activPAL

The study applied adjusted cadence thresholds of ≥100 steps/min for MPA and ≥130 steps/min for VPA instead of the activPAL device defaults. The activPAL is fundamentally unable to detect the intensity of non-stepping vigorous activities such as cycling, swimming, or weightlifting. The activPAL's default VPA threshold of 212 steps/min is considered unrealistically high even for trained athletes, and a review of 39 studies confirmed it systematically underestimates VPA. Device discomfort may have suppressed participants' activity levels during the measurement week, introducing potential reactivity bias. The activPAL4 is a thigh-worn accelerometer recognised as the gold standard for sedentary behaviour measurement in real-world settings.