Capturing step counts at slow walking speeds in older adults: Comparison of ankle and waist placement of measuring device

Simpson, Lisa; Eng, Janice J.; Klassen, Tara D.; Lim, Shannon B.; Louie, Dennis R.; Parappilly, Beena; Sakakibara, Brodie M.; Zbogar, Dominik

doi:10.2340/16501977-1993

Cited by 66 publications

(73 citation statements)

References 28 publications

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“…Step counts for adults have been observed as valid, although Fitbit One devices tend to be inaccurate for measuring distance [13] and moderate-to-vigorous physical activity [10]. When placed at the ankle, Fitbit One has been observed to provide valid step counts of older adults at slow speeds [11]. Storm et al and Diaz et al found that Fitbit One underestimated step counts during treadmill walking and running [9, 12].…”

Section: Introductionmentioning

confidence: 99%

Physical activity among children: objective measurements using Fitbit One® and ActiGraph

Hamari¹,

Kullberg²,

Ruohonen³

et al. 2017

BMC Res Notes

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BackgroundSelf-quantification of health parameters is becoming more popular; thus, the validity of the devices requires assessments. The aim of this study was to evaluate the validity of Fitbit One step counts (Fitbit Inc., San Francisco, CA, USA) against Actigraph wActisleep-BT step counts (ActiGraph, LLC, Pensacola, FL, USA) for measuring habitual physical activity among children.DesignThe study was implemented as a cross-sectional experimental design in which participants carried two waist-worn activity monitors for five consecutive days.MethodsThe participants were chosen with a purposive sampling from three fourth grade classes (9–10 year olds) in two comprehensive schools. Altogether, there were 34 participants in the study. From these, eight participants were excluded from the analysis due to erroneous data. Primary outcome measures for step counts were Fitbit One and Actigraph wActisleep-BT. The supporting outcome measures were based on activity diaries and initial information sheets. Classical Bland–Altman plots were used for reporting the results.ResultsThe average per-participant daily difference between the step counts from the two devices was 1937. The range was [116, 5052]. Fitbit One gave higher step counts for all but the least active participant. According to a Bland–Altman plot, the hourly step counts had a relative large mean bias across participants (161 step counts). The differences were partially explained by activity intensity: higher intensity denoted higher differences, and light intensity denoted lower differences.ConclusionsFitbit One step counts are comparable to Actigraph step counts in a sample of 9–10-year-old children engaged in habitual physical activity in sedentary and light physical activity intensities. However, in moderate-to-vigorous physical activity, Fitbit One gives higher step counts when compared to Actigraph.

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Section: Introductionmentioning

confidence: 99%

Physical activity among children: objective measurements using Fitbit One® and ActiGraph

Hamari¹,

Kullberg²,

Ruohonen³

et al. 2017

BMC Res Notes

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“…For example, [191] shows that a Fitbit ® attached to the hip accurately tracks step-counting among healthy community-dwelling older adults, and it was reported in [192] that the Fitbit ® may be more accurate for step-counting at slow walking speed when attached on the ankle rather than on the waist. A similar comparison among three trackers has been carried out in [193] taking into account a waist and wrist positioning, resulting in high accuracy at slow speed with a sensor attached at the waist.…”

Section: Wearables For Senior Citizens: Related Work and Limitationsmentioning

confidence: 99%

A Review of Activity Trackers for Senior Citizens: Research Perspectives, Commercial Landscape and the Role of the Insurance Industry

Tedesco

Barton

O’Flynn

2017

Sensors

107

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The objective assessment of physical activity levels through wearable inertial-based motion detectors for the automatic, continuous and long-term monitoring of people in free-living environments is a well-known research area in the literature. However, their application to older adults can present particular constraints. This paper reviews the adoption of wearable devices in senior citizens by describing various researches for monitoring physical activity indicators, such as energy expenditure, posture transitions, activity classification, fall detection and prediction, gait and balance analysis, also by adopting consumer-grade fitness trackers with the associated limitations regarding acceptability. This review also describes and compares existing commercial products encompassing activity trackers tailored for older adults, thus providing a comprehensive outlook of the status of commercially available motion tracking systems. Finally, the impact of wearable devices on life and health insurance companies, with a description of the potential benefits for the industry and the wearables market, was analyzed as an example of the potential emerging market drivers for such technology in the future.

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“…The inaccuracy of the monitor when placed at the hip while walking slowly is a significant limitation considering that many individuals with disabilities, including those with poststroke hemiparesis, have a self‐selected gait speed under 0.8 m/s . The error rate of the evaluated monitor tested with short distances (15 m) and in a straight‐ahead direction became acceptable (<10%) for speeds as slow as 0.4 m/s when the device was placed at the right ankle in older healthy adults or at the nonparetic ankle in poststroke individuals . This observation was recently replicated in a clinical context.…”

Section: Introductionmentioning

confidence: 99%

“…11,12 In this context, one activity monitor has received particular attention. When the evaluated device is placed at the hip (as recommended by the manufacturer) in older healthy individuals walking slower than 0.8 m/s, its step error rate is higher than 10% 13 (ie, arbitrary threshold used previously and considered acceptable 14 ). The inaccuracy of the monitor when placed at the hip while walking slowly is a significant limitation considering that many individuals with disabilities, including those with poststroke hemiparesis, have a self-selected gait speed under 0.8 m/s.…”

Section: Introductionmentioning

confidence: 99%

Activity Monitor Placed at the Nonparetic Ankle Is Accurate in Measuring Step Counts During Community Walking in Poststroke Individuals: A Validation Study

Duclos

Aguiar

Aïssaoui

et al. 2019

PM&R

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Background Different environmental factors may affect the accuracy of step‐count activity monitors (AM). However, the validation conditions for AM accuracy largely differ from ecological environments. Objectives To assess and compare the accuracy of AM in counting steps among poststroke individuals: during different locomotor tasks, with AM placed at the nonparetic ankle or hip, and when walking in a laboratory or inside a mall. Design Validation study. Settings Laboratory and community settings. Participants Twenty persons with chronic hemiparesis, independent walkers. Methods First session: participants performed level walking (6‐minute walk test [6MWT]), ramps, and stairs in the laboratory with AM placed at the nonparetic ankle and hip. Second session: participants walked a mall circuit, including the three tasks, with AM placed at the nonparetic ankle. The sessions were video recorded. Main Outcome Measurements Absolute difference between the steps counted by AM and the steps viewed on the video recordings (errors, %); occurrence of errors greater than 10%. Results Median errors were similar for the 6MWT (0.86 [0.22, 7.70]%), ramps (2.17 [0.89, 9.61]%), and stairs (8.33 [2.65, 19.22]%) with AM at the ankle. Step‐count error was lower when AM was placed at the ankle (8.33 [2.65, 19.22]%) than at the hip (9.26 [3.25, 42.63]%, P = .03). The greatest errors were observed among the slowest participants (≤0.4 m/s) on ramps and stairs, whereas some faster participants (>1 m/s) experienced the greatest error during the 6MWT. Median error was slightly increased in the mall circuit (2.67 [0.61, 12.54]%) compared with the 6MWT (0.50 [0.24, 6.79]%, P = .04), with more participants showing errors >10% during the circuit (7 vs 2, P = .05). Conclusions Step counts are accurately measured with AM placed at the nonparetic ankle in laboratory and community settings. Accuracy can be altered by stairs and ramps among the slowest walkers and by prolonged walking tasks among faster walkers. Level of Evidence III.

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Capturing step counts at slow walking speeds in older adults: Comparison of ankle and waist placement of measuring device

Abstract: The Fitbit One can accurately capture steps at slow speeds when placed at the ankle and thus may be appropriate for capturing physical activity in slow-walking older adults.

Cited by 66 publications

References 28 publications

Physical activity among children: objective measurements using Fitbit One® and ActiGraph

Physical activity among children: objective measurements using Fitbit One® and ActiGraph

A Review of Activity Trackers for Senior Citizens: Research Perspectives, Commercial Landscape and the Role of the Insurance Industry

Activity Monitor Placed at the Nonparetic Ankle Is Accurate in Measuring Step Counts During Community Walking in Poststroke Individuals: A Validation Study

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