Activpal3

Manufactured by PAL Technologies

Sourced in United Kingdom

The ActivPAL3 is a wearable device that uses accelerometers to monitor physical activity, posture, and sedentary behavior. It is designed to be worn on the thigh and provides objective data on time spent sitting, standing, and walking.

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Lab products found in correlation

Tegaderm transparent dressing, by 3M (1 mentions) Activpal, by PAL Technologies (1 mentions) Palstickies, by PAL Technologies (1 mentions) Freestyle libre pro, by Abbott (1 mentions) Adxl362, by Analog Devices (1 mentions)

15 protocols using activpal3

Measuring Physical Activity with ActivPAL

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The level of physical activity was checked using an accelerometer (activPAL3TM, PALTechnologies Ltd., Glasgow, United Kingdom). This evaluation was carried out 24 h after hospitalization and the beginning of the drug treatment, in which individuals should remain with the equipment for five days and removed in hospital discharge. In addition, it was performed after 30 days and three months of hospital discharge likewise.
Initially, the accelerometer was wrapped in plastic wrap paper and then placed under a transparent waterproof dressing (Tegaderm™ Roll) and fastened by a second transparent dressing (Hydrofilm Roll) in the middle third of the anterior region of the right thigh between the inguinal fold and the patella.
The ActivPALTM Professional software (Pal Technologies Ltd., 2013) was used to download and interpret the data. The data generated by the ActivPALTM Professional software was opened in Excel to calculate the daily time spent sitting/ lying down, standing, walking and number of steps.
The data analysis considered the sum of standing and walking time as active time and sitting and lying down time as inactive time. In addition, the analysis considered data for the average of five days and at least 10 h for monitoring the level of physical activity during waking hours were also considered [24] (link).

Oliveira B.S.V., Sentanin A.C., Bueno L.G., Carvalho Da Silva M.M., Arcuri J.F, & Pires Di Lorenzo V.A. (2021). Evaluation of the Level of Physical Activity and Muscle Strength of Quadriceps in Patients Hospitalized for E-COPD: A Longitudinal Study. COPD, 18(5).

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Multimodal Physical Activity Monitoring

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The free-living physical activity monitoring period involved participants wearing a wrist-worn accelerometer (GENEActiv, Activinsights, Kimbolton, UK) on their non-dominant wrist, and a thigh-worn accelerometer, the activPAL3 TM (PAL Technologies Ltd., Glasgow, UK). The activPAL was waterproofed with a nitrile sleeve and attached directly to the skin using a Hypafix dressing at the midline on the anterior aspect of the thigh; participants were asked, only to remove the activPAL to replace dressings. Participants were asked to wear the devices continuously 24 h per day for up to 8 days. Participants also completed a sleepwake log to help isolate sleep from waking behaviour.

Perks J., Mcbride P., Rayt H., Payne T., Edwardson C., Rowlands A.V., Messeder S.J., Yates T, & Sayers R. (2023). Efficacy of a personalised activity plan for BREAKing UP sitting time in patients with intermittent claudication (the BREAK UP study). Diabetes research and clinical practice, 204.

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Sedentary Behavior Assessment Protocol

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Sedentary behavior will be assessed by three indicators including total daily sedentary time, prolonged sedentary time (time spent sitting >30 minutes and >60 minutes), and number of sit-to-stand transitions. These three sedentary behaviors will be measured by 7 days of activPAL 3 (PAL Technologies, U.K) device monitoring prior to the beginning of the intervention/control protocol and again after the conclusion of the protocol for both study arms. The activPAL 3 monitor is a tri-axial accelerometer that also includes an inclinometer, worn on thigh (Fig 4). Due to the activPAL 3 position on the thigh, the activPAL 3 monitor is the most sensitive device to distinguish sitting (horizontal position) and standing (vertical position) [43 (link), 44 (link)]. The activPAL 3 has demonstrated great test-retest reliability and criterion validity with direct observation to classify sitting, standing, and stepping [45 (link)].

Park C., Larsen B., Mogos M., Muchira J., Dietrich M., LaNoue M., Jean J., Norfleet J., Doyle A., Ahn S, & Mulvaney S. (2024). A multiple technology-based and individually-tailored Sit Less program for people with cardiovascular disease: A randomized controlled trial study protocol. PLOS ONE, 19(5), e0302582.

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Postural and Stepping Assessment using ActivPAL3

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Posture and stepping were measured using the activPAL3, worn on the front of the thigh (PAL Technologies Ltd, Glasgow, UK). The monitor uses proprietary analysis algorithms to determine posture (sedentary time, upright time) and stepping (stepping time and steps). Each participant was fitted with four activPAL3 monitors randomly selected from a pool of 10. activPAL3 monitors were affixed to the skin with hydrogel pads as close as possible to the manufacturer's recommended position of a third of the way down the anterior thigh[14], three on the right leg (two piggybacked one on top of the other) and one on the left (supplementary figure S1). Placement was made by eye as no anatomical frame of reference for placement was provided by the manufacturer.

Sellers C., Dall P., Grant M, & Stansfield B. (2016). Validity and reliability of the activPAL3 for measuring posture and stepping in adults and young people. Gait & posture, 43.

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Measuring Physical Activity with activPAL3

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The activPAL3 (PAL Technologies Ltd, Glasgow, UK) is a single unit (2.4 x 4.3 x 0.5 cm 3 , 10g), tri-axial accelerometer with a sampling frequency of 20Hz. The activPAL3 was positioned on the anterior mid-thigh of the participants self-reported strongest or dominant leg and for the purposes of this study it was attached using micropore tape.

Coulter E.H., Miller L., McCorkell S., McGuire C., Algie K., Freeman J., Weller B., Mattison P.G., McConnachie A., Wu O, & Paul L. (2017). Validity of the activPAL3 activity monitor in people moderately affected by Multiple Sclerosis. Medical engineering & physics, 45.

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Physical Activity Monitoring with Inertial Sensor

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The daily walking duration (24 h) as proxy for physical activity is monitored with a thigh-worn inertial sensor for three consecutive weekdays (activPAL3™, PAL Technologies Ltd., Glasgow, UK) that was shown to be reliable and sufficient to predict habitual physical activity in older adults [48 (link), 49 (link)].

Dautel A., Eckert T., Gross M., Hauer K., Schäufele M., Lacroix A., Hendlmeier I., Abel B., Pomiersky R., Gugenhan J., Büchele G., Reber K.C., Becker C, & Pfeiffer K. (2019). Multifactorial intervention for hip and pelvic fracture patients with mild to moderate cognitive impairment: study protocol of a dual-centre randomised controlled trial (OF-CARE). BMC Geriatrics, 19, 125.

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Accelerometer-based Physical Activity Assessment

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Physical activity was assessed with the ActivPal™ (PAL Technologies Ltd, Glasgow, UK), a small, lightweight (35 × 53 × 7 mm, 15 g) piezoelectric triaxial accelerometer. The monitor was attached to participants’ upper thigh with hydrogel adhesion pads (PALstickies™, PAL Technologies Ltd, Galsgow, UK) and a Tegaderm™ transparent dressing (3M, St Paul, Minneapolis, USA). Accelerometry measurements were made at a sampling rate of 15 Hz and summarised into 15 s epochs, then downloaded and analysed using the manufacture’s software (ActivPal3™ version 7.1.18, PAL Technologies, Glasgow, UK).

Cho P.S., Vasudevan S., Maddocks M., Spinou A., Chamberlain Mitchell S., Wood C., Jolley C.J, & Birring S.S. (2019). Physical Inactivity in Pulmonary Sarcoidosis. Lung, 197(3), 285-293.

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Continuous Glucose Monitoring and Physical Activity

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Glucose concentrations were measured every 15 min using the Freestyle Libre Pro (Abbott), which was placed precisely at the back of the upper arm. The AUC and iAUC were calculated with the trapezoid rule over a 96‐h period using GraphPad Prism 8 (FAO/WHO, 1998 (link)). The baseline glucose concentration for the iAUC was determined by taking the average minimal 1‐h value of each measurement day.
Accelerometry‐based physical activity levels were measured using the activPAL3 (PAL Technologies Ltd), a validated accelerometer for measuring physical activity and sedentary behavior (Edwardson et al., 2017 (link)). The accelerometer was placed on the anterior side of the left thigh 10 cm above the patella to monitor daily activity patterns and was worn uninterrupted for a median duration of 120 h (range: 95–144 h). Data were processed using the PAL analysis software with the CREA algorithm (Version 8.11.4.61; PAL Technologies Ltd). Physical activity score expressed as the metabolic equivalent time of task per second (MET/s) and total sedentary time in seconds was extracted from the 15‐s epoch file.

Kleinloog J.P., Mensink R.P., Roodt J.O., Thijssen D.H., Hesselink M.K, & Joris P.J. (2022). Aerobic exercise training improves not only brachial artery flow‐mediated vasodilatation but also carotid artery reactivity: A randomized controlled, cross‐over trial in older men. Physiological Reports, 10(16), e15395.

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Measuring Physical Activity Post-Stroke

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Physical activity will be measured over 4 days using a triaxial accelerometer (activPAL3™, PAL Technologies Ltd., Glasgow, UK) secured to the middle of the anterior non-paretic thigh and reported as steps/day. This device has been shown to demonstrate concurrent validity for step count, by demonstrating low error (1.6%) and high concurrence with direction observation (ICC 0.99, 95% CI 0.98 to 1.0) in people with stroke walking in an outdoor circuit [37 (link)], and test-retest reliability when walking indoors across days (ICC 0.98, 95% CI 0.93–0.99) [37 (link)].

Brauer S.G., Kuys S.S., Paratz J.D, & Ada L. (2018). Improving physical activity after stroke via treadmill training and self management (IMPACT): a protocol for a randomised controlled trial. BMC Neurology, 18, 13.

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Validation of MOX Activity Logger

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The MOX Activity Logger (MOX; Maastricht Instruments, Maastricht, NL) (Maastricht Instruments BVa, 2020 ) contains a tri-axial accelerometer (ADXL362, Analog Devices, Norwood, MA, US). This small, light-weight, waterproof device (35 mm × 35 mm × 10 mm, 11 g) measures raw acceleration data (±8 g) in three orthogonal sensor axes (X, Y, and Z) at a 25 Hz sampling rate. The raw data is stored directly on the internal memory. The MOX has storage capacity and battery life for continuous measurements up to 7 days. Device configuration, data transfer and charging of the device are possible via an USB connection. Data analysis is performed offline. The MOX was worn in the front trouser pocket, attached with a clip, to secure a fixed orientation of the device with respect to axial mobility of the upper leg. This wear location is shown in Figure 1.
Two commonly used activity trackers, the activPAL (activPAL3, PAL Technologies Ltd, Glasgow, Scotland, UK) and the Fitbit Alta HR (Fitbit; Fitbit Inc., San Fransisco, CA, US) were used as reference for a more relevant interpretation of the validation results. Based on the recommendations of the manufactures the activPAL is worn on the dominant leg ten centimetres above the patella (activPAL) and the Fitbit is worn on the non-dominant wrist (Fitbit, 2020a ).

Ummels D., Bijnens W., Aarts J., Meijer K., Beurskens A.J, & Beekman E. (2020). The Validation of a Pocket Worn Activity Tracker for Step Count and Physical Behavior in Older Adults during Simulated Activities of Daily Living. Gerontology and Geriatric Medicine, 6, 2333721420951732.

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