Step-Count Accuracy of 3 Motion Sensors for Older and Frail Medical Inpatients

Arch Phys Med Rehabil. 2017 Feb;98(2):295-302. doi: 10.1016/j.apmr.2016.08.476. Epub 2016 Sep 22.

Abstract

Objective: To measure the step-count accuracy of an ankle-worn accelerometer, a thigh-worn accelerometer, and a pedometer in older and frail inpatients.

Design: Cross-sectional design study.

Setting: Research room within a hospital.

Participants: Convenience sample of inpatients (N=32; age, ≥65 years) who were able to walk 20m independently with or without a walking aid.

Interventions: Patients completed a 40-minute program of predetermined tasks while wearing the 3 motion sensors simultaneously. Video recording of the procedure provided the criterion measurement of step count.

Main outcome measures: Mean percentage errors were calculated for all tasks, for slow versus fast walkers, for independent walkers versus walking-aid users, and over shorter versus longer distances. The intraclass correlation was calculated, and accuracy was graphically displayed by Bland-Altman plots.

Results: Thirty-two patients (mean age, 78.1±7.8y) completed the study. Fifteen (47%) were women, and 17 (51%) used walking aids. Their median speed was .46m/s (interquartile range [IQR], .36-.66m/s). The ankle-worn accelerometer overestimated steps (median error, 1% [IQR, -3% to 13%]). The other motion sensors underestimated steps (median error, 40% [IQR, -51% to -35%] and 38% [IQR -93% to -27%], respectively). The ankle-worn accelerometer proved to be more accurate over longer distances (median error, 3% [IQR, 0%-9%]) than over shorter distances (median error, 10% [IQR, -23% to 9%]).

Conclusions: The ankle-worn accelerometer gave the most accurate step-count measurement and was most accurate over longer distances. Neither of the other motion sensors had acceptable margins of error.

Keywords: Dimensional measurement accuracy; Frail elderly; Inpatients; Rehabilitation; Walking.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accelerometry / instrumentation*
  • Accelerometry / standards
  • Aged
  • Aged, 80 and over
  • Canes
  • Cross-Sectional Studies
  • Female
  • Humans
  • Inpatients
  • Male
  • Remote Sensing Technology / instrumentation*
  • Remote Sensing Technology / standards
  • Walkers
  • Walking / physiology*