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Article
Step count accuracy during poststroke physical therapy and simulated activities
Translational Journal of the American College of Sports Medicine
  • Lindsay Toth, University of North Florida
  • C. E. Henderson
  • A. S. Kaplan
  • T. G. Hornby
Document Type
Article
Publication Date
1-1-2022
Abstract

Introduction/purpose: The amount of stepping activity during rehabilitation post-stroke can predict walking outcomes, although the most accurate methods to evaluate stepping activity are uncertain with conflicting findings on available stepping monitors during walking assessments. Rehabilitation sessions also include non-stepping activities and the ability of activity monitors to differentiate these activities from stepping is unclear. The objective of this study was to examine the accuracy of different activity monitors worn by individuals post-stroke with variable walking speeds during clinical physical therapy (PT) and research interventions focused on walking.

Methods: In Part I, 28 participants post-stroke wore a StepWatch, ActiGraph with and without a Low Frequency Extension (LFE) filter, and Fitbit on paretic and non-paretic distal shanks at or above the ankle during clinical PT or research interventions with steps simultaneously hand counted. Mean absolute percent errors were compared between limbs and tasks performed. In Part II, 12 healthy adults completed 8 walking and 9 non-walking tasks observed during clinical PT or research. Data were descriptively analyzed and used to assist interpretation of Part I results.

Results: Part I results indicate most devices did not demonstrate an optimal limb configuration during research sessions focused on walking, with larger errors during clinical PT on the non-paretic limb. Using the limb that minimized errors for each device, the StepWatch had smaller errors than the ActiGraph and Fitbit (p

Conclusions: The StepWatch and ActiGraph-LFE had smaller errors than the Fitbit or ActiGraph, with greater errors in those walking at slower speeds. Inclusion of non-stepping activities affected step counts and should be considered when measuring stepping activity in individuals post-stroke to predict locomotor outcomes following rehabilitation.

Digital Object Identifier (DOI)
10.1249/tjx.0000000000000186
PubMed ID
35425853
Citation Information
Lindsay Toth, C. E. Henderson, A. S. Kaplan and T. G. Hornby. "Step count accuracy during poststroke physical therapy and simulated activities" Translational Journal of the American College of Sports Medicine Vol. 7 Iss. 1 (2022)
Available at: http://works.bepress.com/lindsay-toth/7/