Validity of Fitbit activity monitoring for adults with progressive muscle diseases

Disabil Rehabil. 2022 Dec;44(24):7543-7553. doi: 10.1080/09638288.2021.1995057. Epub 2021 Oct 31.


Purpose: Measuring physical activity informs activity recommendations in clinical practice and provides outcomes in clinical trials that are meaningful to patients. Activity assessment in muscle disease is challenging and there is insufficient evidence to support any single activity measure; however, multi-modal activity measurement might have potential.

Materials and methods: This two-part study included 20 and 95 adults with progressive muscle diseases with mobility ranging from independent to assisted, including wheelchair users. Their activity was measured using a multi-sensor Fitbit activity monitor, for which criterion validity and acceptability were tested in study 1 and validity, reliability, and responsiveness were tested in the longitudinal, home-based study 2.

Results: Study 1: Fitbit was acceptable and had strong criterion validity (rho/kappa ≥0.90), although up to 15% measurement error. Study 2: Fitbit had satisfactory concurrent and construct validity, reliability, and responsiveness. However, Fitbit active minutes registered 75 min more activity per week than gold standard moderate and vigorous physical activity (MVPA) time.

Conclusions: Fitbit had satisfactory measurement properties for monitoring physical activity in adults with progressive muscle diseases. However, Fitbit should not be considered an exact step counter, heart rate monitor or calorimeter and Fitbit active minutes are not synonymous with MVPA time.Implications for rehabilitationPeople with progressive muscle diseases mobilise independently, with walking aids and with wheelchairs; physical activity measurement can be challenging in this population.Multisensor smart activity monitoring by Fitbit had satisfactory validity, reliability, responsiveness, and acceptability for the estimation of physical activity in adults with progressive muscle diseases.Fitbit active minutes are not synonymous with moderate and vigorous physical activity (MVPA) time measured using a research grade accelerometer.

Keywords: Fitbit; Physical activity; muscular dystrophy; reliability; responsiveness; validity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accelerometry
  • Adult
  • Exercise* / physiology
  • Fitness Trackers*
  • Humans
  • Monitoring, Ambulatory
  • Monitoring, Physiologic
  • Muscles
  • Reproducibility of Results