Physical activity monitoring in stroke: SenseWear Pro2 activity accelerometer versus Yamax Digi-Walker SW-200 pedometer.

PURPOSE: Determine validity and reliability of SenseWear Pro2 Armband (SWP2A) and Yamax Digi-Walker SW-200 Pedometer (YDWP) in stroke and healthy adults.

METHODS: Fifteen stroke patients and 15 healthy participants wore SWP2A on upper arm and YDWP at hip/knee. Different activities were performed: treadmill walking, walking up/down a step, cycling and walking on an even surface. Steps and Energy Expenditure (EE) were measured and compared to steps counted manually and indirect calorimetry. Repeated measurements were compared to determine reliability of both devices.

RESULTS: Spearman correlation coefficients between knee-worn YDWP and counted steps while walking on an even surface was ≥0.89 in healthy and ≥0.95 in stroke. Treadmill walking revealed high Spearman correlation coefficients in healthy individuals (rs ≥ 0.90) and at 1.5 km/h in stroke (rs = 0.69). During other activities YDWP often underestimated steps. SWP2A data revealed inconsistent results in EE and steps. Reliability tested by repeated measurements varied between 0.66 and 0.98 for YDWP and 0.61 and 0.97 for SWP2A.

CONCLUSION: YDWP and SWP2A are both reliable. Only knee-worn YDWP is a valid device to measure steps except high intensity walking in stroke. YDWP systematically undercounts steps during other activities of short duration. This study could not demonstrate valid measurement of steps/EE in stroke using SWP2A. Implications for Rehabilitation Stroke is a disabling disease with residual neurologic deficits, which impairs mobility and predisposes them to sedentary behavior. A Yamax Digi-Walker SW-200 knee-worn pedometer showed to be a valid and reliable technique to measure ambulatory activity in stroke. A valid instrument to measure energy expenditure in stroke needs to be explored.