Original article
The Use of Pedometers in Stroke Survivors: Are They Feasible and How Well Do They Detect Steps?

Presented as a poster (preliminary results of 13 participants) to the British Geriatrics Society, April 22, 2010, Edinburgh, Scotland; and to the UK Stroke Forum (pedometer feasibility, accuracy, and acceptability data), December 2010, Glasgow, Scotland.
https://doi.org/10.1016/j.apmr.2011.08.047Get rights and content

Abstract

Carroll SL, Greig CA, Lewis SJ, McMurdo ME, Sniehotta FF, Johnston M, Johnston DW, Scopes J, Mead GE. The use of pedometers in stroke survivors: are they feasible and how well do they detect steps?

Objectives

To determine (1) the feasibility of pedometers for stroke patients and (2) the level of agreement between pedometers and actual step count.

Design

Observational agreement study.

Setting

Six stroke units.

Participants

Independently mobile stroke patients (N=50) ready for hospital discharge.

Interventions

Patients were asked to apply 3 pedometers: 1 around the neck and 1 above each hip. Patients performed a short walk lasting 20 seconds, then a 6-minute walk test 6MWT. Video recordings determined the criterion standard step count.

Main Outcome Measure

Agreement between the step count recorded by pedometers and the step count recorded by viewing the criterion standard video recordings of the 2 walks.

Results

Five patients (10%) needed assistance to put on the pedometers, and 5 (10%) could not read the step count. Thirty-nine (78%) would use pedometers again. Below a gait speed of about 0.5m/s, pedometers did not generally detect steps. Agreement analyses showed that even above 0.5m/s, pedometers undercounted steps for both the short walk and 6MWT; for example, the mean difference between the video recorder and pedometer around the neck was 5.93 steps during the short walk and 32.4 steps during the 6MWT.

Conclusions

Pedometers are feasible but generally do not detect steps at gait speeds below about 0.5m/s, and they undercount steps at gait speeds above 0.5m/s.

Section snippets

Methods

Ethical approval was from South East Scotland Research Ethics Committee 01.

Results

Fifty-one (76%) of 67 eligible patients agreed to participate, 1 of whom was unable to perform the walks safely and was excluded (table 1).

Discussion

To our knowledge, this is the first study in stroke patients to systematically record the feasibility of pedometers and to explore the influence of pedometer position on step count recordings, and it is the largest study to determine agreement between the pedometer step counts and a criterion standard measure of step count. Most patients correctly read step counts, all patients could take pedometers off, and only 5 (10%) needed help putting them on. Most would be willing to use pedometers again.

Conclusions

This study has shown that pedometers are feasible for use in ambulatory stroke patients. However, below a gait speed of 0.5m/s, agreement between the pedometer step count and the video-recorded step count is low, with many pedometers not detecting any steps. We are now developing a behavioral change intervention to increase physical activity after stroke, using a pedometer to provide feedback on step count, but restricting this intervention to patients with gait speeds of greater than 0.5m/s.

Acknowledgments

We thank the clinicians who helped with recruitment.

References (18)

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Supported by The Chief Scientist Office, Scottish Government (ref no. CZG/2/428) and by the Scottish Stroke Research Network.

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

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