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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
Author(s) -
Duclos Noémie C.,
Aguiar Larissa T.,
Aissaoui Rachid,
Faria Christina D.C.M.,
Nadeau Sylvie,
Duclos Cyril
Publication year - 2019
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1002/pmrj.12080
Subject(s) - stairs , activity monitor , ankle , physical medicine and rehabilitation , medicine , physical therapy , hemiparesis , gait , preferred walking speed , physical activity , surgery , lesion , civil engineering , engineering
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 .