Noémie C Duclos1,2, Larissa T Aguiar1,2,3, Rachid Aissaoui4, Christina D C M Faria3, Sylvie Nadeau1,2, Cyril Duclos1,2. 1. School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada. 2. Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada. 3. Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil. 4. Department of Automated Manufacturing Engineering, Imaging and Orthopaedics Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), École de Technologie Supérieure, Montreal, Canada.
Abstract
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.
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.
Authors: Daniel Fuller; Emily Colwell; Jonathan Low; Kassia Orychock; Melissa Ann Tobin; Bo Simango; Richard Buote; Desiree Van Heerden; Hui Luan; Kimberley Cullen; Logan Slade; Nathan G A Taylor Journal: JMIR Mhealth Uhealth Date: 2020-09-08 Impact factor: 4.773