Validity of Different Activity Monitors to Count Steps in an Inpatient Rehabilitation Setting

Treacy, Daniel; Hassett, Leanne; Schurr, Karl; Chagpar, Sakina; Paul, Serene S.; Sherrington, Catherine

doi:10.1093/ptj/pzx010

Cited by 113 publications

(130 citation statements)

References 25 publications

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“…A recent study comparing the accuracy of activity monitors worn on the wrist and the waist by people with PD performing short walks in a laboratory environment found that although the waist‐worn devices were more accurate, all devices underestimated step counts . Similarly, another study found that ActiGraphs worn on the waist were less than 80% accurate when participants walked at speeds between 0.8 and 1.2 m/s, with this accuracy decreasing further at slower walking speeds, possibly because of insufficient acceleration at the waist with slower swing‐through of the leg . Notably, in the present study, more time was recorded in slow walking (<1.04 m/s) by the waist monitor than the wrist monitor, suggesting that both monitors may be underestimating the amount of walking undertaken at slow speeds.…”

Section: Discussionmentioning

confidence: 98%

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

Kim

Hassett

Nguy

et al. 2019

Movement Disord Clin Pract

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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.

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Section: Discussionmentioning

confidence: 98%

“…To further analyze the effects of motor impairments, future studies could focus on attaining a larger sample, including participants with more severe impairments. This may also allow exploration to determine the contributions of PD impairments to the difference in step and activity counts in people with different clinical phenotypes of PD …”

Section: Discussionmentioning

confidence: 99%

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

Kim

Hassett

Nguy

et al. 2019

Movement Disord Clin Pract

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“…Another issue is that most studies report having tested monitors accuracy over a short distance (15 m) with the monitor placed at the ankle while walking on level ground. Only one study investigated the validity of monitors in measuring step counts during the 6‐minute walk test (6MWT), among inpatients including some poststroke individuals . This may indeed represent the minimal distance required for outings in the community after discharge .…”

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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“…Activity monitors measure accelerations of the body segment to which the device is attached to, and the signal is filtered and pre‐processed by the monitor to obtain activity counts. Despite the advancements in technology, activity monitors can be inaccurate in capturing the activity of slow‐moving patients . A systematic review of 134 activity monitor‐based studies showed that accelerometers underestimate steps during slow walking by as much as 60% .…”

Section: Introductionmentioning

confidence: 99%

“…Thus, it is important to validate these monitors in all study populations, i.e. people with visual impairment, not just older populations …”

Section: Introductionmentioning

confidence: 99%

Validating the accuracy of an activity monitor in a visually impaired older population

Bajaj

Ramulu

Dillon

et al. 2018

Ophthalmic Physiologic Optic

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Validity of Different Activity Monitors to Count Steps in an Inpatient Rehabilitation Setting

Cited by 113 publications

References 25 publications

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

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

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

Validating the accuracy of an activity monitor in a visually impaired older population

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