Motion sensors may be applied for the assessment of physical activity. This paper reviews the evolution of these instruments from the mechanical pedometer to the electronic accelerometer. We conclude that for accurate assessment of physical activity under free living conditions the recently introduced accelerometer looks most promising, although little information was available regarding the reliability of these instruments. Subsequently, reliability of an accelerometer with a three-directional sensor was examined. Intrainstrument variation in a bench test was less than 8% during four measurements over a week. Interinstrument variation during treadmill experiments while subjects wore two accelerometers at the same time was on average 22% and was not improved after adjustment for differences found in the bench test. Reproducibility in the treadmill experiment was approximately 76, 85, and 95% at 3, 5, and 7 km/h, respectively. Bench testing revealed that the sensitivity of a piezoelectric element is prone to shifts, probably due to mechanical, electromagnetic, and/or temperature shock, which may be encountered during outdoor application. However, the relevance of the bench test in this study may be questioned, as results did not correspond with the findings in subjects. This needs further investigation.