Physical activity monitoring in stroke: SenseWear Pro2 Activity accelerometer versus Yamax Digi-Walker SW-200 Pedometer

Abstract Purpose: Determine validity and reliability of SenseWear Pro2 Armband (SWP2A) and Yamax Digi-Walker SW-200 Pedometer (YDWP) in stroke and healthy adults. Methods: Fifteen stroke patients and 15 healthy participants wore SWP2A on upper arm and YDWP at hip/knee. Different activities were performed: treadmill walking, walking up/down a step, cycling and walking on an even surface. Steps and Energy Expenditure (EE) were measured and compared to steps counted manually and indirect calorimetry. Repeated measurements were compared to determine reliability of both devices. Results: Spearman correlation coefficients between knee-worn YDWP and counted steps while walking on an even surface was ≥0.89 in healthy and ≥0.95 in stroke. Treadmill walking revealed high Spearman correlation coefficients in healthy individuals (rs ≥ 0.90) and at 1.5 km/h in stroke (rs = 0.69). During other activities YDWP often underestimated steps. SWP2A data revealed inconsistent results in EE and steps. Reliability tested by repeated measurements varied between 0.66 and 0.98 for YDWP and 0.61 and 0.97 for SWP2A. Conclusion: YDWP and SWP2A are both reliable. Only knee-worn YDWP is a valid device to measure steps except high intensity walking in stroke. YDWP systematically undercounts steps during other activities of short duration. This study could not demonstrate valid measurement of steps/EE in stroke using SWP2A. Implications for Rehabilitation Stroke is a disabling disease with residual neurologic deficits, which impairs mobility and predisposes them to sedentary behavior. A Yamax Digi-Walker SW-200 knee-worn pedometer showed to be a valid and reliable technique to measure ambulatory activity in stroke. A valid instrument to measure energy expenditure in stroke needs to be explored.

[1]  Scott E Crouter,et al.  Spring-levered versus piezo-electric pedometer accuracy in overweight and obese adults. , 2005, Medicine and science in sports and exercise.

[2]  G. Bedogni,et al.  Poor agreement between a portable armband and indirect calorimetry in the assessment of resting energy expenditure. , 2008, Clinical nutrition.

[3]  Gerald V. Smith,et al.  Hemiparetic muscle atrophy and increased intramuscular fat in stroke patients. , 2002, Archives of physical medicine and rehabilitation.

[4]  M. Decramer,et al.  Quantifying physical activity in daily life with questionnaires and motion sensors in COPD , 2006, European Respiratory Journal.

[5]  Gerald V. Smith,et al.  Microprocessor-based ambulatory activity monitoring in stroke patients. , 2002, Medicine and science in sports and exercise.

[6]  K. M. Gill,et al.  Clinical Gait Assessment in the Neurologically Impaired , 1984 .

[7]  J. Eluf-Neto,et al.  The Brazilian Family Health Program and secondary stroke and myocardial infarction prevention: a 6-year cohort study. , 2012, American journal of public health.

[8]  Y Schutz,et al.  Physical activity assessment using a pedometer and its comparison with a questionnaire in a large population survey. , 1995, American journal of epidemiology.

[9]  David B Allison,et al.  Evaluation of a portable device to measure daily energy expenditure in free-living adults. , 2007, The American journal of clinical nutrition.

[10]  C. Wolfe,et al.  A long-term follow-up of stroke patients. , 1997, Stroke.

[11]  Richard F. Macko,et al.  Exercise rehabilitation after stroke , 2006, NeuroRX.

[12]  M. Gregorič,et al.  Alterations in gait resulting from deliberate changes of arm-swing amplitude and phase. , 1997, Clinical biomechanics.

[13]  R. Gosselink,et al.  Skeletal muscle weakness, exercise tolerance and physical activity in adults with cystic fibrosis , 2009, European Respiratory Journal.

[14]  C. Pieper,et al.  The reliability, validity, and stability of a measure of physical activity in the elderly. , 1996, Archives of physical medicine and rehabilitation.

[15]  N. Lincoln,et al.  Assessment of motor function in stroke patients. , 1979, Physiotherapy.

[16]  Catrine Tudor-Locke,et al.  Comparison of pedometer and accelerometer accuracy under controlled conditions. , 2003, Medicine and science in sports and exercise.

[17]  J. Hidler,et al.  Biomechanics of overground vs. treadmill walking in healthy individuals. , 2008, Journal of applied physiology.

[18]  K. M. Gill,et al.  Clinical gait assessment in the neurologically impaired. Reliability and meaningfulness. , 1984, Physical therapy.

[19]  D. Bassett,et al.  Pedometer measures of free-living physical activity: comparison of 13 models. , 2004, Medicine and science in sports and exercise.

[20]  D. Cicchetti.  Methodological Commentary The Precision of Reliability and Validity Estimates Re-Visited: Distinguishing Between Clinical and Statistical Significance of Sample Size Requirements , 2001 .

[21]  R. Neptune,et al.  Comparison of Motor Control Deficits During Treadmill and Overground Walking Poststroke , 2011, Neurorehabilitation and neural repair.

[22]  L. Green,et al.  Assessment of Habitual Physical Activity and Paretic Arm Mobility Among Stroke Survivors by Accelerometry , 2007, Topics in stroke rehabilitation.

[23]  D. Hinkle,et al.  Applied statistics for the behavioral sciences , 1979 .

[24]  Catherine Sackley,et al.  Pedometer step counts in individuals with neurological conditions , 2009, Clinical rehabilitation.

[25]  Charlie Potter,et al.  Comparison of activity monitors to estimate energy cost of treadmill exercise. , 2004, Medicine and science in sports and exercise.

[26]  H. Feys,et al.  Are patients 1 year post-stroke active enough to improve their physical health? , 2012, Disability and rehabilitation.

[27]  B E Ainsworth,et al.  Accuracy of five electronic pedometers for measuring distance walked. , 1996, Medicine and science in sports and exercise.

[28]  R. Macko,et al.  Reduced ambulatory activity after stroke: the role of balance, gait, and cardiovascular fitness. , 2005, Archives of physical medicine and rehabilitation.

[29]  Kim L Coleman,et al.  Accelerometer monitoring of home- and community-based ambulatory activity after stroke. , 2004, Archives of physical medicine and rehabilitation.

[30]  N. Solomon,et al.  Prevalence of stroke and stroke-related disability. Estimates from the Auckland stroke studies. , 1997, Stroke.

[31]  R. C. Oldfield.  The assessment and analysis of handedness: the Edinburgh inventory. , 1971, Neuropsychologia.

[32]  E. Antman,et al.  ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). , 2002, Journal of the American College of Cardiology.

[33]  K. Michael.  Fatigue and stroke. , 2002, Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses.

[34]  E. Melanson,et al.  Commercially available pedometers: considerations for accurate step counting. , 2004, Preventive medicine.

[35]  F. Pitta,et al.  Relationship between pulmonary function and physical activity in daily life in patients with COPD. , 2008, Respiratory medicine.

[36]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[37]  E. Roth,et al.  Physical activity and exercise recommendations for stroke survivors: an American Heart Association scientific statement from the Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical , 2004, Circulation.

[38]  S. Siegel,et al.  Nonparametric Statistics for the Behavioral Sciences , 2022, The SAGE Encyclopedia of Research Design.

[39]  M. Shaughnessy,et al.  Stroke Prevention and Management in Older Adults , 2006, The Journal of cardiovascular nursing.

[40]  Janice J Eng,et al.  Submaximal exercise in persons with stroke: test-retest reliability and concurrent validity with maximal oxygen consumption. , 2004, Archives of physical medicine and rehabilitation.

[41]  Marie Johnston,et al.  The use of pedometers in stroke survivors: are they feasible and how well do they detect steps? , 2012, Archives of physical medicine and rehabilitation.

[42]  Anouk Lamontagne,et al.  The effect of arm movements on the lower limb during gait after a stroke. , 2010, Gait & posture.