Criterion validity of ActiGraph monitoring devices for step counting and distance measurement in adults and older adults: a systematic review.
Armelle-Myriane Ngueleu, Corentin Barthod, Krista Lynn Best and 3 others
PMID 36253787WHAT IT FOUND
ActiGraph step counts were most accurate with GT3X+/wGT3X+ or wGT3X-BT on the hip at self-selected comfort walking speeds.
Slow walking below 0.9 m/s was poor, though a low frequency extension filter helped GT3X+. Wrist wear and older devices gave poor counts. Distance evidence was limited.
Key findings
01Across 21 studies of 637 adults and older adults, GT3X+/wGT3X+ and wGT3X-BT matched reference step counts better than 7164, GT1M, and wGTX+.
02Step counting was not valid below 0.9 m/s, and hip-worn wGT3X-BT was less valid at 0.5 m/s.
03Wrist-worn ActiGraph step counts differed significantly from reference counts, while hip-worn devices generally showed better validity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The review included only healthy adults and older adults. It does not show how valid the devices are for people with stroke or other walking impairments. Most studies were short indoor tests, from 2 to 15 min, and only two studies were outdoor. Small errors over short tests may become larger over a day. Study samples were small, so results cannot be generalized. Many studies did not report signal processing, sensitivity, dynamic range, or analysis algorithm. Device comparisons are difficult. Only one study assessed distance, so conclusions about distance are limited. Quality was mixed: on COSMIN, 11 articles were high-quality, 2 moderate-quality, and 8 low-quality.
The easy way to misread this
Do not conclude that ActiGraph step counts are accurate for all walking assessments. The review found poor default validity below 0.9 m/s and for wrist-worn devices, and only one study tested distance.