Skip to main content
Log in

Physical Activity Assessment in Children and Adolescents

  • Review Article
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

Chronic disease risk factors, including a sedentary lifestyle, may be present even in young children, suggesting that early prevention programmes may be critical to reducing the rates of chronic disease. Accurate assessment of physical activity in children is necessary to identify current levels of activity and to assess the effectiveness of intervention programmes designed to increase physical activity. This article summarises the strengths and limitations of the methods used to evaluate physical activity in children and adolescents. MEDLINE searches and journal article citations were used to locate 59 articles that validated physical activity measurement methods in children and adolescents. Only those methods that were validated against a more stringent measure were included in the review.

Based on the definition of physical activity as any bodily movement resulting in energy expenditure (EE), direct observation of the individual’s movement should be used as the gold standard for physical activity research. The doubly labelled water technique and indirect calorimetry can also be considered criterion measures for physical activity research, because they measure EE, a physiologic consequence closely associated with physical activity. Devices such as heart rate monitors, pedometers and accelerometers have become increasingly popular as measurement tools for physical activity. These devices reduce the subjectivity inherent in survey methods and can be used with large groups of individuals. Heart rate monitoring is sufficiently valid to use in creating broad physical activity categories (e.g. highly active, somewhat active, sedentary) but lacks the specificity needed to estimate physical activity in individuals. Laboratory and field validations of pedometers and accelerometers yield relatively high correlations using oxygen consumption (r = 0.62 to 0.93) or direct observation (r = 0.80 to 0.97) as criterion measures, although, they may not be able to capture all physical activity.

Physical activity has traditionally been measured with surveys and recall instruments. These techniques must be used cautiously in a paediatric population that has difficulty recalling such information. Still, some studies have reported 73.4% to 86.3% agreement between these instruments and direct observation. Future investigations of physical activity instruments should validate the novel instrument against a higher standard. Additional studies are needed to investigate the possibility of improving the accuracy ofmeasurement by combining 2 or more techniques. The accurate measurement of physical activity is critical for determining current levels of physical activity, monitoring compliance with physical activity guidelines, understanding the dose-response relationship between physical activity and health and determining the effectiveness of intervention programmes designed to improve physical activity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Table I
Table II
Table III
Table IV
Table V
Table VI
Table VII
Table VIII

Similar content being viewed by others

References

  1. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985; 100: 126–31

    PubMed  CAS  Google Scholar 

  2. Berenson GS, McMahon CA, Voors AW, et al. Cardiovascular risk factors in children: the early natural history of atherosclerosis and essential hypertension. New York: Oxford University Press, 1980

    Google Scholar 

  3. Pate RR, Pratt M, Blair SN, et al. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995; 273 (5): 402–7

    Article  PubMed  CAS  Google Scholar 

  4. U.S. Department of Health and Human Services. Physical activity and health: a report of the surgeon general. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996

    Google Scholar 

  5. Bao W, Srinivasan SR, Wattigney WA, et al. Persistence of multiple cardiovascular risk clustering related to Syndrome X from childhood to young adulthood. Arch Intern Med 1994; 154: 1842–7

    Article  PubMed  CAS  Google Scholar 

  6. Lauer RM, Connor WE, Learverton PE, et al. Coronary heart disease risk factors in school children: the Muscatine Study. J Pediatr 1975; 86 (5): 697–706

    Article  PubMed  CAS  Google Scholar 

  7. Williams CL, Carter BJ, Wynder EL. Prevalence of selected cardiovascular and cancer risk factors in a pediatric population: the ’Know Your Body’ Project, New York. Prev Med 1981; 10: 235–50

    Article  PubMed  CAS  Google Scholar 

  8. Grundy SM, Blackburn G, Higgins M, et al. Physical activity in the prevention and treatment of obesity and its comorbidities. Med Sci Sports Exerc 1999; 31 (11 Suppl.): 502–8

    Google Scholar 

  9. Hill JO, Trowbridge FL. Childhood obesity: future directions and research priorities. Pediatrics 1998; 101: 570–4

    Article  PubMed  CAS  Google Scholar 

  10. Laporte RE, Montoye HJ, Caspersen CJ. Assessment of physical activity in epidemiologic research: problems and prospects. Public Health Rep 1985; 100: 131–46

    PubMed  CAS  Google Scholar 

  11. Katzmarzyk PT, Malina RM, Song TM, et al. Physical activity and health-related fitness in youth: a multivariate analysis. Med Sci Sports Exerc 1998; 30 (5): 709–14

    Article  PubMed  CAS  Google Scholar 

  12. MacAuley D, McCrum EE, Stott G, et al. Levels of physical activity, physical fitness and their relationship in the Northern Ireland Health and Activity Survey. Int J Sports Med 1998; 19 (7): 503–11

    Article  PubMed  CAS  Google Scholar 

  13. Puhl J, Greaves KA, Hoyt M, et al. Children’s activity rating scale (CARS): description and evaluation. Res Q Exerc Sport 1990; 61 (1): 26–36

    PubMed  CAS  Google Scholar 

  14. Bailey RC, Olson J, Pepper SL, et al. The level and tempo of children’s physical activities: an observational study. Med Sci Sports Exerc 1995; 27 (7): 1033–41

    Article  PubMed  CAS  Google Scholar 

  15. Epstein LH, McGowan C, Woodall K. A behavioral observation system for free play activity in young overweight female children. Res Q Exerc Sport 1984; 55 (2): 180–3

    Google Scholar 

  16. O’Hara NM, Baranowski T, Simons-Morton BG, et al. Validity of the observation of children’s physical activity. Res Q Exerc Sport 1989; 60 (1): 42–7

    PubMed  Google Scholar 

  17. McKenzie T, Sallis JF, Patterson T, et al. BEACHES: an observational system for assessing children’s eating and physical activity behaviors and associated events. Appl Behav Anal 1991; 24 (1): 141–51

    Article  CAS  Google Scholar 

  18. Rowe PJ, Schuldheisz JM, van der Mars H. Validation of SOFIT for measuring physical activity of first- to eighth-grade students. Pediatr Exerc Sci 1997; 9 (2): 136–49

    Google Scholar 

  19. McKenzie T, Sallis JF, Nader PR. SOFIT: system for observing fitness instruction time. J Teach Phys Educ 1992; 62: 195–205

    Google Scholar 

  20. Klesges RC, Coates TJ, Moldenhauer-Klesges L, et al. The FATS: an observational system for assessing physical activity in children and associated parent behavior. Behav Assess 1984; 6: 333–45

    Google Scholar 

  21. McKenzie T. Observational measures of children’s physical activity. J Sch Health 1991; 61 (5): 220–3

    Article  Google Scholar 

  22. Schoeller DA, Ravussin E, Schutz Y, et al. Energy expenditure by doubly labelled water: validation in humans and proposed calculation. Am J Physiol 1986; 250 (5 Pt 2): R823–30

    Google Scholar 

  23. Klein PD, James WPT, Wong WW, et al. Calorimetric validation of the doubly-labelled water method for determination of energy expenditure in man. Human Nutr Clin Nutr 1984; 38: 95–106

    CAS  Google Scholar 

  24. Schoeller DA, Webb P. Five-day comparison of the doubly labeled water method with respiratory gas exchange. Am J Clin Nutr 1984; 40: 153–8

    PubMed  CAS  Google Scholar 

  25. Jones PJ, Winthrop AL, Schoeller DA, et al. Validation of doubly labelled water for assessing energy expenditure in infants. Pediatr Res 1987; 21 (3): 242–6

    Article  PubMed  CAS  Google Scholar 

  26. Goran MI, Carpenter WH, Poehlman ET. Total energy expenditure in 4- to 6-yr-old children. Am J Physiol 1993; 264 (5 Pt 1): E706–11

    Google Scholar 

  27. Bitar A, Vermorel M, Fellmann N, et al. Heart rate recording method validated by whole body indirect calorimetry in 10- yr-old children. J Appl Physiol 1996 Sep; 81 (3): 1169–73

    PubMed  CAS  Google Scholar 

  28. Emons HJ, Groenenboom DC, Westerterp KR, et al. Comparison of heart rate monitoring combined with indirect calorimetry and the doubly labelled water (2H2(18)O) method for the measurement of energy expenditure in children. Eur J Appl Physiol 1992; 65 (2): 99–103

    Article  CAS  Google Scholar 

  29. Eston RG, Rowlands AV, Ingledew DK. Validity of heart rate, pedometry, and accelerometry for predicting the energy cost of children’s activity. J Appl Physiol 1998; 84 (1): 362–71

    PubMed  CAS  Google Scholar 

  30. Louie L, Eston RG, Rowlands AV, et al. Validity of heart rate, pedometry, and accelerometry for estimating the energy cost of activity in Hong Kong Chinese boys. Pediatr Exerc Sci 1999; 11 (3): 229–39

    Google Scholar 

  31. Sallis JF, Buono MJ, Roby J, et al. The Caltrac accelerometer as a physical activity monitor for school-age children. Med Sci Sports Exerc 1990; 22 (5): 698–703

    Article  PubMed  CAS  Google Scholar 

  32. Troutman SR, Allor KM, Hartmann DC, et al. MINI-LOGGER reliability and validity for estimating energy expenditure and heart rate in adolescents. Res Q Exerc Sport 1999 Mar; 70 (1): 70–4

    PubMed  CAS  Google Scholar 

  33. Freedson PS. Electronic motion sensors and heart rate as measures of physical activity in children. J Sch Health 1991; 61 (5): 215–9

    Article  Google Scholar 

  34. Livingstone MB, Coward WA, Prentice AM, et al. Daily energy expenditure in free-living children: comparison of heart-rate monitoring with the doubly labelled water (2H2(18)O) method. Am J Clin Nutr 1992 Aug; 56 (2): 343–52

    PubMed  CAS  Google Scholar 

  35. Maffeis C, Pinelli L, Zaffanello M, et al. Daily energy expenditure in free-living conditions in obese and non-obese children: comparison of doubly labelled water (2H2(18)O) method and heart-rate monitoring. Int J Obes Relat Metab Disord 1995 Sep; 19 (9): 671–7

    PubMed  CAS  Google Scholar 

  36. Van de Berg-Emons RJ, Saris WH, Westerterp KR, et al. Heart rate monitoring to assess energy expenditure in children with reduced physical activity. Med Sci Sports Exerc 1996 Apr; 28 (4): 496–501

    Article  PubMed  Google Scholar 

  37. Ceesay SM, Prentice AM, Day KC, et al. The use of heart rate monitoring in the estimation of energy expenditure: a validation study using indirect whole-body calorimetry. Br J Nutr 1989; 61 (2): 175–86

    Article  PubMed  CAS  Google Scholar 

  38. Livingstone MBE, Prentice AM, Coward WA, et al. Simultaneous measurement of free-living energy expenditure by the doubly labelled water method and heart-rate monitoring. Am J Clin Nutr 1990; 52: 59–65

    PubMed  CAS  Google Scholar 

  39. Armstrong N, Balding J, Gentle P, et al. Patterns of physical activity among 11 to 16 year old British children. BMJ 1990; 301: 203–5

    Article  PubMed  CAS  Google Scholar 

  40. Gilbey H, Gilbey M. The physical activity of Singapore primary school children as estimated by heart rate monitoring. Pediatr Exerc Sci 1995; 7: 26–35

    Google Scholar 

  41. Gilliam TB, Freedson PS, Geenen DL, et al. Physical activity patterns determined by heart rate monitoring in 6–7 year-old children. Med Sci Sports Exerc 1981; 13 (1): 65–7

    PubMed  CAS  Google Scholar 

  42. Janz KF, Golden JC, Hansen JR, et al. Heart rate monitoring of physical activity in children and adolescents: the Muscatine Study. Pediatrics 1992; 89: 256–61

    PubMed  CAS  Google Scholar 

  43. Sallo M, Silla R. Physical activity with moderate to vigorous intensity in preschool and first-grade schoolchildren. Pediatr Exerc Sci 1997; 9: 44–54

    Google Scholar 

  44. Karvonen J, Vuorimaa T. Heart rate and exercise intensity during sports activities: practical application. Sports Med 1988; 5 (5): 303–11

    Article  PubMed  CAS  Google Scholar 

  45. Simons-Morton BG, Parcel GS, O’Hara NM, et al. Health-related physical fitness in childhood: status and recommendations. Ann Rev Public Health 1988; 9: 403–25

    Article  CAS  Google Scholar 

  46. Allor KM, Pivarnik JM. Use of heart rate cut points to assess physical activity intensity in sixth-grade girls. Pediatr Exerc Sci 2000; 12 (3): 284–92

    Google Scholar 

  47. Bassett DRJ, Ainsworth BE, Leggett SR, et al. Accuracy of five electronic pedometers for measuring distance walked. Med Sci Sports Exerc 1996 Aug; 28 (8): 1071–7

    Article  PubMed  Google Scholar 

  48. Bassey EJ, Dallosso HM, Fentem PH, et al. Validation of a simple mechanical accelerometer (pedometer) for the estimation of walking activity. Eur J Appl Physiol 1987; 56 (3): 323–30

    Article  CAS  Google Scholar 

  49. Sequeira MM, Rickenbach M, Wietlisbach V, et al. Physical activity assessment using a pedometer and its comparison with a questionnaire in a large population survey. Am J Epidemiol 1995 Nov 1; 142 (9): 989–99

    PubMed  CAS  Google Scholar 

  50. Saris WH, Binkhorst RA. The use of pedometer and actometer in studying daily physical activity in man. Pt II: validity of pedometer and actometer measuring the daily physical activity. Eur J Appl Physiol 1977 Oct 31; 37 (3): 229–35

    Article  CAS  Google Scholar 

  51. Kilanowski CK, Consalvi AR, Epstein LH. Validation of an electronic pedometer for measurement of physical activity in children. Pediatr Exerc Sci 1999; 11 (1): 63–8

    Google Scholar 

  52. Westerterp KR. Physical activity assessment with accelerometers. Int J Obes Relat Metab Disord 1999 Apr; 23 Suppl. 3: S45–9

    Article  Google Scholar 

  53. Klesges RC, Klesges LM, Swenson AM, et al. A validation of two motion sensors in the prediction of child and adult physical activity levels. Am J Epidemiol 1985 Sep; 122 (3): 400–10

    PubMed  CAS  Google Scholar 

  54. Klesges LM, Klesges RC. The assessment of children’s physical activity: a comparison of methods. Med Sci Sports Exerc 1987 Oct; 19 (5): 511–7

    PubMed  CAS  Google Scholar 

  55. Mukeshi M, Gutin B, Anderson WA, et al. Validation of the Caltrac movement sensor using direct observation in young children. Pediatr Exerc Sci 1990; 2 (3): 249–54

    Google Scholar 

  56. Noland M, Danner F, DeWalt K, et al. The measurement of physical activity in young children. Res Q Exerc Sport 1990 Jun; 61 (2): 146–53

    PubMed  CAS  Google Scholar 

  57. Bray MS, Wong WW, Morrow JRJ, et al. Caltrac versus calorimeter determination of 24-h energy expenditure in female children and adolescents. Med Sci Sports Exerc 1994 Dec; 26 (12): 1524–30

    PubMed  CAS  Google Scholar 

  58. Sallis JF, Strikmiller PK, Harsha DW, et al. Validation of interviewer- and self-administered physical activity checklists for fifth grade students. Med Sci Sports Exerc 1996; 28 (7): 840–51

    Article  PubMed  CAS  Google Scholar 

  59. Johnson RK, Russ J, Goran MI. Physical activity related energy expenditure in children by doubly labelled water as compared with the Caltrac accelerometer. Int JObes Relat Metab Disord 1998 Nov; 22 (11): 1046–52

    Article  CAS  Google Scholar 

  60. Ballor DL, Burke LM, Knudson DV, et al. Comparison of three methods of estimating energy expenditure: caltrac, heart rate, and video analysis. Res Q Exerc Sport 1989 Dec; 60 (4): 362–8

    PubMed  CAS  Google Scholar 

  61. Fairweather SC, Reilly JJ, Grant S, et al. Using the Computer Science and Applications (CSA) activity monitor in preschool children. Pediatr Exerc Sci 1999; 11: 413–20

    Google Scholar 

  62. Trost SG, Ward DS, Moorehead SM, et al. Validity of the Computer Science and Applications (CSA) activity monitor in children. Med Sci Sports Exerc 1998; 30 (11): 629–33

    PubMed  CAS  Google Scholar 

  63. Welk GJ, Corbin CB, Kampert JB. The validity of the Tritrac- R3D activity monitor for the assessment of physical activity: II. Temporal relationships among objective assessments. Res Q Exerc Sport 1998 Dec; 69 (4): 395–9

    PubMed  CAS  Google Scholar 

  64. Treuth MS, Adolph AL, Butte NF. Energy expenditure in children predicted from heart rate and activity calibrated against respiration calorimetry. Am J Physiol 1998 Jul; 275 (1 Pt 1): E12–8

    Google Scholar 

  65. Baranowski T, Dworkin RJ, Cieslik CJ, et al. Reliability and validity of self report of aerobic activity: Family Health Project. Res Q 1984; 55 (4): 309–17

    Google Scholar 

  66. Sallis JF. Self-report measures of children’s physical activity. J Sch Health 1991; 61 (5): 215–9

    Article  PubMed  CAS  Google Scholar 

  67. Simons-Morton BG, O’Hara NM, Parcel GS, et al. Children’s frequency of participation in moderate to vigorous physical activities. Res Q Exerc Sport 1990; 61 (4): 307–14

    PubMed  CAS  Google Scholar 

  68. Craig SB, Bandini LG, Lichtenstein AH, et al. The impact of physical activity on lipids, lipoproteins, and blood pressure in preadolescent girls. Pediatrics 1996 Sep; 98 (3 Pt 1): 389–95

    PubMed  CAS  Google Scholar 

  69. Goran MI, Hunter G, Nagy TR, et al. Physical activity related energy expenditure and fat mass in young children. Int J Obes 1997; 21: 171–8

    Article  CAS  Google Scholar 

  70. Trost SG, Ward DS, McGraw B, et al. Validity of the Previous Day Physical Activity Recall (PDPAR) in fifth-grade children. Pediatr Exerc Sci 1999; 11: 341–8

    Google Scholar 

  71. Janz KF, Witt J, Mahoney LT. The stability of children’s physical activity as measured by accelerometry and self-report. Med Sci Sports Exerc 1995; 27 (9): 1326–32

    PubMed  CAS  Google Scholar 

  72. McMurray RG, Harrell JS, Bradley CB, et al. Comparison of a computerized physical activity recall with a triaxial motion sensor in middle-school youth. Med Sci Sports Exerc 1998 Aug; 30 (8): 1238–45

    Article  PubMed  CAS  Google Scholar 

  73. Weston AT, Petosa R, Pate RR. Validity of an instrument for measurement of physical activity in youth. Med Sci Sports Exerc 1997; 29 (1): 138–43

    Article  PubMed  CAS  Google Scholar 

  74. Sallis JF, Condon SA, Goggin KJ, et al. The development of self-administered physical activity surveys for 4th grade students. Res Q Exerc Sport 1993; 64 (1): 25–31

    PubMed  CAS  Google Scholar 

  75. Kowalski KC, Crocker PRE, Faulkner RA. Validation of the physical activity questionnaire for older children. Pediatr Exerc Sci 1997; 9 (2): 174–86

    Google Scholar 

  76. Falk B, Bar-Or O, Calvert R, et al. Sweat gland response to exercise in the heat among pre-, mid-, and late-pubertal boys. Med Sci Sports Exerc 1992; 24: 313–9

    PubMed  CAS  Google Scholar 

  77. Wallace JP, McKenzie TL. Observed vs. recalled exercise behavior: a validation of a seven day exercise recall for boys 11 to 13 years old. Res Q Exerc Sport 1985; 56 (2): 161–5

    Google Scholar 

  78. Sallis JF, Buono MJ, Roby J, et al. Seven-day recall and other physical activity self-reports in children and adolescents. Med Sci Sports Exerc 1993; 25 (1): 99–108

    Article  PubMed  CAS  Google Scholar 

  79. Simons-Morton BG, Taylor WC, Wei Huang I. Validity of the physical activity interview and Caltrac with preadolescent children. Res Q Exerc Sport 1994; 65 (1): 84–8

    PubMed  CAS  Google Scholar 

  80. Halverson Jr CF, Waldrop MF. The relations of mechanically recorded activity level to varieties of preschool play behavior. Child Develop 1973; 44: 678–81

    Article  Google Scholar 

  81. Manios Y, Kafatos A, Markakis G. Physical activity of 6-yearold children: Validation of two proxy reports. Pediatr Exerc Sci 1998; 10 (2): 176–88

    Google Scholar 

  82. Whiteman D, Green A. Wherein lies the truth? Assessment of agreement between parent proxy and child respondents. Int J Epidemiol 1997 Aug; 26 (4): 855–9

    Article  PubMed  CAS  Google Scholar 

  83. Murphey JK, Alpert BS, Christman JV, et al. Physical fitness in children: a survey method based on parental report. Am J Public Health 1988; 78 (6): 708–10

    Article  Google Scholar 

  84. Rajmil L, Fernandez E, Gispert R, et al. Influence of proxy respondents in children’s health interview surveys. J Epidemiol Community Health 1999 Jan; 53 (1): 38–42

    Article  PubMed  CAS  Google Scholar 

  85. Bouchard C, Tremblay A, LeBlanc C, et al. A method to assess energy expenditure in children and adults. Am J Clin Nutr 1983 Mar; 37 (3): 461–7

    PubMed  CAS  Google Scholar 

  86. Seliger V, Trefny Z, Bartunkova S, et al. The habitual activity and physical fitness of 12 year old boys. Acta Paediatr Belg 1974; 28: 54–9

    PubMed  Google Scholar 

  87. Bratteby LE, Sandhagen B, Fan H, et al. A 7-day activity diary for assessment of daily energy expenditure validated by the doubly labelled water method in adolescents. Eur J Clin Nutr 1997 Sep; 51 (9): 585–91

    Article  PubMed  CAS  Google Scholar 

  88. Garcia AW, Pender NJ, Antonakos CL, et al. Changes in physical activity beliefs and behaviors of boys and girls across the transition to junior high school. J Adolesc Health 1998; 22: 392–402

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John R. Sirard.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sirard, J.R., Pate, R.R. Physical Activity Assessment in Children and Adolescents. Sports Med 31, 439–454 (2001). https://doi.org/10.2165/00007256-200131060-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-200131060-00004

Keywords

Navigation