Accelerometer Based Body Movement Quantification in Classroom
Lectures: Seated Activity Comparison Between Body Regions
Muhammad Asad Ullah Khan, Francesca Gallè, Giada Ballarin, Patrizia Calella, Giuseppe Cerullo,
Giorgio Liguori and Giuliana Valerio
Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Via Medina 40, Naples, Italy
Keywords: Accelerometers, Body Region Movement, Classroom Activity, Prolonged Sitting, Leg Fidgeting.
Abstract: Sitting behavior research rarely consider non-ambulatory movement in separate body regions. This study used
accelerometers, a sedentary cut off criterion, and measurement variables to evaluate movement accumulation
in trunk, waist, and foot regions of students in a 42-minute classroom session. Findings show that all three
sites were unique in stationary and movement measures (P≤0.012). Trunk and waist spent almost entire lesson
period in stationary state (98%) whereas foot spent larger proportion in movement (9%). In addition, longest
stationary period in trunk and waist regions exceeded the 30-minute threshold of prolonged sitting by a margin
of 1 to 2 minutes as opposed to the foot. Altogether, trunk and waist recorded negligible seated activity and
foot recorded sporadic and frequent movement. Based on health connection of body regions movement while
sitting, we believe that some movement may be better than no movement at all. Since trunk and wait were
inactive during the lesson period, strategies could be established to encourage intermittent movement in static
body regions and facilitation of movement in already active regions. However, further investigation is needed
to better understand dependencies of localized body activity on students’ wellbeing in prolonged sessions of
classroom lessons.
1 INTRODUCTION
Prolong sitting (PS) is typically defined as bouts of
uninterrupted sitting for 30 minutes or longer (Léger,
Cardoso, Dion, & Albert, 2022). It can interfere with
cognitive abilities (Triglav et al., 2019), aggravate
cardiometabolic risks (Honda et al., 2016), impact
glucose metabolism (Saunders, Chaput, & Tremblay,
2014), induce chronic low back (Bontrup et al.,
2019), elevate blood pressures, fatigue, and
musculoskeletal symptoms in spine and lower limbs
(Daneshmandi, Choobineh, Ghaem, & Karimi, 2017),
distress vascular function in lower limbs (Paterson et
al., 2020), (Credeur et al., 2019). It was shown that
mere 10 consecutive minutes of continuous sitting
was sufficient to impair leg microvascular function
(Vranish et al., 2018). Among many groups of adult
population, young university students were found to
engage in PS behaviours against general everyday
movement recommendations (Garn & Simonton,
2023). Due to increased sitting times, students gained
2.7 kg in transitioning from college to the university
second-year (Deforche, Van Dyck, Deliens, & De
Bourdeaudhuij, 2015), possible reason of which
could be the increased sedentary activities in the
universities. Academics require students to spend
larger portion of their day in PS sessions in the
laboratories, cafeteria, or library of university
campuses (Keating et al., 2020). In classrooms alone,
students are seated for lectures lasting up to 3 hours
(Bligh, 2000) which is long enough to expose this
group of young adults to the health risks of PS
(Goncalves et al., 2022). Research shows that
uninterrupted classroom sitting of 10 minutes could
progressively lead to discomfort and sleepiness in
students (Hosteng, Reichter, Simmering, & Carr,
2019).
Short breaks between lessons offer an opportunity
to get and move but most students remain in their
seats socializing, doing assignments, eating, or just
relaxing (Cowgill et al., 2021). Standup-based
approaches (Smith, Fagan, LeSarge, & Prapavessis,
2017) such as activity microbreaks (Lynch,
O’Donoghue, & Peiris, 2022) or standing desks
(Jerome, Janz, Baquero, & Carr, 2017) have been
proposed but their implementation is limited by
students’ beliefs, impediments to infrastructure, or
144
Khan, M., Gallè, F., Ballarin, G., Calella, P., Cerullo, G., Liguori, G. and Valerio, G.
Accelerometer Based Body Movement Quantification in Classroom Lectures: Seated Activity Comparison Between Body Regions.
DOI: 10.5220/0012184400003587
In Proceedings of the 11th International Conference on Sport Sciences Research and Technology Support (icSPORTS 2023), pages 144-150
ISBN: 978-989-758-673-6; ISSN: 2184-3201
Copyright © 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

classroom tradition (Pachu, Strachan, McMillan,
Ripat, & Webber, 2020). Seat-based movement
devices such as specialized sitting platforms (Tanoue
et al., 2016) and rubber balls (Dickin, Surowiec, &
Wang, 2017) may also be impractical due to
classroom layout and affordability. Keeping in view
these shortcomings, the question of allowing
movement in PS sessions may be settled by
appreciating the notion of in-chair movements
(ICMs) (“In-Chair Movements of Healthy People
during Prolonged Sitting,” 2014), dynamic sitting
(DS) (van der Berg et al., 2019), and fidgeting (Fryer
et al., 2022). Even in ordinary chairs, ICMs and DS
allow seated movement to balance static sitting
posture and fidgety movements compensate for a
sustained seated idleness (Ricciardi, Maggi, &
Nocera, 2019). Seated movement has been
investigated in workplace environments (Ricciardi et
al., 2019) but evidence on its incidence in students
attending classroom sessions is yet to be explored.
The PS threshold of 30 minutes discriminates
between sitting and ambulation (Altenburg et al.,
2021), but it does not give a full report on non-
ambulatory movement of different body regions.
Lecture-attending students may accumulate varying
frequency of seated movement in trunk, waist, and
foot regions until the end of the lecture session. For
instance, postural transitions due to erection and
slouching of torso along sagittal plane (Cho, Cho, &
Park, 2020) can produce spells of vertical movement
in trunk region. Similarly, sustained pressure causing
displacement of buttocks on chair’s seat-pan (Arippa,
Nguyen, Pau, & Harris-Adamson, 2022) can also
cause perpendicular movement in waist region. Toe
and heel tapping, foot position change, or sporadic
fidgeting (Senaratne, Ellis, Oviatt, & Melvin, 2020)
may also be anticipated as repetitive up-down
movement in the foot region.
As trunk, waist, and foot regions are positioned at
different degrees of freedom in a classroom chair,
each may accumulate episodes (or bouts) of varying
movement until the end of lecture session. Based on
this understanding, the aim is to quantify stationary
and movement states across trunk, waist, and foot
regions and evaluate whether substantial differences
in movement exists between them. Specifically, we
are interested in finding times spent by each region in
stationary and movement bouts, and also identifying
which regions exceed the stationary threshold of 30
minutes of PS during the lecture session.
We build our analysis on a movement-intensity
cut-point and variables of stationary and movement
measures (Boerema, van Velsen, Vollenbroek, &
Hermens, 2020) to analyse if a particular region was
more active than others. A comparative overview of
movement in trunk, waist, and foot would enable the
identification of relatively least and most active
regions in lecture attending classroom students. The
outcomes could encourage students/researchers to
allocate focus of seated movement on
stationary/active regions rather than the whole body,
as well as set a direction for further research in this
field.
2 METHODOLOGY
2.1 Participants and Instruments
The goal of this study is to evaluate stationary and
movement states in trunk, waist, and foot regions in
seated classroom students.
Participants were lecture attending students
enrolled in a degree course of Movement Sciences at
the University of Naples Parthenope Italy. Online
questionnaires were used for recruitment and
submission of personal consent to process the data.
All participants provided additional verbal consent to
wear accelerometers. The protocol was approved by
ethics committee reference number 0032042,
“University of Campania L. Vanvitelli”.
The sample included 15 able bodied participants
(6 Females, 5 Males, 4 undeclared, Age: 23.5±2.88,
BMI: 23.9±2.38 Three accelerometers were tied to
the anterior trunk, right waist, and right ankle on each
participant for seated body region movement
measurement and evaluation during the lesson period.
Trunk-unit was positioned roughly over the sternum
with the fastening belt following a line connecting the
right and left axilla. Waist-unit was positioned
laterally on the right-side superior to the iliac crest.
Foot-unit was placed slightly superior to right ankle
just above the lateral malleolus. Hands were not used
as site of movement measurement as accelerometer
placement on wrists could obstruct the ongoing lesson
tasks such as note-taking, typing, etc. All
accelerometers were placed on clothing and each
participant was free to opt out of the experiment any
time. Recordings were considered valid only if sitting
during the lesson was not interrupted by stand-up or
removal of the device. Accelerometer model wGT3x
(Actigraph Pensacola, FL-USA), initialized at 30 Hz
(Brønd & Arvidsson, 2016), epoch-length of 10 sec
was used for recordings. Movement data were
downloaded and processed using Actilife Software
Version 6.13.4. All chairs had a reclinable back rest
with a fixed seat pan.
Accelerometer Based Body Movement Quantification in Classroom Lectures: Seated Activity Comparison Between Body Regions
145

Figure 1: Box plots showing post-hoc pairwise comparison and differences in movement measures. Top left: Differences of
time in stationary bouts was significant between trunk-foot and waist-foot pairs. Top right: Differences in longest stationary
bout were significant between trunk-foot and waist-foot pair. Bottom left: Variation of time in movement breaks was
significant between trunk-foot and waist-foot pairs. Bottom right: Insignificant differences in longest movement break were
noted between all three pairs. P-value interpretation. P = 0.123 (ns), 0.0332 (*), 0.002 (**), 0.0002 (***). The (+) symbol
shows the position of mean relative to the median. The vertical axis shows time in minutes.
2.2 Data Reduction and Variable
Definitions
All data was downloaded and reduced for further
analysis after the session. The length of lecture and
accelerometer wear time (WT) were aligned to 42
minutes since most valid accelerometer recordings
were consistent with this length. Epochs were
upscaled to 15 seconds so that 4 epochs were
contained in a single minute. A minute was either
stationary or a movement minute, depending on the
level of counts above or below the reference cut point
of 100 counts per minute (cpm) (Altenburg et al.,
2021). Consequently, a stationary bout was defined as
time accumulated in consecutive stationary minutes
(Honda et al., 2016) whereas a movement bout (or
break) was defined as time collected in consecutive
movement minutes (Dalene et al., 2022). The
minimum length of stationary and movement
bouts/breaks was set to 5 minutes which could extend
up to the total WT. Only vertical movement counts
were assigned to stationary and movement variables
in order to avoid complex computations. The choice
of variables was based on relevance to health
outcomes of PS (Boerema et al., 2020). For each body
region, two variables were derived to evaluate
stationary bouts.
i. Time in stationary bouts (TSB)
ii. Longest stationary bout (LSB)
TSB refers to the total time spent in stationary bouts
by a region whereas LSB corresponds to the single
longest bout of uninterrupted stationary state. Period
of interruption between two stationary bouts was
called a movement break. For each region, two
variables of movement breaks were evaluated.
i. Time in movement breaks (TMB)
ii. Longest movement break (LMB)
TMB refers to the total time spent by all episodes
of movement and LMB corresponds to the single
longest episode of movement among all.
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Table 1: Overall and pairwise comparisons of movement measures. TSB, Time in stationary bouts; LSB, Longest stationary
bout; TMB, Time in movement breaks; LMB, Longest movement break.
Movement
variable
Overall comparison
P-value [F]
Pairwise comparisons
Remarks on median difference
P-value [
r
ank sum difference]
trun
k
-waist trun
k
-foot waist-foot
TSB 0.0029 [11.69]
0.3 min more in trunk
>0.9999 [-2]
9 min more in trunk
0.0318 [14]
8.7 min more in waist
0.0100 [16]
LSB 0.0010 [13.73]
1.8 min more in trunk
>0.9999 [3]
21 min more in trunk
0.0030 [18]
19.2 min more in waist
0.0180 [15]
TMB 0.0009 [14.04]
No difference
>0.9999 [3]
3.5 min more in foot
0.0411 [-13]
3.5 min more in foot
0.007 [-16.5]
LMB 0.0126 [8.750]
No difference
>0.9999 [2.5]
3.5 min more in foot
0.2037 [-10]
2 min more in foot
0.6700 [-12.5]
2.3 Statistical Analysis
Each variable was tested for normality using Shapiro-
Wilk test in each region. Their average was matched
cross all regions using Freidman tests (F and P-value)
and post-hoc (Dunn’s) pair-wise comparison between
every two regions. In addition to medians and 95%
confidence interval (C.I), percentages in proportion to
WT for each variable were compared across regions.
Statistical descriptors were plotted in Box &
Whiskers. Significance level ‘alpha’ was set to α=
0.05. All calculations and plots were obtained from
GraphPad Prism v. 2.2.
3 RESULTS
All four variables in all regions were not distributed
normally (P<0.01). Average TSB in trunk and waist
was 41.8 min and 41.5 min, respectively. Similarly,
average LSB in trunk and waist was 32.8 min and 31
min, respectively. Average TMB and LMB in both
trunk and waist was 0.3 min. In foot region, average
TSB and LSB were 32.8 min and 11.8 min,
respectively. Average TMB and LMB in foot was 3.8
min and 2.3 minute, respectively.
Both trunk and waist regions spent >98% of
lesson time in stationary state and <1% in episodic
movement. Comparatively, foot spent about 78% of
lesson time in stationary bouts and 9% in intermittent
movement. Average longest uninterrupted stationary
period in trunk and waist regions constituted at least
73% of the lesson time. The same in foot, however,
spanned only 28% of the lesson time. The average
longest episode of movement in trunk and waist
stretched 0.7% of lesson time. In foot the spanned
about 5.5% of lesson time.
Global difference of average minutes in all four
stationary and movement variables was significant
across trunk, waist, and foot region (P≤0.013).
Pairwise comparisons show that the longest
uninterrupted stationary bout in trunk and waist was
19 to 21 min longer than that in the foot (P<0.01).
Both these regions spent on average 8 to 9 min more
in stationary bouts (P<0.03), and 3.5 min less in
movement breaks (P<0.042) compared to the foot.
All other differences were not significant (P>0.2).
Detailed global and pairwise comparisons are shown
in figure and table 1.
4 DISCUSSION
The goal of this study was to find regions of least and
most movement among trunk, waist, and foot using
accelerometers and variable measures of sitting
behaviour in lecture attending students. Second, we
analysed which regions were stationary up to the
point of crossing the 30 min threshold of PS. Trunk
and waist were similar in all four measures of
stationary and movement patterns. Both trunk and
waist spent almost entire lecture session in a
stationary state. The longest uninterrupted stationary
period was also recorded in trunk and waist region.
Its length exceeded the 30-minute threshold of
uninterrupted PS by a margin of 1 to 2 minutes. Foot,
however, was equally different from trunk as much as
it was from the waist. It remained well within the
bounds of PS threshold by sufficiently distributing its
movement rather than staying at a complete rest.
Conclusively, trunk and waist were altogether in a
stationary state and foot recorded relatively higher
movement activity.
This relative pattern of movement distribution in
different body regions could be attributed to simple
underlying causes. Whether students intentionally did
not move the upper portion of their bodies or the
sitting situation itself is responsible, it makes sense to
Accelerometer Based Body Movement Quantification in Classroom Lectures: Seated Activity Comparison Between Body Regions
147

assume that both waist and trunk are solidly attached
to the base and back of the chair. The fixed
mechanical system in used classroom chairs might
have inhibited the trunk and pelvic movements in the
waist region (Tanoue et al., 2016). Foot-floor contact
and hand placement on a desk (in lesson tasks such as
taking notes) creates a stabilizing effect on the upper
body could possibly have inhibited movement in hips
and buttocks (Nüesch, Kreppke, Mündermann, &
Donath, 2018). In contrast, relatively higher
movement was recorded in the foot possibly due to a
higher degree of motion in legs while sitting. Students
were not engaged in any meaningful task (Ricciardi
et al., 2019) during the lesson period, larger
movement in foot region possibly accumulated due to
leg fidgeting, vertical thigh activity, or heel/toe taps,
etc (Esseiva, Caon, Mugellini, Khaled, & Aminian,
2018). Several unexplained personal or
environmental factors could also have contributed to
this pattern of stationarity and movement distribution
in the three regions.
Although this study did not measure the
consequences of stationary and moving body regions
on student’s health, associations of foot region
movement have been previously found with energy
expenditure. Gluteal femoral muscular contractions
in foot movement significantly increased energy
expenditure in individuals sitting in standard chairs
(Koepp, Moore, & Levine, 2017). Generally, lower
limb movement has been linked to positive impact on
an individual’s leg vascular health (Morishima et al.,
2016), executive functions (Fryer et al., 2022), resting
energy expenditure (Koepp, Moore, & Levine, 2016).
Some associations have also been reported between
seated movement behavior and BMI, waist
circumference and the metabolic syndrome (van der
Berg et al., 2019). Nevertheless, prevalence of higher
movement in foot region may be better than no
movement at all. It is merely a speculation but small
amount of leg fidgeting in prolonged sitting
classroom sessions may provide some preventive
benefits.
To our knowledge, this study was the first in
measuring accumulated stationary and movement
times using accelerometers and standard classroom
chairs. Accelerometers were a suitable choice for
detecting body region movement regardless of their
placement on body sites (Senaratne et al., 2020). They
can reliably measure limb movement (Fortune,
Lugade, & Kaufman, 2014) and foot activity in seated
posture when placed at the ankle position (Chalkley,
Ranji, Westling, Chockalingam, & Witchel, 2017).
While compliant sitting surfaces have a more
significant effect in eliciting trunk, waist, and foot
movement (Wang, Weiss, Haggerty, & Heath, 2014),
the larger activity found in foot was not hurdled by
horizontal static seat surface of used classroom chair.
It is imperative that people often participate in
involuntary and spontaneous seated body movements
such as moving on chair in varying contexts
(Ricciardi et al., 2019). This applies to students
attending a lesson presentation as well who, based on
the findings, can proceed to move stationary regions
of their bodies or remove any barriers interfering in
movement of already active regions. Since most
students choose to stay seated even in their free time,
foot movement in classroom chairs could evolve as a
habit that can extend anywhere, at any time, and for
those who may find stand up or walking breaks
challenging (Pettit-Mee, Ready, Padilla, & Kanaley,
2021). From an epidemiological view, small seated
movement in chairs could be medically important in
the long run (Koepp et al., 2016) since many students
could adapt this as a habit beyond classrooms in their
life (Nüesch et al., 2018).
Population of students attentive to long lesson
presentations are undesirably exposed to the risks
associated with extended periods of sitting.
Traditional movement interventions are not only
challenging to implement but they also lack in
evoking non-ambulatory seated movement of
different body regions. In order to encourage specific
seated movement behaviors, this study emphasized
on detecting and comparing accumulated movement
between three distinct body regions. As it is common
for classroom lectures to exceed the 30-minute
threshold of continuous sitting, we were able to
discern regions that had the tendency to exceed that
threshold. Based on the knowledge of least and most
active regions, future research could be extended
towards development of suitable interventions that
enhance activity in vulnerable body regions and aid
in prevention of likely negative health impacts.
Finally, there were some limitations that should be
carefully considered prior to further investigation. For
instance, cut-off criterion can decisively alter the
measurements of selected variables. Attention should
be paid to its selection as it has potential to offset the
resulting movement outcomes. Moreover,
calculations in this study were performed using only
vertical component of movement. It is possible to
have a diverse understanding of seated movement
patterns if multidimensional approach is opted. In
addition, mutual relationship between the movement
variables was also not taken into account. Recruiting
hybrid variables could enable assessment of temporal
patterns of movement progression. Unfortunately, we
faced sample size, lesson time, and some other
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unexplained protocol restrictions. A more
comprehensive study design can also replenish the
gaps due to varied epoch length, sensor typology, and
sample heterogeneity. The direct connection of seated
body movement to localized energy expenditures also
warrants a further examination.
5 CONCLUSIONS
This study evaluated stationary and movement
periods in body regions of seated students attentive to
lecture presentation. Using accelerometers placed at
three body sites, a cut off criterion, and a set of
measurement variables, we found that foot region
accumulated most movement as compared to trunk
and waist until the end of lesson. Trunk and waist also
exceeded the 30-minute threshold of prolonged
sitting as opposed to foot which engaged in unassisted
episodic movement. Realizing that body trunk and
waist are more stationary than foot, students and
interventionists can encourage diverse movement
strategies in upper body regions in standard
classroom chairs. To make a more detailed
assessment of stationary and movement states and
their associated health connection, we recommend a
rigorous examination on alternative detection
modalities, compliant sitting surfaces, variable inter-
relationship, temporal dynamics, and localized
energy costs of seated activity.
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