{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T18:04:25Z","timestamp":1779991465101,"version":"3.53.1"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ActiGraph","award":["Digital Endpoint Accelerator Research (DEAR) Grant 2022"],"award-info":[{"award-number":["Digital Endpoint Accelerator Research (DEAR) Grant 2022"]}]},{"name":"Critical Path Institute","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Swedish Heart-Lung Foundation Post-doctoral Research Fellow (Abroad) Scholarship","award":["nr. 20220860"],"award-info":[{"award-number":["nr. 20220860"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    People with coronary heart disease (CHD) are encouraged to meet the public health moderate-to-vigorous aerobic physical activity (MVPA) guidelines for secondary prevention of cardiovascular disease. However, no accelerometer aerobic intensity cut-points are currently available to classify MVPA in this population. This study aimed to establish absolute and relative aerobic physical activity intensity accelerometer cut-points in people with CHD and compare the new with existing cut-points in an international cohort. Eighty-six participants with CHD performed a resting-metabolic-rate (RMR) assessment, activities-of-daily-living (ADLs) and a peak treadmill test with mixed-chamber gas analysis while wearing two ActiGraph GT3X accelerometers (hip and wrist). The average RMR was 2.8 ml.kg\n                    <jats:sup>-1<\/jats:sup>\n                    .min\n                    <jats:sup>-1<\/jats:sup>\n                    , 20% less than the commonly used 1 Metabolic Equivalent of Task (3.5 ml.kg\n                    <jats:sup>-1<\/jats:sup>\n                    .min\n                    <jats:sup>-1<\/jats:sup>\n                    ). The study sample was randomly split into a training and independent validation set (2:1) allowing for cross validation. In the training set, there were significant positive correlations between accelerometer counts.min\n                    <jats:sup>-1<\/jats:sup>\n                    (y-axis, vector-magnitude (VM)) and intensity (relative and absolute) across both accelerometer hip- and wrist-placements for all activities (p\u2009&lt;\u20090.001). Using Generalized Estimating Equation modelling, there was a strong linear relationship between accelerometer counts and absolute intensity for hip-placement (R\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090.62\u20130.71), and weaker relationships for hip relative intensity (R\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090.40\u20130.47) and wrist-placement (R\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090.09\u20130.25). In the validation set, Bland-Altman plots found that the mean differences between predicted and actual absolute and relative intensity measures were negligible for all accelerometer counts.min\n                    <jats:sup>-1<\/jats:sup>\n                    (y-axis, VM) and placements (hip, wrist), although the dispersion of the differences (95% limits of agreement) were wide. Hip VM counts.min\n                    <jats:sup>-1<\/jats:sup>\n                    cut-points were found to best identify absolute and relative MVPA. In the international comparison (n\u2009=\u2009176), participants completed significantly more MVPA using the new cut-points (p\u2009&lt;\u20090.001). Thus, accelerometer cut-points developed in healthy individuals appear to under-estimate physical activity intensity in this population and cut-points specific to people with CHD should be used.\n                  <\/jats:p>\n                  <jats:p>Australian New Zealand Clinical Trials Registry: ACTRN12623000605695.<\/jats:p>","DOI":"10.1371\/journal.pone.0349618","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T17:23:46Z","timestamp":1779989026000},"page":"e0349618","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validating hip- and wrist-ActiGraph accelerometer cut-points for physical activity intensities in people living with coronary heart disease"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2047-7012","authenticated-orcid":true,"given":"Nicole","family":"Freene","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"B\u00e4ck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6723-0316","authenticated-orcid":true,"given":"Theo","family":"Niyonsenga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3757-3972","authenticated-orcid":true,"given":"Kate","family":"Pumpa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Rangaraj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze Hao","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soraya","family":"Joseph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Davey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"L\u00f6nn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"pone.0349618.ref001","volume-title":"ACS in perspective: The importance of secondary prevention","author":"Deloitte Access 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