Daily physical activity assessment with accelerometers: new insights and validation studies.

The field of application of accelerometry is diverse and ever expanding. Because by definition all physical activities lead to energy expenditure, the doubly labelled water (DLW) method as gold standard to assess total energy expenditure over longer periods of time is the method of choice to validate accelerometers in their ability to assess daily physical activities. The aim of this paper was to provide a systematic overview of all recent (2007-2011) accelerometer validation studies using DLW as the reference. The PubMed Central database was searched using the following keywords: doubly or double labelled or labeled water in combination with accelerometer, accelerometry, motion sensor, or activity monitor. Limits were set to include articles from 2007 to 2011, as earlier publications were covered in a previous review. In total, 38 articles were identified, of which 25 were selected to contain sufficient new data. Eighteen different accelerometers were validated. There was a large variability in accelerometer output and their validity to assess daily physical activity. Activity type recognition has great potential to improve the assessment of physical activity-related health outcomes. So far, there is little evidence that adding other physiological measures such as heart rate significantly improves the estimation of energy expenditure.