Table 2.
Studies included in the systematic review
| Populationand setting | Device | Aim and methods | Endpoints | Findings | |
|---|---|---|---|---|---|
| Bania [51] | 10 participants with spastic diplegic CP (6 male, age: 18. 6±2.7years) were included in the validation study | An activPAL monitor was placed mid-thigh on the frontal aspect of the thigh | To determine the criterion validity and the retest reliability of the activPAL in adolescents and young adults with diplegic CP | Time spent standing | Criterion validityTime standing: R 2 0.97; MD (SD)–0.06 (0.2); 95% LOA–8.6 to 2.6 Time sitting: R 2 0.96; MD (SD) 0.5 (0.5); 95% LOA 1.3 to 20 Step count: R 2 0.99; MD (SD)–13.8 (11.8); 95% LOA 3.3 to 0.8 |
| Time spent sitting | |||||
| Criterion validity study | |||||
| 24 participants with spastic diplegic CP (11 male, age: 18.7±2.9 years) were included in the retest reliability study | The participants were recorded with a video camera for 12 min, during which they were asked to stand up and sit down twice, as well as to complete a 6MWT | Step count (steps/day) | |||
| Criterion: an observer, blinded to the activPAL output, watched the videos and counted the number of steps and the time spent in sitting and standing | Retest reliabilityTime standing: ICC 0.60; MD (SD) −0.31 (1.10); 95% CI–0.081 to 0.19 Time sitting: ICC 0.66; MD (SD) 0.37 (1.28); 95% CI–0.021 to 0.95 Step count: ICC 0.87; MD (SD)–411 (1,301); 95% CI–1,044 to 142 | ||||
| Clinical setting | |||||
| Retest reliability study | |||||
| The participants wore the activPAL monitor for 7 days, and for another 7 days 12 weeks later. They were advised to wear it at all times except during bathing and swimming | |||||
| A daily log was also given to the participants in which to note their activities during the 7-day period | |||||
| Dijkstra et al. [27] | 32 PD patients (17 male, age: 67.3±6.6 years, BMI: 26.7±4.0) | A DynaPort was placed in a belt and positioned between and above the posterior superior iliac spines | To determine the accuracy of an accelerometer system for detecting walking periods and steps in subjects with PD during controlled indoor walking tasks | Gait duration | Gait duration during all tasksAbsolute percentage error DynaPort: 11.1±4.5 |
| Step count | |||||
| Research laboratory | Step counts during all tasksAbsolute percentage error (ICC) DynaPort: 6.9±3.0 (0.98) Left Digi-Walker: 11.1±9.0 (0.87) Right Digi-Walker: 16.3±13.7 (0.75) | ||||
| 8 walking tasks: (1) walking 15 m at the preferred walking speed; (2) walking 15 m slower than preferred; (3) walking 15 m faster than preferred; (4) walking 10 m at one's own pace; (5) walking 5 m at one's own pace; (6) walking 3 m at one's own pace; (7) walking 15 m at the preferred speed while counting backward from 100 to 0 in steps of 5; and (8) walking 15 m at the preferred speed while carrying a tray with two cups filled with water. All tasks were videotaped. The gait characteristics as observed on video were taken as the gold standard | |||||
| A Yamax Digi-Walker (SW-200) was attached to the belt at the left and the right hip | |||||
| Populationand setting | Device | Aim and methods | Endpoints | Findings | |
| Downset al. [53] | 12femaleparticipantswith Rettsyndrome(age:12.9±8.0years) | A StepWatch activity monitor was attached around the right ankle proximal to the lateral malleolus with an elastic and Velcro strap | To assess the accuracy of the StepWatch activity monitor and investigate relationships between daily step counts, gross motor skills, and age | Step count | Step count: MD 0 steps/min; LOA–10 to 10 |
| Agreement did not differ with the level of general (p = 0.389) or complex gross motor skills (p = 0.221) | |||||
| Home environment | Data collection comprised two parts: | ||||
| 1. The participants were videotaped while performing normal walking activities in indoor and outdoor settings for periods of up to 30 min. Gross motor skills were assessed with the Gross Motor Scale for Rett syndrome | |||||
| The participants were less active than their healthy peers (difference 6,086 steps/day;p = 0.001), and physical activity was significantly greater in those who were younger and with greater levels of motor skills | |||||
| 2. The participants wore the StepWatch during 7 consecutive days. Caregivers recorded the time the StepWatch was fitted in the morning and when removed at bedtime | |||||
| Elsworthet al. [32] | 43 adults with neurological conditions (n = 20 stroke,n = 16 MS,n = 5 muscular dystrophy,n = 1 SCI,n = 1 TBI; 26 male, 17 female, age: 54±13 years, BMI: 26±4)a | A Yamax Digi-Walker (SW-200) was positioned midway between the iliac crest and umbilicus over the right leg in line with the midline of the thigh | To assess the accuracy of a pedometer in measuring step counts in neurologically impaired individuals walking at a self-selected walking speed | Step count | All: MD (SD) 27 (11); ICC (95% Cl) 0.73 (0.23 to 0.93);p = 0.003 |
| Stroke: MD (SD) 31 (113); ICC (95% CI) 0.58 (0.20 to 0.81);p = 0.026 | |||||
| The participants were asked to walk along a 16-m walkway in a quiet corridor at their normal speed using walking aids as required for a period of 2 min. An observer manually recorded the participants' step counts using a manual step counter | MS: MD (SD) 23 (81); ICC (95% CI) 0.84 (0.60 to 0.94);p = 0.044 | ||||
| Clinical setting | |||||
| Muscular dystrophy: MD (SD) 7.2 (176); ICC (95% CI) 0.38 (−0.62 to 0.91);p = 0.866 | |||||
| SCI step count difference: 130 steps | |||||
| TBI step count difference: 5 steps | |||||
| Fulk et al. [42] | 30strokeparticipants (15male, age:61.6±10.4years)and 20 TBI participants (19 male, 1female, age:40.3±11.6years) | A Fitbit Ultra and Yamax Digi-Walker (SW-701)were worn on the belt or waistband on the side of the less affected leg | To examine the accuracy of two commercial activity monitors, the Fitbit Ultra and the Nike FuelBand, in identifying stepping activity in people with stroke and TBI and to compare the accuracy of these two activity monitors with that of the StepWatch Activity Monitor and the Yamax Digi-Walker | Step count | All participantsStepWatch: MD (95% CI) 4.7 (1.11 to 8.35); ICC (95% CI) 0.97 (0.92 to 0.99) |
| Fitbit Ultra: MD (95% CI)–9.7 (−0.12 to −19.28); ICC (95% CI) 0.73 (0.56 to 0.83) | |||||
| Researchlaboratory | A Nike FuelBand was worn on the wrist of the less affected arm | ||||
| The participants wore all four activity monitors simultaneously and performed the 2MWT, during which they were videotaped. A researcher counted the steps taken by the participants from the video record | Digi-Walker: MD (95% CI)–28.8 (−12.66 to −43.50); ICC (95% CI) 0.42 (0.14 to 0.63) | ||||
| A StepWatch Activity Monitor was strapped above the lateral malleolus of the less affected leg | |||||
| Nike FuelBand: MD (95% CI)–66.2 (−43.63 to −88.67); ICC (95% CI) 0.20 (−0.076 to 0.46) | |||||
| Haleet al. [33] | 47 participants (17 male, age:63.7±15.5years;MSn = 11, PDn = 7,stroken = 20,controlsn = 9) | An RT3 accelerometer was attached to the waistbelt in a central back position | To investigate the reliability of a triaxial accelerometer to measure physical activity in adults with and without neurologic dysfunction | Activity count | Test-retest reliability activity counts over the two test periodsAll: ICC (95% CI) 0.85 (0.74 to 0.91);p = 0.00; SEM 23% |
| The participants wore the RT3 during waking hours (except while bathing, swimming, or lying in bed) for 7 consecutive days while maintaining their typical weekly schedules. They were instructed to complete a daily activity log. After 7 days a 7-day recall questionnaire was administered. 8 weeks later the procedure was repeated, using the same RT3 unit. The mean daily data for the first 3 days and for 7 days of measuring were calculated | |||||
| Home environment | Activity counts7-day: 124,831±74,373; 3-day: 132,252±92,394;p = 0.03 | ||||
| RT3 data correlation with the 7-day recall questionnaire (R = 0.01, 1%) | |||||
| Hiremathand Ding[49] | 24paraplegicparticipants (19 male, age: 41.4±11.4 years) | An SWA was worn on the right upper arm over the triceps muscle | To evaluate the performance of the SWA and RT3 activity monitors in estimating EE in manual wheelchair users with paraplegia for a variety of physical activities | EE | SWA Absolute percentage error in EE range: 24.4 to 125.8% ICC (LOA) 0.62 (0.49 to 0.73);p<0.05 (for all activities) |
| Researchlaboratory | |||||
| An RT3 was secured around the waist with a belt clip holster | The activity session consisted of resting and three 8-min activity routines: wheelchair propulsion, arm ergometer exercise, and deskwork. The criterion of EE was measured with a K4b2 portable metabolic cart | RT3 Absolute percentage error in EE range: 22.0 to 52.8% ICC (LOA) 0.64 (0.51 to 0.73);p<0.05 (for all activities) | |||
| Population and setting | Device | Aim and methods | Endpoints | Findings | |
| Kayes et al. [34] | 31 participants with MS (10 male, median age: 50 years, range: 34–80) Research laboratory | An Actical accelerometer was mounted onto waistbands and fitted around the participants' waists over the iliac crest of the left hip | To explore the test-retest reliability and validity of the Actical accelerometer in people with MS The participants were scheduled to attend 2 testing sessions, 7 days apart. They completed a series of 6 activities (reading newspaper, washing, vacuuming, stair climbing, 30-s chair stand test, and 6MWT) while wearing the Actical and a Polar heart rate monitor. The Borg RPE was used to measure self-reported activity intensity | Activity count | Test-retest reliabilityICC (95% Cl), bias,p value (95% LOA) Newspaper reading: 0.00 (0.00 to 0.37), 0.4,p = 0.48 (±16) Washing: 0.38 (0.07 to 0.70), 2.7,p = 0.84 (±145) Vacuuming: 0.75 (0.58 to 0.91), 7,p = 0.73 (±247) Stairs: 0.85 (0.76 to 0.95), 96.3,p = 0.26 (±1,065) Chair stand: 0.87 (0.77 to 0.96), 31.8,p = 0.74 (±1,192) 6MWT: 0.90 (0.83 to 0.97),–139,p = 0.33 (±1,330) |
| ValidityEstimate (95% CI),p value Newspaper reading: 0.097 (−0.211 to 0.018),p = 0.10 Washing: 0.02 (-0.002 to 0.042),p = 0.07 Vacuuming: 0.019 (0.007 to 0.030),p = 0.002 Stairs: 0.002 (-0.001 to 0.005),p = 0.16 Chair stand: 0.005 (0.002 to 0.009),p = 0.005 6MWT: 0.004 (0.002 to 0.006),p<0.001 | |||||
| Populationand setting | Device | Aim and methods | Endpoints | Findings | |
| Klassenet al. [43] | 43 participantsafter stroke(30male, age: 65±10.66 years) | A Fitbit One was positioned on each participant's non-paretic side on a waistband and ankle strap (above the lateral malleolus) | To examine the effect of walking speed on the accuracy of an accelerometer-based activity monitor in ambulatory individuals after stroke and to compare the effect of position (waist vs. ankle) on the accuracy of an accelerometer-based activity monitor | Step count | Fitbit anklePercentage error (SD) [95% Cl] 0.3 m/s: 15.8 (22.3) [9.1 to 22.7] 0.4 m/s: 5.5 (10.3) [2.4 to 8.6] 0.5 m/s: 4.5 (6.7) [2.4 to 6.6] 0.6 m/s: 4 (4.9) [2.4 to 5.6] 0.7 m/s: 4.9 (8.2) [2.1 to 7.7] 0.8 m/s: 6.9 (11.7) [2.8 to 11.0] 0.9 m/s: 4.9 (8.3) [1.8 to 8] |
| Research laboratory | |||||
| The participants walked a distance of 15 m for 8 walking trials: 1 trial at a self-selected walking speed and 7 trials from 0.3 to 0.9 m/s in 0.1 m/s increments. Each trial was videorecorded, and two independent viewers counted the actual number of steps from the video recordings of each trial | |||||
| Fitbit waistPercentage error (SD) [95% Cl] 0.3 m/s: 84.6 (30.5) [75.5 to 93.7] 0.4 m/s: 59.1 (40.1) [47.1 to 71.1] 0.5 m/s: 38.3 (33.2) [28.0 to 48.6] 0.6 m/s: 16.6 (17.8) [10.8 to 22.4] 0.7 m/s: 11.8 (17.0) [6.1 to 17.5] 0.8 m/s: 10.1 (13.6) [5.4 to 14.8] 0.9 m/s: 7.7 (8.9) [4.3 to 11.1] | |||||
| Paired ttestFitbit ankle vs. Fitbit waist: 0.3 m/s:p<0.001 0.4 m/s:p<0.001 0.5 m/s:p<0.001 0.6 m/s:p = 0.002 0.7 m/s:p = 0.21 0.8 m/s:p = 0.84 0.9 m/s:p = 0.58 | |||||
| Learmonthet al. [35] | 82 participants with MS (20 male, age: 49.2±9 years) | An ActiGraph GT3X was worn around the waist | To determine the reliability, precision, and clinically important change of accelerometry in participants with MS | Activity count | Activity count: ICC 0.883; 95% Cl 0.815 to 0.926; SEM 28,450; CV 17%; MDC 78,860 |
| Home environment | The participants wore the ActiGraph for 7 days during waking hours exclusive of bathing or swimming. The same procedure was repeated 6 months later | Step count | Step count: ICC 0.907; 95% CI 0.853 to 0.94; SEM 726; CV 16%; MDC 2,011 | ||
| Populationand setting | Device | Aim and methods | Endpoints | Findings | |
| Lord et al. [47] | 12people withPD (4male, age: 70.5±3.3 years)a | The Vitaport activity monitor consists of a portable data recorder attached to a belt worn around the waist, with 5 accelerometers attached to the body: 1 on each leg positioned on the lateral aspect of the mid-thigh, and 3 on the lower third of the sternum | To test the concurrent validity of the Vitaport activity monitor by comparing it to the GAITRite in controls and people with PD, to establish the use of the Vitaport activity monitor during a functional walk test, and to estimate the measurement error of the Vitaport activity monitor under these conditions | Gait speed | Gait speedMD(SD) [95% CI]; ICC Simple walk: −0.06 (0.04) [−0.06 to −0.3]; 0.99 Dual motor: −0.00 (0.09) [−0.06 to 0.5]; 0.91 Dual cognitive: −0.07 (0.05) [−0.10 to −0.04]; 0.97 Multiple task: 0.01 (0.08) [−0.06 to 0.03]; 0.94 |
| Step length | |||||
| Research laboratory | |||||
| Step frequency | |||||
| Four different walking tasks were performed: simple walking, dual motor task, dual cognitive task, and multiple task. Spatial and temporal variables of gait were measured using a GAITRite electronic walkway and the Vitaport activity monitor | |||||
| Step lengthMD(SD) [95% CI]; ICC Simple walk: −0.03 (0.02) [−0.04 to −0.01]; 0.97 Dual motor: 0.00 (0.04) [−0.02 to 0.03]; 0.85 Dual cognitive: 0.03 (0.03) [−0.05 to −0.01]; 0.92 Multiple task: 0.00 (0.02) [−0.01 to 0.02]; 0.93 | |||||
| Step frequencyMD (SD) [95% CI]; ICC Simple walk: 0.15 (0.04) [0.12 to 0.18]; 0.98 Dual motor: 0.14 (0.07) [0.09 to 0.19]; 0.96 Dual cognitive: 0.15 (0.04) [0.12 to 0.18]; 0.98 Multiple task: 0.11 (0.11) [0.03 to 0.18]; 0.92 | |||||
| Motl et al. [36] | 567 participants with MS (93 male, age: 47±10 years) | An ActiGraph 7164 was worn on a belt around the waist above the non-dominant hip | To estimate the reliability of objective measures of physical activity over a period of 6 months in persons with MS | Activity count | Activity counts/daySignificant change in over 6 months;t(474) = 3.92,p = 0.0001,d = 0.18; ICC 0.84 (95% CI 0.81 to 0.87); value significantly different from 0; F (1, 474) = 6.53,p = 0.0001 |
| Home environment | Minutes of MVPA | ||||
| The participants wore the ActiGraph during waking hours, except while bathing, showering, or swimming, for 7 days and then completed a battery of questionnaires that contained the Godin Leisure-Time Exercise Questionnaire (GLTEQ) on the eighth day. The same procedures were completed at baseline and 6 months later at follow-up | |||||
| Minutes of MVPA/daySignificant change over 6 months,t(474) = 5.38,p = 0.0001,d = 0.30; ICC 0.84 (95% CI 0.80 to 0.87); value significantly different from 0; F (1, 474) = 6.09,p = 0.0001 | |||||
| Populationand setting | Device | Aim and methods | Endpoints | Findings | |
| Motl et al. [37] | 51 participantswithMS (8 male, 43female, age:53.1±11.3years) | An actibelt accelerometer was attached to the participants' waist with a special buckle | To determine the accuracy of the actibelt for measuring walking speed during the 6MWT among persons with MS | Walking speed | The actibelt significantly overestimated walking speed (−0.12±0.17 m/s,p<0.0001). The overestimation was more pronounced in participants with moderate (−0.10±0.16 m/s) and severe (−0.26±0.12 m/s) disability. No significant overestimation was seen in those with mild disability (−0.02±0.11) |
| Researchlaboratory | The participants performed a 6MWT in a rectangular, carpeted corridor. The distance traveled (m) was recorded using a measuring wheel and was then converted into actual walking speed (m/s) for comparability with the actibelt output | ||||
| Overall standard error of the estimate: 0.10 m/s (95% Cl 1.10 to 1.50) Percent error rate (SD) [95% Cl] 54 m/min: 4.1 (9.1) [0.9 to 7.3] 80 m/min: 0.2 (0.8) [−0.2 to 0.63] 107 m/min: 0.3 (1.9 [−0.3 to 0.9] | |||||
| Motl et al. [38] | 24 participantswith MS(4male, age: 43.5±12.2 years)a | An ActiGraph 7164 was worn on an elastic belt that was positioned on the participants' right hip | To examine the accuracy of the ActiGraph accelerometer for measuring steps taken during controlled conditions by persons with MS compared with a sample of individuals without MS | Step count | |
| Research laboratory | |||||
| The participants performed three 6MWT on a treadmill, at 54, 80, and 107 m/min. There was a 6-min period of rest between walking periods. The actual number of steps taken was counted by observation using a hand-held tally counter | There was a statistically significant and large main effect for speed [F(2, 92) 59.13,p <0.0001,η2 = 0.17] | ||||
| Mudge andStott[44] | 40 participants with chronic stroke (23 male, 17 female, age: 69.2±12.6 years) | A StepWatch activity monitor was attached to the lateral side of the ankle of the non-paretic leg with a strap or cuff | To assess the test-retest reliability of the StepWatch activity monitor in individuals with chronic stroke | Step count | Total step count: ICC 0.989; CV 10.7%;±95% LOA 37.8% |
| Number of steps at high, medium, and low stepping rates | Number of steps at medium stepping rate: ICC 0.964; CV 17.8%; ±95% LOA 87.1% | ||||
| Home environment | The participants were instructed to wear the monitor for 3 days and for the same 3 days the following week, removing it for sleeping and showering | ||||
| Number of steps at high stepping rate: ICC 0.926; CV 37.6%; ±95% LOA 153% | |||||
| Number of steps at low stepping rate: ICC 0.953; CV 11.1%; ±95% LOA 63.6% | |||||
| Populationand setting | Device | Aim and methods | Endpoints | Findings | |
| Nightingale et al. [50] | 17male manual wheelchair users (age: 36±10 years) | An ActiGraph GT3X and a GENEActiv accelerometer were worn on the right wrist and upper arm | To assess the validity of two commonly used accelerometer devices, at two different anatomical locations, for the prediction of physical activity EE in manual wheelchair users in a controlled laboratory environment | EE | MAPE ActiGraph upper arm: 35.3±30.8% ActiGraph wrist: 33.0±39.5% GENEActiv upper arm: 20.4±14.3% GENEActiv wrist: 21.0±15.1% |
| Community gym | Activity count | ||||
| The participants completed 10 activities: resting, folding clothes, propulsion on a 1% gradient (3-6 and 7 km/h), and propulsion at 4 km/h (with an additional 8% body mass, 2 and 3% gradient) on a motorised wheelchair treadmill. IC was used as a criterion measurement of physical activity EE | Overall percent error of estimate (±95% LOA)ActiGraph upper arm: 15±87% ActiGraph wrist: 14±97% GENEActiv upper arm: 3±49% GENEActiv wrist: 4±50% | ||||
| Pearson CCActiGraph upper arm: 0.68 ActiGraph wrist: 0.82 GENEActiv upper arm: 0.87 GENEActiv wrist: 0.88 | |||||
| Rand et al. [45] | 40 adult communitydwelling participants with stroke (13 male, age: 66.5±9.6 years, BMI: 24.63±3.6) | Two Actical monitors were positioned over the anterior-superior iliac spine on the paretic and the non-paretic side | To assess the reliability of the Actical accelerometer for the paretic and the non-paretic side in people with stroke | EE | Paretic hipActivity count: ICC 0.95 (95% CI 0.92 to 0.97); SEM 18,324; MDC 50,792 EE: ICC 0.95 (95% CI 0.92 to 0.97); SEM 31.38; MDC 86.98 |
| Activity count | |||||
| The participants wore the Actical monitors continuously for 3 days and were instructed to go about their normal lives | |||||
| Home environment | |||||
| Non-paretic hipActivity count: ICC 0.94 (95% CI 0.91 to 0.97); SEM 17,690; MDC 49,035 EE: ICC 0.95 (95% CI 0.90 to 0.96); SEM 32.26; MDC 89.42 | |||||
| Paretic vs. non-paretic hipActivity count: ICC 0.98 (95% CI 0.97 to 0.99); SEM 9,755; MDC 27,039 EE: ICC 0.96 (95% CI 0.93 to 0.98); SEM 27.63; MDC 76.58 | |||||
| Populationand setting | Device | Aim and methods | Endpoints | Findings | |
| Ryanet al. [52] | 18adults(10male, age: 31.9±9.5 years, BMI: 25.3± 4.8) with CPa Clinical setting | An RT3 was worn on the right hip in the mid-axillary line An SWA was positioned over the triceps muscle of the right arm IDEEA sensors were worn on the chest, thighs, and soles of the feet | To evaluate the validity of the SWA, the IDEEA, and the RT3 at estimating EE in adults and children with CP EE data were collected using each monitor during rest and a number of walking activities. IC was used as the criterion measure of EE | EE | MAPE RT3: 17.2% (range 0.4 to 37.9) SWA: 35.5% (range 8.2 to 74.9) IDEEA: 16.3% (range 8.4 to 24.5) LOA RT3:–2.47 to 3.18 kcal/min SWA:–5.38 to 3.35 kcal/min IDEEA:–2.41 to 3.78 kcal/min |
| Sandroff et al. [39] | 63 participants with MS (15 male, age: 50.7±9.2 years) Research laboratory | A StepWatch activity monitor was worn on an elastic strap around the ankle above the right lateral malleolus An ActiGraph GT3X+ was worn on an elastic belt around the waist and above the right hip | To examine the accuracy of the StepWatch and ActiGraph in capturing steps taken at various speeds during over-ground ambulation in people with MS The participants completed three 6MWT: at CWS, at FWS (+0.5 mph of CWS), and at SWS (−0.5 mph of CWS). The actual number of steps taken was counted through direct observation using hand-held tally counters | Step count | ActiGraph step count accuracy: CWS 97.4%; FWS 95.6%; SWS 95.5% StepWatch step count accuracy: CWS 99.8%; FWS 99.9%; SWS 99.9% |
| Sandroff and Motl [40] | 41 participants with MS (5 male, 36 female, age: 47.7±8.8 years) and 41 age-matched healthy controls (5 male, age: 47.7±9.1 years) Research laboratory and home environment | An ActiGraph 7164 and a GT3X accelerometer were worn on an elastic belt around the waist on the non-dominant hip | To compare the activity count outputs from the 7164 and GT3X models of the ActiGraph in persons with MS and healthy controls under free-living and laboratory conditions The participants concurrently wore the accelerometers for 6 days during waking hours, except while swimming, bathing, or showering. They also undertook up to 5 bouts of walking that were each 6 min in duration on a treadmill The 5 possible walking speeds were 54, 67, 80, 94, and 107 m/min | Activity count | Free-living - difference between units12,487 (SD 27,199),p<0.01, ICC 0.983 (95% CI 0.967 to 0.991) Treadmill walking - difference between units54 m/min: 178 (SD 226),p<0.01, ICC 0.869 (95% CI 0.651 to 0.937) 67 m/min: 73 (SD 390),p = 0.09, ICC 0.891 (95% CI 0.831 to 0.930) 80 m/min:–30 (SD 484),p = 0.61, ICC 0.9 (95% CI 0.837 to 0.939) 94 m/min: 42 (SD 664),p = 0.64, ICC (95% CI 0.834 to 0.943) 107 m/min: 70 (SD 893),p = 0.61, ICC (95% CI 0.701 to 0.901) |
| Populationand setting | Device | Aim and methods | Endpoints | Findings | |
| Schmidt et al. [41] | 20 participantsdiagnosed withPD (n = 11) and MS (n = 9) | A StepWatch activity monitor was worn on an elastic strap around the ankle above the lateral malleolus | To explore the validity of the StepWatch Step Activity Monitor (SAM) in assessing stride counts in persons with PD or MS | Number of strides | Pearson CC for MS: 0.99 Pearson CC for PD: 1.0 |
| Clinical setting | The participants walked 15 m over a GaitMat II while wearing the StepWatch activity monitor. The strides counted by the GM were compared with the strides counted by the StepWatch activity monitor | StepWatch mean strides (95% CI): 15.55 (13.43 to 17.67) GaitMat II mean strides (95% CI): 15.85 (13.59 to 18.11) | |||
| Speelman et al. [48] | Part a: 28 participantswithPD(age:65.5±6.6years) | A DynaPort activity monitor was placed in a belt, positioned on the lower back between the posterior superior iliac spines | To evaluate the ability of the DynaPort activity monitor to estimate walking distances in PD | Walking distance | Difference between DynaPort and gold standard: <16% |
| Part b: 23 participantswithPD(age:63.8±9.4years) | Part a: the participants walked at their preferred speed along a marked linear distance in a hallway (ranging between 21 and 27 m) | Step length | In case of a longer walking distance, the LOA were–43 and +41%. The difference between the results and the gold standard did exceed more than 40% | ||
| Community setting | |||||
| Part b: the participants walked along a much longer (max. distance 1,097 m) and more complex“real life” walking trajectory (walking in the hospital corridors, with curves and path deviations). The actually measured walking distance was taken as the gold standard | |||||
| Population and setting | Device | Aim and methods | Endpoints | Findings | |
| Vanroy et al. [46] | 15 stroke patients (9 male, age: 60.4±10.26 years)a | A Yamax Digi-Walker (SW-200) was worn on the anterior side of the hip (on the belt) and the anterolateral side of the knee (patella support strap) on the non-hemiplegic side in stroke patients | To examine the validity and reliability of the SWA and the Digi-Walker in measuring the number of steps and EE in stroke patients and healthy individuals | Step count | Step count Validity (Spearman CC)Treadmill walking: SWA right–0.37 to 0.60; SWA left–0.52 to 0.46; Digi-Walker hip–0.41 to 0.90; Digi-Walker knee 0.30 to 0.69 Normal walking: SWA right–0.13; SWA left–0.23; Digi-Walker hip 0.33; Digi-Walker knee 0.95 Brisk walking: SWA right–0.04; SWA left 0.46; Digi-Walker hip 0.46; Digi-Walker knee 0.98 |
| EE | |||||
| Clinical setting | |||||
| Different activities were performed: treadmill walking, walking up/down a step, cycling, and walking on an even surface. Validity was examined by comparing the number of steps registered by the SWA and the Digi-Walker with that counted with a hand-held tally counter. EE was measured with the SWA and compared to IC. To determine the reliability of the two devices, repeated measurements on the treadmill and bike were compared for the number of steps and EE | |||||
| A SenseWear Armband (Pro2) was worn on both upper arms and positioned on the triceps muscle halfway between the acromion and the olecranon | |||||
| Test-retest reliability (ICC)Treadmill walking 1.5 km/h: SWA right 0.98; SWA left 0.89; Digi-Walker hip 0.88; Digi-Walker knee 0.73 Treadmill walking 3 km/h: SWA right 0.93; SWA left 0.92; Digi-Walker hip 0.96; Digi-Walker knee 0.95 | |||||
| Population and setting | Device | Aim and methods | Endpoints | Findings | |
| <B>EE </B> Validity (Spearman CC)Lying: SWA right 0.56; SWA left 0.49 Standing: SWA right 0.79; SWA left 0.81 Sitting: SWA right 0.78; SWA left 0.85 Treadmill walking: SWA right 0.01 to 0.75; SWA left 0.50 to 0.82 Stepping: SWA right 0.29 to 0.59; SWA left 0.48 to 0.71 Cycling: SWA right 0.54 to 0.71; SWA left 0.00 to 0.52 | |||||
| Test-retest reliability (ICC)Treadmill walking 1.5 km/h: SWA right 0.85; SWA left 0.76 Treadmill walking 3 km/h: SWA right 0.63; SWA left 0.97 Cycling 30 W: SWA right 0.90; SWA left 0.84 Cycling 50 W: SWA right 0.95; SWA left: 0.98 | |||||
| 2MWT, 2-min walk test; 6MWT, 6-min walk test; BMI, body mass index; CC, correlation coefficient; Cl, confidence interval; CV, coefficient of variation; CP, cerebral palsy; CWS, comfortable walking speed; EE, energy expenditure; FWS, fast walking speed; IC, indirect calorimetry; ICC, intra-class correlation coefficients; LOA, limits of agreement; MAPE, mean absolute percentage error; MD, meandifference; MDC, minimal detectable change; MS, multiple sclerosis; MVPA, moderate-to-vigorous-intensity physical activity; PD, Parkinson disease; RPE, rate of perceived exertion; SCI, spinal cord injury; SEM, standard error of measurement; SWS, slow walking speed; TBI, traumatic brain injury.a The study included young healthy participants as well; however, the results are presented only for the population of interest. |