A Comparison of Activity Monitor Data from Devices Worn on the Wrist and the Waist in People with Parkinson's Disease

Abstract

Background It is unclear if it is appropriate for people with Parkinson's disease (PD) to wear activity monitors on the wrist because of the potential influence of impairments on the data. Objective The objective of this study was to determine (1) whether activity monitor data collected from devices worn at the wrist and waist are comparable and (2) the contribution of PD impairments to any differences in step and activity counts at the wrist and waist. Methods A total of 46 community‐dwelling people with PD wore an accelerometer at the wrist and waist simultaneously for 1 week. Motor impairments (rigidity, bradykinesia, tremor, dyskinesia) were assessed using the Movement Disorders Society Unified Parkinson's Disease Rating Scale part III (motor examination) and part IV (motor complications). Results Higher values were recorded by the wrist monitor for steps/day (wrist, 9236 [standard deviation (SD) 3812]; waist, 5324 [SD 2800]; difference 3912; P < 0.001) and activity counts/day (wrist, 872,590 [SD 349,148]; waist, 186,491 [SD 101,989]; difference 686,099; P < 0.001). However, the wrist and waist values were strongly correlated (steps, r = 0.89; counts, r = 0.74; P ≤ 0.001). Increased tremor and dyskinesia explained 19% of the variation in the difference in average steps/day, and these variables plus reduced bradykinesia explained 24% of the variation in the difference in average activity counts/day. Conclusion Wrist monitors are likely to overestimate activity, particularly in people with tremor and dyskinesia. Nonetheless, activity monitors can be worn on the wrist if the aim is to monitor change rather than accurately record activity.

Physical activity profiles in Parkinson’s disease

“…Despite the proven benefits of PA on motor and non-motor symptoms, people with PD are generally less physically active than people of similar age without the disease. Community-dwellers who are independently ambulatory take approximately 5000 steps/day [ 16 – 18 ], even those who are newly diagnosed [ 19 ] and prior to the commencement of anti-Parkinson medications [ 20 ]. When viewed in relation to the approximated 7000 steps/day required of older adults in order to meet health recommendations [ 21 ], the activity patterns of people with PD reflect sedentary lifestyles [ 22 ].…”

“…A major challenge for people with PD is the achievement of sustained bouts of MVPA [ 17 – 19 ], a pattern even apparent among those with higher step counts [ 23 ]. On average, people with PD appear to spend 75% of their waking time in SB, and between 2 and 6% of their total time in MVPA [ 16 , 17 , 24 ].…”

Gait Kinematic Parameters in Parkinson’s Disease: A Systematic Review

“…However, an optimal and standardized method remains for establishing [15]. The number and location of the sensors are key aspects for the success of assessments with TOMs, especially in a free-living context [8,16]. To increase wearing compliance without hindering the precision of data collection the number of sensors should be kept to a minimum, and the least obtrusive devices preferred [8,16].…”

“…The number and location of the sensors are key aspects for the success of assessments with TOMs, especially in a free-living context [8,16]. To increase wearing compliance without hindering the precision of data collection the number of sensors should be kept to a minimum, and the least obtrusive devices preferred [8,16]. Today, although the lower back is not considered the most comfortable and unobtrusive location, it has been shown that a single sensor (accelerometer) in this location is able to capture with precision, physical activity and gait parameters in a laboratory and freeliving context [16,17].…”

“…To increase wearing compliance without hindering the precision of data collection the number of sensors should be kept to a minimum, and the least obtrusive devices preferred [8,16]. Today, although the lower back is not considered the most comfortable and unobtrusive location, it has been shown that a single sensor (accelerometer) in this location is able to capture with precision, physical activity and gait parameters in a laboratory and freeliving context [16,17]. Recently, there has been a move toward using sensors on the wrist or embedded in smartphones.…”