Abstract
Study design
Cross-sectional validation study.
Objectives
To develop a raw acceleration signal-based random forest (RF) model for predicting total energy expenditure (TEE) in manual wheelchair users (MWUs) and evaluate the preliminary field validity of this new model, along with four existing models published in prior literature, using the Doubly Labeled Water (DLW) method.
Setting
General community and research institution in Pittsburgh, USA.
Methods
A total of 78 participants’ data from two previous studies were used to develop the new RF model. A seven-day cross-sectional study was conducted to collect participants’ free-living physical activity and TEE data, resting metabolic rate, demographics, and anthropometrics. Ten MWUs with spinal cord injury (SCI) completed the study, with seven participants having valid data for evaluating the preliminary field validity of the five models.
Results
The RF model achieved a mean absolute error (MAE) of 0.59 ± 0.60 kcal/min and a mean absolute percentage error (MAPE) of 23.6% ± 24.3% on the validation set. For preliminary field validation, the five assessed models yielded MAE from 136 kcal/day to 1141 kcal/day and MAPE from 6.1% to 50.2%. The model developed by Nightingale et al. in 2015 achieved the best performance (MAE: 136 ± 96 kcal/day, MAPE: 6.1% ± 4.7%), while the RF model achieved comparable performance (MAE: 167 ± 99 kcal/day, MAPE: 7.4% ± 5.1%).
Conclusions
Two existing models and our newly developed RF model showed good preliminary field validity for assessing TEE in MWUs with SCI and the potential to detect lifestyle change in this population. Future large-scale field validation studies and model iteration are recommended.
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Data availability
The datasets supporting this study and the developed total energy expenditure prediction model are available upon reasonable request from the corresponding author.
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Acknowledgements
We would like to acknowledge and thank Steven J Anthony for his assistance in conducting the field validation study protocol and data collection.
Funding
This study was funded by the Veterans Affairs (VA) Rehabilitation Research & Development under Grant # 1I01RX000971-01A2 conducted at the Human Engineering Research Laboratories (Pittsburgh, PA) and the James J. Peters VA Medical Center (Bronx, NY). This study used data from another study conducted by our team and funded by the National Institute of Disability, Independent Living and Rehabilitation Research, Rehabilitation Engineering Research Center on Recreational Technologies Benefiting Individuals with Disabilities (#H133E120005), conducted at the Human Engineering Research Laboratories (Pittsburgh, PA) and the Lakeshore Foundation (Birmingham, AL). The content is solely the responsibility of the authors and does not represent the official views of the Department of Veterans Affairs or the United States Government.
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ZH was responsible for conducting the study protocol, screening potential participants, performing data collection and analysis, obtaining and interpreting results, updating reference lists, and developing this paper in its entirety. ALV was responsible for designing the protocol, screening potential participants, performing data collection and analysis, obtaining and interpreting results, and editing the paper. JPD was responsible for performing data analysis, obtaining the results, and editing the paper. DD provided guidance throughout the study, including formulating the paper plan, supervising data collection, data analysis, and result interpretation, as well as editing the paper.
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This study involves human participants and is in accordance with the Declaration of Helsinki. This study was approved by the Institutional Review Boards of the VA Pittsburgh Healthcare System (IRB#: 1617254) and the University of Pittsburgh (IRB#: STUDY19060030). We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research. Informed consent was obtained from all participants.
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Huang, Z., Veerubhotla, A.L., DeLany, J.P. et al. Preliminary field validity of ActiGraph-based energy expenditure estimation in wheelchair users with spinal cord injury. Spinal Cord 62, 514–522 (2024). https://doi.org/10.1038/s41393-024-01012-6
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DOI: https://doi.org/10.1038/s41393-024-01012-6
