Counting Steps in Activities of Daily Living in People With a Chronic Disease Using Nine Commercially Available Fitness Trackers: Cross-Sectional Validity Study

Darcy Ummels; Emmylou Beekman; Kyra Theunissen; Susy Braun; Anna J Beurskens

doi:10.2196/mhealth.8524

Counting Steps in Activities of Daily Living in People With a Chronic Disease Using Nine Commercially Available Fitness Trackers: Cross-Sectional Validity Study

JMIR Mhealth Uhealth. 2018 Apr 2;6(4):e70. doi: 10.2196/mhealth.8524.

Authors

Darcy Ummels^{1

2

3}, Emmylou Beekman^{1

2

3}, Kyra Theunissen¹, Susy Braun^{4

5}, Anna J Beurskens^{1

3}

Affiliations

¹ Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Zuyd University of Applied Sciences, Heerlen, Netherlands.
² ParaMedisch Centrum Zuid, Sittard, Netherlands.
³ Care and Public Health Research Institute School for Public Health and Primary Care, Department of Family Medicine, Maastricht University Medical Centre, Maastricht, Netherlands.
⁴ Research Centre for Nutrition, Lifestyle and Exercise, Zuyd University of Applied Sciences, Heerlen, Netherlands.
⁵ Care and Public Health Research Institute School for Public Health and Primary Care, Department of Health Services Research, Maastricht University Medical Centre, Maastricht, Netherlands.

Abstract

Background: Measuring physical activity with commercially available activity trackers is gaining popularity. People with a chronic disease can especially benefit from knowledge about their physical activity pattern in everyday life since sufficient physical activity can contribute to wellbeing and quality of life. However, no validity data are available for this population during activities of daily living.

Objective: The aim of this study was to investigate the validity of 9 commercially available activity trackers for measuring step count during activities of daily living in people with a chronic disease receiving physiotherapy.

Methods: The selected activity trackers were Accupedo (Corusen LLC), Activ8 (Remedy Distribution Ltd), Digi-Walker CW-700 (Yamax), Fitbit Flex (Fitbit inc), Lumoback (Lumo Bodytech), Moves (ProtoGeo Oy), Fitbit One (Fitbit inc), UP24 (Jawbone), and Walking Style X (Omron Healthcare Europe BV). In total, 130 persons with chronic diseases performed standardized activity protocols based on activities of daily living that were recorded on video camera and analyzed for step count (gold standard). The validity of the trackers' step count was assessed by correlation coefficients, t tests, scatterplots, and Bland-Altman plots.

Results: The correlations between the number of steps counted by the activity trackers and the gold standard were low (range: -.02 to .33). For all activity trackers except for Fitbit One, a significant systematic difference with the gold standard was found for step count. Plots showed a wide range in scores for all activity trackers; Activ8 showed an average overestimation and the other 8 trackers showed underestimations.

Conclusions: This study showed that the validity of 9 commercially available activity trackers is low measuring steps while individuals with chronic diseases receiving physiotherapy engage in activities of daily living.

Keywords: accelerometer; activity tracker; chronic disease; physical activity; physical therapy; validity; wearable.

©Darcy Ummels, Emmylou Beekman, Kyra Theunissen, Susy Braun, Anna J Beurskens. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 02.04.2018.