Estimation of Energy Expenditure for Wheelchair Users Using a Physical Activity Monitoring System.
OBJECTIVE
To develop and evaluate energy expenditure (EE) estimation models for a physical activity monitoring system (PAMS) in manual wheelchair users with spinal cord injury (SCI).


DESIGN
Cross-sectional study.


SETTING
University-based laboratory environment, a semistructured environment at the National Veterans Wheelchair Games, and the participants' home environments.


PARTICIPANTS
Volunteer sample of manual wheelchair users with SCI (N=45).


INTERVENTION
Participants were asked to perform 10 physical activities (PAs) of various intensities from a list. The PAMS consists of a gyroscope-based wheel rotation monitor (G-WRM) and an accelerometer device worn on the upper arm or on the wrist. Criterion EE using a portable metabolic cart and raw sensor data from PAMS were collected during each of these activities.


MAIN OUTCOME MEASURES
Estimated EE using custom models for manual wheelchair users based on either the G-WRM and arm accelerometer (PAMS-Arm) or the G-WRM and wrist accelerometer (PAMS-Wrist).


RESULTS
EE estimation performance for the PAMS-Arm (average error ± SD: -9.82%±37.03%) and PAMS-Wrist (-5.65%±32.61%) on the validation dataset indicated that both PAMS-Arm and PAMS-Wrist were able to estimate EE for a range of PAs with <10% error. Moderate to high intraclass correlation coefficients (ICCs) indicated that the EE estimated by PAMS-Arm (ICC3,1=.82, P<.05) and PAMS-Wrist (ICC3,1=.89, P<.05) are consistent with the criterion EE.


CONCLUSIONS
Availability of PA monitors can assist wheelchair users to track PA levels, leading toward a healthier lifestyle. The new models we developed can estimate PA levels in manual wheelchair users with SCI in laboratory and community settings.
['Hiremath|Shivayogi V|SV|', 'Intille|Stephen S|SS|', 'Kelleher|Annmarie|A|', 'Cooper|Rory A|RA|', 'Ding|Dan|D|']
D061725:Accelerometry D000328:Adult D003430:Cross-Sectional Studies D004734:Energy Metabolism D015444:Exercise D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D018670:Monitoring, Ambulatory D013119:Spinal Cord Injuries D014910:Wheelchairs
Estimation Wheelchairs Spinal cord injuries Energy metabolism Exercise test Motor activity Rehabilitation Smartphone