outputs gathered from these devices can be interpreted by healthcare professionals. This study aimed to explore how feedback from wearable devices translate to physical activity recommendations in wheelchair users with spinal cord injury (SCI). METHODS Data was pooled from four studies conducted between 2014 and 2023 in community-dwelling individuals with paraplegia (n = 60, aged: 45 ± 9 years, time since injury: 16 ± 11 years, neurological level of injury: T2–L2). 6 ± 1 days (daily wear time: 95 ± 3%) of individually calibrated Actiheart™ data were analysed to determine the volume of moderate-to-vigorous intensity activity (> 3 Metabolic Equivalents) that corresponded to the FAO/WHO/UNU guidance for a required physical activity level (PAL = Total Energy Expenditure/Resting Metabolic Rate) of 1.75. The Actiheart™ is a multi-sensor wearable device that has previously been validated specifically in individuals with SCI. RESULTS At the mean PAL (1.44 ± 0.15) reported in our cohort, total moderate-to-vigorous intensity physical activity was around 177 ± 214 minutes per week. Regression equations suggest that ~ 519 minutes per week represents a more appropriate target for wearable monitoring purposes to achieve the standardised PAL guidance of 1.75 from the FAO/WHO/UNU. This target accounts for normal moderate-to-vigorous intensity lifestyle activities and represents ~ 5% of a 24-hour period. CONCLUSIONS Our findings demonstrate that outputs from a research-grade wearable device are not compatible with current SCI-specific (90 minutes of moderate-to-vigorous intensity exercise per week) or general population physical activity (150 minutes of moderate-to-vigorous intensity activity per week). recommendations These guidelines refer to the amount of activity required on top of normal lifestyle activities (e.g., over-and-above normal moderate-to-vigorous lifestyle activities). Without the awareness raised by this analysis, healthcare practitioners, researchers or individuals with SCI self-monitoring physical activity levels using wearable devices may erroneously conclude that such recommendations are being substantially exceeded.</p>