Validity and Interinstrument Reliability of a Medical Grade Physical Activity Monitor in Older Adults

in Journal for the Measurement of Physical Behaviour

Click name to view affiliation

Myles W. O’BrienAcadia University
Dalhousie University

Search for other papers by Myles W. O’Brien in
Current site
Google Scholar
PubMed
Close
*
,
William R. WojcikAcadia University

Search for other papers by William R. Wojcik in
Current site
Google Scholar
PubMed
Close
*
, and
Jonathon R. FowlesAcadia University

Search for other papers by Jonathon R. Fowles in
Current site
Google Scholar
PubMed
Close
*
Restricted access

Wearable physical activity monitors are associated with an increase in user’s habitual physical activity levels. Most of the older adult population do not meet the national moderate- to vigorous-intensity physical activity (MVPA) recommendations and may benefit from being prescribed a physical activity monitor. The PiezoRx is a class one medical grade device that uses step rate thresholds to measure MVPA. The validity and reliability of the PiezoRx in measuring MVPA has yet to be determined in older persons. We assessed the validity and interinstrument reliability of the PiezoRx to measure steps and MVPA in older adults. Participants (n = 19; 68.8 ± 2.3 years) wore an Omron HJ-320 pedometer, ActiGraph GT3X accelerometer, and four PiezoRx monitors during a five-stage treadmill walking protocol. The PiezoRx devices were set at moderate physical activity and vigorous physical activity step rate thresholds (steps per minute) of 100/120, 110/130, adjusted for height and adjusted for height + fitness. The PiezoRx exhibited a stronger correlation (intraclass correlation coefficient = .82) with manually counted steps than the ActiGraph (intraclass correlation coefficient = .53) and Omron (intraclass correlation coefficient = .54) and had a low absolute percentage error (3 ± 6%). The PiezoRx with moderate physical activity/vigorous physical activity step thresholds adjusted to 110/130 was strongly correlated to indirect calorimetry (0.84, p < .001) and best distinguished each walking stage as MVPA or not (sensitivity: 88%; specificity: 95%). The PiezoRx monitor is a valid and reliable measure of step count and MVPA among older adults. The device’s ability to measure MVPA in absolute terms was improved when step rate thresholds for moderate physical activity/vigorous physical activity were increased to 110/130 steps per minute in this population.

O’Brien, Wojcik, and Fowles are with the School of Kinesiology, Centre of Lifestyle Studies, Acadia University, Wolfville, Nova Scotia, Canada. O’Brien is also with the Division of Kinesiology, Dalhousie University, Halifax, Nova Scotia, Canada.

Fowles (Jonathon.fowles@acadiau.ca) is corresponding author.
  • Collapse
  • Expand
  • Barnett, A., van den Hoek, D., Barnett, D., & Cerin, E. (2016). Measuring moderate-intensity walking in older adults using the ActiGraph accelerometer. BMC Geriatrics, 16(1), 211. PubMed ID: 27931188 doi:10.1186/s12877-016-0380-5

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Beets, M.W., Agiovlasitis, S., Fahs, C.A., Ranadive, S.M., & Fernhall, B. (2010). Adjusting step count recommendations for anthropometric variations in leg length. Journal of Science and Medicine in Sport, 13(5), 509512. PubMed ID: 20096631 doi:10.1016/j.jsams.2009.11.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bourke, A.K., Ihlen, E.A.F., & Helbostad, J.L. (2019). Validation of the activPAL3 in free-living and laboratory scenarios for the measurement of physical activity, stepping, and transitions in older adults. Journal for the Measurement of Physical Behaviour, 2(2), 5865. doi:10.1123/jmpb.2018-0056

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chodzko-Zajko, W.J., Proctor, D.N., Fiatarone Singh, M.A., Minson, C.T., Nigg, C.R., Salem, G.J., & Skinner, J.S. (2009). Exercise and physical activity for older adults. Medicine & Science in Sports & Exercise, 41(7), 15101530. PubMed ID: 19516148 doi:10.1249/MSS.0b013e3181a0c95c

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Colley, R.C., Barnes, J.D., Leblanc, A.G., Borghese, M., Boyer, C., & Tremblay, M.S. (2013). Validity of the SC-StepMX pedometer during treadmill walking and running. Applied Physiology, Nutrition, and Metabolism, 38(5), 520524. PubMed ID: 23668759 doi:10.1139/apnm-2012-0321

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Colley, R.C., Butler, G., Garriguet, D., Prince, S.A., & Roberts, K.C. (2018). Comparison of self-reported and accelerometer-measured physical activity in Canadian adults. Health Reports, 29(12), 315. PubMed ID: 30566204

    • Search Google Scholar
    • Export Citation
  • Canadian Society for Exercise Physiology. (2013). Canadian Society for Exercise Physiology—Physical activity training for health. Ottawa, Ontario: Author.

    • Search Google Scholar
    • Export Citation
  • Dall, P., McCrorie, P., Granat, M., & Stansfield, B. (2013). Step accumulation per minute epoch is not the same as cadence for free-living adults. Medicine & Science in Sports & Exercise, 45(10), 19952001. PubMed ID: 23568091 doi:10.1249/MSS.0b013e3182955780

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dasgupta, K., Rosenberg, E., Joseph, L., Cooke, A.B., Trudeau, L., Bacon, S.L., … SMARTER Trial Group. (2017). Physician step prescription and monitoring to improve ARTERial health (SMARTER): A randomized controlled trial in patients with type 2 diabetes and hypertension. Diabetes, Obesity and Metabolism, 19(5), 695704. PubMed ID: 28074635 doi:10.1111/dom.12874

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ebbeling, C.B., Ward, A., Puleo, E.M., Widrick, J., & Rippe, J.M. (1991). Development of a single-stage submaximal treadmill walking test. Medicine & Science in Sports & Exercise, 23(8), 966973. PubMed ID: 1956273 doi:10.1249/00005768-199108000-00014

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ehrler, F., Weber, C., & Lovis, C. (2016). Influence of pedometer position on pedometer accuracy at various walking speeds: A comparative study. Journal of Medical Internet Research, 18(10), e268. PubMed ID: 27713114 doi:10.2196/jmir.5916

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Freedson, P.S., Melanson, E., & Sirard, J. (1998). Calibration of the Computer Science and Applications, Inc. accelerometer. Medicine & Science in Sports & Exercise, 30(5), 777781. PubMed ID: 9588623 doi:10.1097/00005768-199805000-00021

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gorman, E., Hanson, H.M., Yang, P.H., Khan, K.M., Liu-Ambrose, T., & Ashe, M.C. (2014). Accelerometry analysis of physical activity and sedentary behavior in older adults: A systematic review and data analysis. European Review of Aging and Physical Activity, 11(1), 3549. doi:10.1007/s11556-013-0132-x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hall, K.S., Howe, C.A., Rana, S.R., Martin, C.L., & Morey, M.C. (2013). METs and accelerometry of walking in older adults. Medicine & Science in Sports & Exercise, 45(3), 574582. PubMed ID: 23059862 doi:10.1249/MSS.0b013e318276c73c

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hergenroeder, A.L., Barone Gibbs, B., Kotlarczyk, M.P., Perera, S., Kowalsky, R.J., & Brach, J.S. (2019). Accuracy and acceptability of commercial-grade physical activity monitors in older adults. Journal of Aging and Physical Activity, 27(2), 222229. PubMed ID: 30117355 doi:10.1123/japa.2018-0036

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Huberty, J.L., Matthews, J.L., Toledo, M., Smith, L., Jarrett, C.L., Duncan, B., & Buman, M.P. (2018). Vinyasa flow: Metabolic cost and validation of hip- and wrist-worn wearable sensors. Journal for the Measurement of Physical Behaviour, 1(4), 174180. doi:10.1123/jmpb.2017-0010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jetté, M., Sidney, K., & Blümchen, G. (1990). Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity. Clinical Cardiology, 13(8), 555565. PubMed ID: 2204507 doi:10.1002/clc.4960130809

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kolt, G.S., Schofield, G.M., Kerse, N., Garrett, N., Ashton, T., & Patel, A. (2012). Healthy steps trial: Pedometer-based advice and physical activity for low-active older adults. The Annals of Family Medicine, 10(3), 206212. PubMed ID: 22585884 doi:10.1370/afm.1345

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kozey, S., Lyden, K., Staudenmayer, J., & Freedson, P. (2010). Errors in MET estimates of physical activities using 3.5 ml·kg−1·min−1 as the baseline oxygen consumption. Journal of Physical Activity and Health, 7(4), 508516. PubMed ID: 20683093 doi:10.1123/jpah.7.4.508

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kwan, M., Woo, J., & Kwok, T. (2004). The standard oxygen consumption value equivalent to one metabolic equivalent (3.5 ml/min/kg) is not appropriate for elderly people. International Journal of Food Sciences and Nutrition, 55(3), 179182. PubMed ID: 15223593 doi:10.1080/09637480410001725201

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lin, L. (1989). A concordance correlation coefficient to evaluate reproducibility. Biometrics, 45(1), 255268. PubMed ID: 2720055 doi:10.2307/2532051

  • Ludbrook, J. (2010). Confidence in Altman-Bland plots: A critical review of the method of differences. Clinical and Experimental Pharmacology and Physiology, 37(2), 143149. PubMed ID: 19719745 doi:10.1111/j.1440-1681.2009.05288.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • O’Brien, M., Kivell, M.J., Wojcik, W.R., D’Entremont, G., Kimmerly, D.S., & Fowles, J.R. (2018a). Influence of anthropometrics on step-rate thresholds for moderate and vigorous physical activity in older adults: Scientific modeling study. JMIR Aging, 1(2), e12363. doi:10.2196/12363

    • Crossref
    • Search Google Scholar
    • Export Citation
  • O’Brien, M., Kivell, M.J., Wojcik, W.R., D’Entremont, G., Kimmerly, D.S., & Fowles, J.R. (2018b). Step rate thresholds associated with moderate to vigorous physical activity in adults. International Journal of Enviromental Research and Public Health, 15(11), e2425. doi:10.3390/ijerph15112454

    • Search Google Scholar
    • Export Citation
  • O’Brien, M., Wojcik, W., D’Entremont, L., & Fowles, J. (2018). Validation of the PiezoRx® step count and moderate to vigorous physical activity times in free living conditions in adults: A pilot study. International Journal of Exercise Science, 11(7), 541551. PubMed ID: 29541342

    • Search Google Scholar
    • Export Citation
  • O’Brien, M., Wojcik, W., & Fowles, J. (2018). Medical-grade physical activity monitoring for measuring step count and moderate-to-vigorous physical activity: Validity and reliability study. JMIR MHealth and UHealth, 6(9), e10706. PubMed ID: 30185406 doi:10.2196/10706

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Peacock, L., Hewitt, A., Rowe, D.A., & Sutherland, R. (2014). Stride rate and walking intensity in healthy older adults. Journal of Aging and Physical Activity, 22(2), 276283. PubMed ID: 23799828 doi:10.1123/japa.2012-0333

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Petrucci, G., Freedson, P., Masteller, B., Cox, M., Staudenmayer, J., & Sirard, J. (2018). Sensitivity of the Misfit Shine™ to detect changes in laboratory-based and free-living physical activity. Journal for the Measurement of Physical Behaviour, 1(1), 1825. doi:10.1123/jmpb.2017-0006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Riley, P.O., Paolini, G., Croce, U.D., Paylo, K.W., & Kerrigan, D.C. (2007). Kinematic and kinetic comparison of overground and treadmill walking in healthy subjects. Gait & Posture, 26(1), 1724. PubMed ID: 16905322 doi:10.1016/j.gaitpost.2006.07.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rowe, D.A., Welk, G.J., Heil, D.P., Mahar, M.T., Kemble, C.D., Calabró, M.A., & Camenisch, K. (2011). Stride rate recommendations for moderate-intensity walking. Medicine & Science in Sports & Exercise, 43(2), 312318. PubMed ID: 20543754 doi:10.1249/MSS.0b013e3181e9d99a

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Saunders, T.J., Gray, C.E., Borghese, M.M., McFarlane, A., Mbonu, A., Ferraro, Z.M., & Tremblay, M.S. (2014). Validity of SC-StepRx pedometer-derived moderate and vigorous physical activity during treadmill walking and running in a heterogeneous sample of children and youth. BMC Public Health, 14(1), 519. doi:10.1186/1471-2458-14-519

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sawyer, B.J., Blessinger, J.R., Irving, B.A., Weltman, A., Patrie, J.T., & Gaesser, G.A. (2010). Walking and running economy: Inverse association with peak oxygen uptake. Medicine & Science in Sports & Exercise, 42(11), 21222127. PubMed ID: 20351592 doi:10.1249/mss.0b013e3181de2da7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stansfield, B., Clarke, C., Dall, P., Godwin, J., Holdsworth, R., & Granat, M. (2015). True cadence and step accumulation are not equivalent: The effect of intermittent claudication on free-living cadence. Gait & Posture, 41(2), 414419. PubMed ID: 25480164 doi:10.1016/j.gaitpost.2014.11.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tedesco, S., Sica, M., Ancillao, A., Timmons, S., Barton, J., & O’Flynn, B. (2019). Accuracy of consumer-level and research-grade activity trackers in ambulatory settings in older adults. PLoS One, 14(5), e0216891. PubMed ID: 31112585 doi:10.1371/journal.pone.0216891

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tudor-Locke, C., Aguiar, E.J., Han, H., Ducharme, S.W., Schuna, J.M., Barreira, T.V., … Staudenmayer, J. (2019). Walking cadence (steps/min) and intensity in 21–40 year olds: CADENCE-adults. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 8. PubMed ID: 30654810doi:10.1186/s12966-019-0769-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tudor-Locke, C., Han, H., Aguiar, E., Barreira, T., Schuna, J.J., Kang, M., & Rowe, D. (2018). How fast is fast enough? Walking cadence (steps/min) as a practical estimate of intensity in adults: A narrative review. British Journal of Sports Medicine, 52(12), 776788. PubMed ID: 29858465 doi:10.1136/bjsports-2017-097628

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Warburton, D.E., Bredin, S.S., Jamnik, V., & Gledhill, N. (2011). Validation of the PAR-Q+ and ePARmed-X+. Health and Fitness Journal of Canada, 4(2), 3846. doi:10.14288/hfjc.v4i2.151

    • Search Google Scholar
    • Export Citation
  • Webber, S.C., Magill, S.M., Schafer, J.L., & Wilson, K.C.S. (2014). GT3X+ accelerometer, Yamax pedometer, and SC-StepMX pedometer step count accuracy in community-dwelling older adults. Journal of Aging and Physical Activity, 22(3), 334341. PubMed ID: 23921227 doi:10.1123/JAPA.2013-0002

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 1284 693 32
Full Text Views 15 6 2
PDF Downloads 11 6 2