We have validated a real-time activity classification algorithm based on monitoring by a body worn system which is potentially suitable for low-power applications on a relatively computationally lightweight processing unit. The algorithm output was validated using annotation data generated from video recordings of 20 elderly volunteers performing both a semi-structured protocol and a free-living protocol. The algorithm correctly identified sitting 75.1% of the time, standing 68.8% of the time, lying 50.9% of the time, and walking and other upright locomotion 82.7% of the time. This is one of the most detailed validations of a body worn sensor algorithm to date and offers an insight into the challenges of developing a real-time physical activity classification algorithm for a tri-axial accelerometer based sensor worn at the waist.