“Stepping Up” Activity Poststroke: Ankle-Positioned Accelerometer Can Accurately Record Steps During Slow Walking

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

doi:10.2522/ptj.20140611

Cited by 80 publications

(73 citation statements)

References 14 publications

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“…The validity and reliability of wearable activity monitors in measuring step counts also appears to be dependent upon the position on the body in which the device is placed. Activity monitors positioned on the ankle appear to be more accurate than wrist-mounted and waist-mounted devices in counting steps, particularly during slow walking conditions [39,42,43]. This may be because larger accelerations occur at the ankle during walking due to the distance from Step count The total step count has excellent test-retest reliability when used for 3 days in individuals with stroke; monitoring for less than a 3-day period is not recommended due to high variability Rett syndrome (27) Home…”

Section: Ankle-worn Devices Provide the Most Accurate Measurement Of mentioning

confidence: 99%

“…Overall the methodological quality of the studies examined was high, with each scoring ≥7. Of the assessed studies, 10 included participants with multiple sclerosis [32][33][34][35][36][37][38][39][40][41], 7 included participants after stroke [32,33,[42][43][44][45][46], 4 included participants with PD [27,33,47,48], 3 included participants with a spinal cord injury [32,49,50], 2 included participants with cerebral palsy [51,52], 2 included participants with a traumatic brain injury [32,42], and participants with Rett syndrome [53] and muscular dystrophy [32] were included in 1 study each. The most frequently used monitors included the StepWatch activity monitor (a biaxial accelerometer) [39,41,42,44,53], the ActiGraph GT3X (a triaxial accelerometer) [35,39,40,50], the SWA (a multisensor device) [46,49,52], and the Digi-Walker pedometer [27,32...…”

Section: Table 2 (Continued)mentioning

confidence: 99%

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Physical Activity Monitoring in Patients with Neurological Disorders: A Review of Novel Body-Worn Devices

2017

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Aim:The aim was to conduct a systematic review to examine the literature reporting the validity and reliability of wearable physical activity monitoring in individuals with neurological disorders. Method: A systematic search of the literature was performed using a specific search strategy in PubMed and CINAHL. A search constraint of articles published in English, including human participants, published between January 2008 and March 2017 was applied. Peerreviewed studies which enrolled adult participants with any neurological disorder were included. For the studies which sought to explore the validity of activity monitors, the outcomes measured using the monitor were compared to a criterion measure of physical activity. The studies' methodological quality was assessed using an adapted version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) framework. Data extracted from each study included the following: characteristics of the study participants, study setting, devices used, study protocol/methods, outcomes measured, and the validity/reliability of measurement produced. Results: Twenty-three studies examining the validity and reliability of 16 different monitors were included. The identified studies comprised participants with a range of different disorders of neurological origin. The available evidence suggests that biaxial or triaxial accelerometer devices positioned around the ankle produce the most accurate step count measurements in patients with neurological disorders. The findings regarding the reliability and validity of activity counts and energy expenditure are largely inconclusive in this population. Discussion: Ankle-worn biaxial or triaxial accelerometer-type devices provide the most accurate measurement of physical activity. However, further work is required in this field be-

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Section: Ankle-worn Devices Provide the Most Accurate Measurement Of mentioning

confidence: 99%

Section: Table 2 (Continued)mentioning

confidence: 99%

Physical Activity Monitoring in Patients with Neurological Disorders: A Review of Novel Body-Worn Devices

2017

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“…Our study indicated that low physical performance or reduced thigh muscle thickness in stroke patients may be due to less PA during convalescence hospitalization. Measuring PA is often difficult in patients with a very slow speed, such as disabled stroke survivors [16]. Our study results may be useful to identify low PA hospitalized stroke patients, who can then be instructed to increase PA.…”

Section: Discussionmentioning

confidence: 93%

“…The average daily number of steps during the middle 2-day period of the 4 days was used as the index of daily PA [17]. This ankle-attached measurement device is not a standardized method, but it was effective for measuring the number of steps taken by individuals who were unable to walk faster than 0.5 m/s in a recent study [16]. The reliability of the step measurement was also calculated before statistical analyses were performed.…”

Section: Measurement Of Pamentioning

confidence: 99%

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Physical Activity, Physical Function, and Quadriceps Muscle Thickness in Male Patients with Sub-Acute Stroke during Hospitalization: A Pilot Study

et al. 2018

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Increasing physical activity (PA) is an important rehabilitation target for patients with sub-acute stroke during hospitalization in order to recover physical function and prevent stroke recurrence. However, the characteristics of low PA in stroke patients during hospitalization who were targets for increased intervention have not been reported. The purpose of this study was to investigate the relationship between the daily number of steps and physical function and quadriceps muscle thickness (QMT) in patients with sub-acute stroke during hospitalization for convalescence rehabilitation. Twenty-nine patients with ischemic or haemorrhagic stroke (mean age, 69 ± 11 years) hospitalized for inpatient convalescent rehabilitation were included. PA was measured using a three-dimensional accelerometer that calculates the daily number of steps taken. Physical function was measured by a short physical performance battery (SPPB; 0–12 points) and the leg motor selectivity score (6 motor stages defined by Brunnstrom), and the QMT of both legs was measured using ultrasonography. PA was significantly correlated with the SPPB score (r = 0.63, p = 0.0002), QMT on the paretic side (r = 0.41, p = 0.02), and QMT on non-paretic side (r = 0.56, p = 0.002). There were no significant effects of the leg motor selectivity score on daily PA (F = 1.37, p = 0.27). In the multiple regression analysis, only the SPPB score showed significant linear regression (β = 0.44, p = 0.02). PA in male patients with sub-acute stroke during hospitalization was related to physical function and QMT and not with the severity of paresis.

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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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“Stepping Up” Activity Poststroke: Ankle-Positioned Accelerometer Can Accurately Record Steps During Slow Walking

Abstract: Although not recommended by the manufacturer, positioning the accelerometer at the ankle (compared with the waist) may fill a long-standing need for a readily available device that provides accurate feedback for the altered and slow walking patterns that occur with stroke.

Cited by 80 publications

References 14 publications

Physical Activity Monitoring in Patients with Neurological Disorders: A Review of Novel Body-Worn Devices

Physical Activity Monitoring in Patients with Neurological Disorders: A Review of Novel Body-Worn Devices

Physical Activity, Physical Function, and Quadriceps Muscle Thickness in Male Patients with Sub-Acute Stroke during Hospitalization: A Pilot Study

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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