Systematic Review of Accelerometer Responsiveness to Change for Measuring Physical Activity, Sedentary Behavior, or Sleep

Measurement of 24-hr movement behaviors is important for assessing adherence to guidelines, participation trends over time, group differences, and whether health-promoting interventions are successful. For a measurement tool to be useful, it must be valid, reliable, and able to detect change, the latter being a measurement property called responsiveness, sensitivity to change, or longitudinal validity. We systematically reviewed literature on the responsiveness of accelerometers to detect change in 24-hr movement behaviors. Databases (PubMed, Scopus, and EBSCOHost) were searched for peer-reviewed papers published in English between 1998 and 2023. Quality/risk of bias was assessed using a customized tool. This study is registered at https://osf.io/qrn8a. Twenty-six papers met the inclusion/exclusion criteria with an overall sample of 1,939 participants. Narrative synthesis was used. Most studies focused on adults (n = 21), and almost half (n = 12) included individuals with specific medical conditions. Studies primarily took place in free-living settings (n = 21) and used research-grade accelerometers (n = 24) worn on the hip (n = 18), thigh (n = 7), or wrist (n = 9). Outcomes included physical activity (n = 19), sedentary time/behavior (n = 12), or sleep (n = 2) and were calculated using proprietary formulas (e.g., Fitbit algorithm), cut points, and/or count-based methods. Most studies calculated responsiveness by comparing before versus after an intervention (n = 16). Six studies included a criterion measure to confirm that changes occurred. Limited research is available on the responsiveness of accelerometers for detecting change in 24-hr movement behaviors, particularly in youth populations, for sleep outcomes, and for commercial and thigh- or wrist-worn devices. Lack of a criterion measure precludes conclusions about the responsiveness even in more frequently studied outcomes/populations.