Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, 58108, USA
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Concurrent validity of the Fitbit for assessing sedentary behavior and moderate-to-vigorous physical activity.
- Published on February 7, 2019
Recent advances in sensor technologies have promoted the use of consumer-based accelerometers such as Fitbit Flex in epidemiological and clinical research; however, the validity of the Fitbit Flex in measuring sedentary behavior (SED) and physical activity (PA) has not been fully determined against previously validated research-grade accelerometers such as ActiGraph GT3X+. Therefore, the purpose of this study was to examine the concurrent validity of the Fitbit Flex against ActiGraph GT3X+ in a free-living condition.
A total of 65 participants (age: M = 42, SD = 14 years, female: 72%) each wore a Fitbit Flex and GT3X+ for seven consecutive days. After excluding sleep and non-wear time, time spent (min/day) in SED and moderate-to-vigorous PA (MVPA) were estimated using various cut-points for GT3X+ and brand-specific algorithms for Fitbit, respectively. Repeated measures one-way ANOVA and mean absolute percent errors (MAPE) served to examine differences and measurement errors in SED and MVPA estimates between Fitbit Flex and GT3X+, respectively. Pearson and Spearman correlations and Bland-Altman (BA) plots were used to evaluate the association and potential systematic bias between Fitbit Flex and GT3X+. PROC MIXED procedure in SAS was used to examine the equivalence (i.e., the 90% confidence interval with ±10% equivalence zone) between the devices.
Fitbit Flex produced similar SED and low MAPE (mean difference [MD] = 37 min/day, P = .21, MAPE = 6.8%), but significantly higher MVPA and relatively large MAPE (MD = 59-77 min/day, P < .0001, MAPE = 56.6-74.3%) compared with the estimates from GT3X+ using three different cut-points. The correlations between Fitbit Flex and GT3X+ were consistently higher for SED (r = 0.90, ρ = 0.86, P < .01), but weaker for MVPA (r = 0.65-0.76, ρ = 0.69-0.79, P < .01). BA plots revealed that there is no apparent bias in estimating SED.
In comparison with the GT3X+ accelerometer, the Fitbit Flex provided comparatively accurate estimates of SED, but the Fitbit Flex overestimated MVPA under free-living conditions. Future investigations using the Fitbit Flex should be aware of present findings.
- Redenius N 1
- Kim Y 2,3
- Byun W 4
Division of Kinesiology, School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Room 301D 3/F, Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong
MRC Epidemiology Unit, University of Cambridge School of Medicine, Cambridge, Cambridgeshire, UK
Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT, 84112, USA
BMC Medical Research Methodology