Intensity thresholds on raw acceleration data: Euclidean norm minus one (ENMO) and mean amplitude deviation (MAD) approaches

© 2016 Bakrania et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Objectives (1) To develop and internally-validate Euclidean Norm Minus One (ENMO) and Mean Amplitude Deviation (MAD) thresholds for separating sedentary behaviours from common light-intensity physical activities using raw acceleration data collected from both hip-and wrist-worn tri-axial accelerometers; and (2) to compare and evaluate the performances between the ENMO and MAD metrics. Methods Thirty-three adults [mean age (standard deviation (SD)) = 27.4 (5.9) years; mean BMI (SD) = 23.9 (3.7) kg/m2; 20 females (60.6%)] wore four accelerometers; an ActiGraph GT3X+ and a GENEActiv on the right hip; and an ActiGraph GT3X+ and a GENEActiv on the nondominant wrist. Under laboratory-conditions, participants performed 16 different activities (11 sedentary behaviours and 5 light-intensity physical activities) for 5 minutes each. ENMO and MAD were computed from the raw acceleration data, and logistic regression and receiver-operating-characteristic (ROC) analyses were implemented to derive thresholds for activity discrimination. Areas under ROC curves (AUROC) were calculated to summarise performances and thresholds were assessed via executing leave-one-out-crossvalidations. Results For both hip and wrist monitor placements, in comparison to the ActiGraph GT3X+ monitors, the ENMO and MAD values derived from the GENEActiv devices were observed to be slightly higher, particularly for the lower-intensity activities. Monitor-specific hip and wrist ENMO and MAD thresholds showed excellent ability for separating sedentary behaviours from motion-based light-intensity physical activities (in general, AUROCs >0.95), with validation indicating robustness. However, poor classification was experienced when attempting to isolate standing still from sedentary behaviours (in general, AUROCs