Wrist Vs Hip Accelerometry In Equine Adaptive Riding For Neurodivergent Children: A Preliminary Study

Adaptive riding utilizes activities with horses that involve physical, psychological, and social components and has been shown to lead to improvements in social skills, emotional regulation, and motor skills in neurodivergent children. However, a lesser-known benefit of adaptive riding is the engagement in physical activity (PA). While adaptive riding clearly involves some form of physical movement, PA within this setting and population has not yet been objectively assessed. PURPOSE: To objectively assess PA levels during adaptive riding sessions by comparing accelerometer placement at two different locations: hip and wrist. METHODS: Children and adolescents (n = 12, age 8.7 ± 2.4 yrs, 75% girls, 71% white) were recruited from an existing adaptive riding program. Participants wore hip- and wrist-placed ActiGraph GT3X accelerometers during adaptive riding sessions. The final sample contained one valid hip and wrist data pair per participant. Evenson cut-points (15-second epoch) were used for the hip and Crouter cut-point (5-second epoch) were used for the wrist. Primary outcomes included the percentage of time spent in sedentary, light (LPA), and moderate-to-vigorous PA (MVPA). A Bland-Altman analysis was performed to compare the device placement. RESULTS: LPA was most dominant during adaptive rising sessions, with mean levels of 65.57 ± 11.2% and 66.48 ± 9.8% measured via hip and wrist devices, respectively. However, wrist accelerometers underestimated sedentary compared to hip (hip: 28.91 ± 7.1% vs. wrist: 12.80 ± 6.3% while overestimating MVPA (hip: 5.25 ± 3.2% vs. wrist: 20.56 ± 8.1%. The absolute discrepancy between hip and wrist for percentage estimates (%mean difference ± SD) were sedentary (16.1 ± 8.2), LPA (0.91 ± 11), and MVPA (15 ± 10.9). CONCLUSIONS: Both the hip and wrist placed accelerometers agree that the majority of time during adaptive riding sessions is spent in LPA, but disagreement emerged between wrist and hip device placement for sedentary and MVPA. Individual variability and study limitations may contribute to the observed discrepancies. Further research and validation studies are warranted to refine the understanding of how much PA occurs during adaptive riding sessions and which location is best for accelerometer placement.