Validating accelerometry as a measure of physical activity and energy expenditure in chronic stroke.
Monica C Serra, Elizabeth Balraj, Beth L DiSanzo and 4 others
PMID 27322733WHAT IT FOUND
Standard accelerometry thresholds underestimate activity intensity in stroke survivors with hemiparetic gait.
New stroke-specific cutpoints for Actical monitors were developed, showing that walking at 2.0 mph is vigorous intensity for this population, not light or moderate.
Key findings
01Actical accelerometers worn on the non-paretic hip were validated against indirect calorimetry during eight activities of daily living in 28 chronic stroke participants.
02New stroke-specific intensity thresholds were established: 125 counts per minute for sedentary/light, 667 for light/moderate, and 1546 for moderate/vigorous physical activity.
03Existing thresholds from healthy adults drastically underestimate energy expenditure during intense activities in stroke survivors by approximately two-fold.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Small sample size (n=28) prevented subgroup analyses by race or gender. The study did not measure subjective ratings of perceived exertion. Four participants could not complete the highest intensity treadmill tasks, limiting data at the upper end of the intensity spectrum for some individuals. The study focused on individuals with residual hemiparetic gait abnormalities; results may not apply to stroke survivors with other types of mobility impairments or those without gait deficits.
Declared interests
The authors declared no conflicts of interest. The study was supported by grants from the NIH and the Department of Veterans Affairs.
The easy way to misread this
Do not assume that standard fitness tracker data is accurate for stroke survivors. Using general population thresholds will significantly underestimate the intensity of their daily activities, potentially leading to inappropriate exercise prescriptions or missed opportunities for intervention.