The validity and reliability of the OneStep smartphone application under various gait conditions in healthy adults with feasibility in clinical practice

Abstract

Objective Primary purpose of this study was to determine the validity and reliability of the OneStep smartphone application in healthy adults. Secondary purpose was to determine the feasibility of measuring gait dysfunction, limitation in spatiotemporal characteristics, longitudinally in patients following total hip or knee arthroplasty. Methods First objective, 20 healthy adults (mean age, 42.3 ± 19.7 years; 60% males; mean body mass index, 29.0 ± 5.2 kg/m2) underwent gait analysis under four gait conditions (self-selected gait speed, fixed gait speed at 0.8 m/s, fixed gait speed at 2.0 m/s and self-selected gait speed with dual task) for the validity and reliability of the smartphone to the motion laboratory. Reliability was determined by intraclass correlation coefficients. Validity was determined by Pearson correlations. Agreement was assessed by the Bland–Altman method. Second objective, 12 additional patients with total hip or knee arthroplasty (mean age, 58.7 ± 6.5 years; 58% males; mean body mass index, 28.9 ± 5.8 kg/m2) were measured at 2- and 10 weeks postoperatively. The smartphone application was used to evaluate change in gait dysfunction over time within the patients’ own environment using paired t test. Results The smartphone application demonstrated moderate-to-excellent intraclass correlation coefficients for reliability between-system (ICC range, 0.56–0.99), -limb (ICC range, 0.62–0.99) and -device (ICC range, 0.61–0.96) for gait analysis of healthy adults. Pearson correlations were low-to-very high between methods (r range, 0.45–0.99). Bland–Altman analysis revealed relative underestimation of spatiotemporal variables by the smartphone application compared to the motion system. For patients following total hip or knee arthroplasty, gait analysis using the OneStep application demonstrated significant improvement (p < 0.001, Cohen’s d > 0.95) in gait dysfunction between 2- and 10 weeks postoperatively. Conclusion The smartphone application can be a valid, reliable and feasible alternative to motion laboratories in evaluating deficits in gait dysfunction in various environments and clinical settings.

Validity and reliability of the Apple Health app on iPhone for measuring gait parameters in children, adults, and seniors

“…Test–retest reliability of the Health app was consistently good to excellent for all gait parameters in adults (ICC = 0.75–0.80) and seniors (ICC = 0.88–0.93). These findings correspond to those reported for the OneStep and Gait Analyzer apps, which also demonstrated good to excellent test–retest reliability for measuring gait speed (ICC = 0.77–0.98), step length (ICC = 0.80–0.97), and/or double support time (ICC = 0.90–0.98) in adults 31 , 33 , 37 . In contrast, reliability of the Health app was poor to moderate for measuring gait speed and step length in children (ICC = 0.39–0.61), which was lower than that of the Gait Analyzer app in children and adolescents (ICC = 0.87–0.94) 30 .…”

“…Validity statistics for measuring gait speed and/or step length were quite similar or only slightly lower than previously observed for the Health app in seniors (ICC = 0.84–0.92) 38 , and for the OneStep (ICC = 0.80–0.96) 32 , 33 and Gait Analyzer apps in adults (mean bias: gait speed = − 0.09 to 0.05 m/s, step length = − 4.0 to 2.3 cm) 37 . The lower validity might be due to the fact that these studies used fixing material for smartphone positioning (pocket holding, waist bag, hip clip) 32 , 33 , 37 , 38 , which has been shown to provide higher validity for smartphone-based gait analysis than when wearing it in the pant pocket 71 , as was done in the current study.…”

The reliability and validity of the OneStep smartphone application for gait analysis among patients with gait asymmetry undergoing rehabilitation for lower limb chronic pain or functional disability

“…1] Discussion This is the fourth study that was conducted to assess the validity and reliability of the OneStep smartphone application. The previous studies were conducted among healthy individuals [20,21] or among patients with minor gait-related problems [29], and found the app to be both reliable and valid. Our sample consisted of patients with mild to moderate lower limb disability or chronic pain, i.e.…”

“…Today, smartphones are widespread and are standardly embodied with IMUs that enable attaining spatial-temporal gait information. Smartphone-based assessment has demonstrated reliability and validity in performing spatiotemporal gait analysis among healthy young adults [18][19][20][21][22] and older adults [23], and among populations with various gait pathologies. These include, but are not limited to Parkinson's disease [24][25][26], rheumatoid arthritis [27], stroke [28], and musculoskeletal disorders [29,30].…”

“…The OneStep smartphone application (Celloscope Ltd., Tel Aviv, Israel) was found to be reliable and valid among healthy persons [20,21] and among people with mild gait-related pathologies [29], in assessing and analyzing spatial-temporal gait parameters. Various reference systems were used, including an APDM mobility lab (APDM Inc.; Portland, OR, USA), a 10-camera motion analysis system (Vicon Motion Systems; Oxford, UK), and a pressure-sensor gait mat (The ProtoKinetics Zeno™ Walkway).…”