Comparing Cadence-Based and Machine Learning Based Estimates for Physical Activity Intensity Classification: the UK Biobank

Objectives: Cadence thresholds have been widely used to categorize physical activity intensity in health-related research. We examined the convergent validity of two cadence-based intensity classification approaches against a machine-learning-based intensity schema in 84,315 participants (>= 40 years) with wrist-worn accelerometers. Design: Validity study. Methods: Both cadence-based methods (one-level cadence, two-level cadence) calculated intensity-specific time based on cadence-thresholds while the two-level cadence identified stepping behaviors first. We used an overlapping plot, mean absolute error, and Spearman's correlation coefficient to examine agreements between the cadence-based and machine-learning methods. We also evaluated agreements between methods based on practically-important-difference (moderate-to-vigorous-physical activity: +/- 20 min/day, moderate-physical activity: +/- 15, vigorous-physical activity: +/- 2.5, light-physical activity: +/- 30). Results: The group-level (median) minutes of moderate-to-vigorous- and moderate-physical activity estimated by one-level cadence were within the range of practically-important-difference compared to the machine-learning method (bias of median: moderate-to-vigorous-physical activity, -3.5, interquartile range [-15.8, 12.2]; moderate-physical activity, -6.0 [-17.2, 4.1]). The group-level vigorous- and light-physical activity minutes derived by two-level cadence were within practically-important-difference range (vigorous-physical activity: -0.9 [-3.1, 0.5]; light-physical activity, -1.3 [-28.2, 28.9]). The individual-level differences between the cadencebased and machine learning methods were high across intensities (e.g., moderate-to-vigorous-physical activity: mean absolute error [one-level cadence: 24.2 min/day; two-level cadence: 26.2]), with the proportion of participants within the practically-important-difference ranging from 8.4 % to 61.6 %. Conclusions: One-level cadence showed acceptable group-level estimates of moderate-to-vigorous and moderate-physical activity while two-level cadence showed acceptable group-level estimates of vigorous- and lightphysical activity. The cadence-based methods might not be appropriate for individual-level intensity-specific time estimation. (c) 2024 The Authors. Published by Elsevier Ltd on behalf of Sports Medicine Australia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).