Comparison of Activity Monitors Accuracy in Assessing Intermittent Outdoor Walking

Purpose This study aimed to determine and compare the accuracy of different activity monitors in assessing intermittent outdoor walking in both healthy and clinical populations through the development and validation of processing methodologies. Methods In study 1, an automated algorithm was implemented and tested for the detection of short (<= 1 min) walking and stopping bouts during prescribed walking protocols performed by healthy subjects in environments with low and high levels of obstruction. The following parameters obtained from activity monitors were tested, with different recording epochs(0.1s/0.033s/1s/3s/10s) and wearing locations(scapula/hip/wrist/ankle): GlobalSat DG100 (GS) and Qstarz BT-Q1000XT/-Q1000eX (QS) speed; ActiGraph wGT3X+ (AG) vector magnitude (VM) raw data, VM counts, and steps; and StepWatch3 (SW) steps. Furthermore, linear mixed models were developed to estimate walking speeds and distances from the monitors parameters. Study 2 validated the performance of the activity monitors and processing methodologies in a clinical population showing profile of intermittent walking due to functional limitations during outdoor walking sessions. Results In study 1, GS(1s, scapula), QS(1s, scapula/wrist) speed, and AG(0.033s, hip) VM raw data provided the highest bout detection rates (>96.7%) and the lowest root mean square errors in speed (<= 0.4 km center dot h(-1)) and distance (<18 m) estimation. Using SW3s, ankle steps, the root mean square error for walking/stopping duration estimation reached 13.6 min using proprietary software and 0.98 min using our algorithm (total recording duration, 282 min). In study 2, using AG(0.033s, hip) VM raw data, the bout detection rate (95% confidence interval) reached 100% (99%-100%), and the mean (SD) absolute percentage errors in speed and distance estimation were 9% (6.6%) and 12.5% (7.9%), respectively. Conclusions GPS receivers and AG demonstrated high performance in assessing intermittent outdoor walking in both healthy and clinical populations.