RAMB - Dezembro

utritional

therapy

assessment

– O

utpatient

mobility

monitoring

(MAM)

ssoc

ras

2016; 62(9):811-815

813

Pedometers are the simplest portable sensors used

for monitoring human movement and record movements

in response to vertical acceleration. Using a mechanism

that detects the impacts produced by steps during loco-

motion, it is possible to calculate the distance covered

and therefore the energy expenditure. The main disad-

vantages are the inability to evaluate static activities,

isometric exercises and activities involving the arms,

thereby resulting in inaccurate energy expenditure esti-

mates. To analyze the effectiveness of physical activity

based on the use of pedometers among adults in an

outpatient setting, a study identified that pedometer

users significantly increased their physical activity by

around 2,500 steps per day compared to participants in

the control group (who did not use the pedometer), as

well as being associated with a reduction in body mass

index and systolic blood pressure.

(

) Another system-

atic review analyzing the use of the pedometer identified

that this intervention provided a modest, yet significant

reduction in body weight, while the magnitude of the

weight loss was associated with the time using the de-

vice.

(

) The use of pedometers by overweight or nor-

mal weight children was identified as an imprecise

method at slower speeds, and was shown to be more

accurate at higher speeds. For the control group, a small-

er error was identified at all speeds, and it was conclud-

ed that for overweight or obese children the use of the

pedometer is related to a lack of precision.

(

)

Accelerometers

are electronic devices that measure

the acceleration of body’s movement in the vertical and

horizontal direction by means of a microprocessor that

scans and filters the acceleration signal and converts it

into a numerical sign, presenting this value as movement

counts over a time interval. As such, they provide an ob-

jective way of quantifying the frequency, duration and

intensity of physical activity given that they are able to

assess the magnitude and the total volume of movement

as a function of time. They are classified into uniaxial,

unidirectional or triaxial, based on their ability to measure

the acceleration of movement on one or more planes

(vertical, mid-lateral and anteroposterior).

(

) The com-

bination of heart rate monitoring and accelerometer as

a way of measuring energy expenditure compensates for

the limitations of both techniques, especially with regard

to discriminating between different types of physical

activity. A study with the aim of estimating energy expen-

diture used the combination of accelerometry and heart

rate as a measurement method, identifying a good level

of agreement with the adopted gold standard (double

labeled water).

(

)

Recommendation

Technological development has enabled the establishment

of techniques for the assessment of physical activity and

the quantification of energy expenditure. Each method

has advantages and disadvantages that depend heavily

on the type of activity, age group and body composition.

As such, until an instrument that fulfills all of the desired

features is identified, a combination of methods could

provide more reliable and accurate data. It is important

to apply an objective questionnaire that helps monitor

the increase or reduction in physical activity, as well as to

identify the style of activity practiced, which may be as-

sociated with heart rate monitoring and accelerometry.

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