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Background: The wearable cardioverter–defibrillator (WCD) has a built-in accelerometer, which allows tracking of patients’ physical activity by remote monitoring. It is unclear whether WCD-measured physical activity, step count, and heart rate correlate with established tools for the assessment of cardiopulmonary fitness such as the 6-min walk test (6MWT). Objective: To correlate measurements of patient physical activity through the WCD with a supervised 6MWT during in-patient cardiac rehabilitation (CR) and to allow their use as surrogate parameters of cardiopulmonary fitness in an out-patient setting. Methods: Consecutive patients with a history of WCD use treated at our center and an in-patient CR following an index hospitalization were included. Baseline characteristics, measurements of WCD accelerometer (median daily step count, median daily activity level), median daily heart rate, and clinically supervised 6MWT at admission and discharge of CR were obtained. Results: Forty-one patients with a mean age of 55.5 (±11.5) years were included. Thirty-five patients (85.4%) were male and 28 patients (68%) had a primary prophylactic WCD-indication. The most common underlying heart diseases were ischemic heart disease (24 patients 58.6%) and dilated cardiomyopathy (13 patients, 31.7%). Median CR duration was 20 (IQR 19.75–26.25) days. 6MWT distance increased from a mean of 329 m (±107) to 470 m (±116) during CR (p < 0.0001). The median daily step count and activity level increased significantly, from 5542 steps (IQR 3718–7055) to 8778 (IQR 6229–12,920, p < 0.0001) and median 117 × 106 (IQR 96 × 106–142 × 106) threshold value exceedance (TVE) to 146 × 106 TVE (IQR 110 × 106–169 × 106, p < 0.0001), respectively. The median heart rate was 74.9 bpm (IQR 65.8–84.5) and 70.2 (IQR 64.1–77.3, p = 0.09) at admission and discharge, respectively. Of all three parameters, median daily step count showed the best correlation to the results of the 6MWT at admission and discharge (r = 0.32, p = 0.04 and 0.37, p = 0.02, respectively). Conclusions: Remote monitoring of median daily step count as assessed by the WCD’s accelerometer showed positive correlation with the 6MWT and could serve as a surrogate for cardiopulmonary exercise capacity. Assessment of daily step count and activity level measured remotely by the WCD could help to tailor optimal exercise instruction for patients not attending CR.

A small pilot study was conducted to assess synergy between almond ingestion and a walking intervention on cardiovascular health in sedentary adults. Participants (n = 12) followed an 8-week walking protocol (target: 10,000 steps/day), and for study weeks 6–8, participants were randomly assigned to almonds (ALM, 70 g/d) or an isocaloric control butter spread (CON). Protocol adherence was verified by plasma vitamin E measurement. Participant step count increased 23% from baseline levels for weeks 3–5 (p = .015) and remained ≥9800 steps/day for the study duration. Although improvements in cardiovascular health were not demonstrated by the walking protocol alone, total and LDL cholesterol were reduced in the ALM group only during study weeks 6–8 (−6 to −10%; p

Background: Walking represents a major component of physical activity (PA), and its restriction could degrade autonomy and quality of life. An important objective for preventive and/or rehabilitative strategies to improve balance and gait in normal and pathological aging conditions is to focus on physical activity. Activity monitors have recently been getting increasingly popular and represent a modern solution to measure—and communicate—PA notably in terms of steps/day. These activity monitors are well-suited for various populations as they can be worn on a variety of locations on the body, including the wrist and the hip (i.e., the two most common locations), in an undifferentiated way according to the manufacturer's instruction. The aim of this study was hence to verify potential differences in step count (SC) by comparing this parameter assessed using wrist- and hip-worn activity trackers over a 24-h period in free-living conditions in young and older adults.Methods: Young adults (n = 22) and older adults (n = 22) voluntarily participated in this study. They were required to wear two commercially-available Actigraph GT3X+ activity monitors simultaneously at two locations recommended by the manufacturer, i.e., one positioned around the wrist and one above the hip, over a 24-h period in free-living conditions. The manufacturer's software was used to obtain estimates of the SC.Results: For both groups, the wrist-worn activity tracker provided significantly higher SC than the hip-worn activity tracker did. For both placements on the body, older adults exhibited significantly lower SC than young adults. Interestingly, for both young and older participants, the difference between both measurements tended to decrease for longer distances.Conclusion: The different estimations of the step count provided by the comparison between two identical Actigraph GT3x on the wrist or the hip during the 24-h observation period in free-living conditions in young and older adults strongly suggests that caution is needed when using total step per day values as an outcome to quantify walking behavior. Probably we can suggest the same caution across implementation of different activity Tracker.

The growing popularity of physical activity (PA) applications (apps) in recent years and the vast amounts of data that they generate present attractive possibilities for surveillance. However, measurement accuracy is indispensable when tracking PA variables to provide meaningful measures of PA. The purpose of this study was to examine the steps and distance criterion validity of freeware accelerometer-based PA smartphone apps, during incremental-intensity treadmill walking and jogging. Thirty healthy adults (25.9 ± 5.7 years) participated in this cross-sectional study. They were fitted with two smartphones (one with Android and one with iOS operating systems), each one simultaneously running four different apps (i.e., Runtastic Pedometer, Accupedo, Pacer, and Argus). They walked and jogged for 5 min at each of the predefined speeds of 4.8, 6.0, and 8.4 km/h on a treadmill, and two researchers counted every step taken during trials with a digital tally counter. Validity was evaluated by comparing each app with the criterion measure using repeated-measures analysis of variance (ANOVA), mean absolute percentage errors (MAPEs), and Bland–Altman plots. For step count, Android apps performed slightly more accurately that iOS apps; nevertheless, MAPEs were generally low for all apps (10%). The findings suggest that accelerometer-based apps are accurate tools for counting steps during treadmill walking and jogging and could be considered suitable for use as an outcome measure within a clinical trial. However, none of the examined apps was suitable for measuring distance.

Rationale, aims, and objectives: Consumer‐based activity trackers aim at quantifying physical activity in a wide range of contexts. Nevertheless, they need to be validated before they are confidently used. This study assessed the concurrent validity of the Nokia Go against reference devices, according to different sensor locations, in two measurement conditions: during a walking task and during a 24‐hour free‐living condition. Methods: We examined the agreement between devices and between locations in the number of steps and total sleep time by using intraclass correlation coefficient and Bland‐Altman method. Results: In the walking task, the agreement is good to excellent for steps between the Nokia Go and the reference device. In the free‐living condition, there is a systematic underestimation of steps in comparison with the ActiGraph. Excellent agreement was found between locations. The device worn at the hip indicated the lowest number of steps, and the device located at the dominant wrist indicated the greatest number of steps. Conclusions: There are high discrepancies in step count between devices because of the different types of activities in daily life. The Nokia Go may be confidently used for step counting during pure walking tasks, at different locations. However, the lack of concurrent validity with ActiGraph call for caution regarding their use in daily living conditions. [ABSTRACT FROM AUTHOR]

This study aimed to explore differences in rates of achieving the weekly physical activity (PA) recommendation between adolescents who preferred fitness PA and those who did not. Furthermore, we investigated the types of PA practiced by adolescents. In total, 9513 participants from the Czech Republic and Poland, aged 15–18 years took part in the study between 2009 and 2016. Out of this source sample, 4977 self-reported their weekly PA using the IPAQ-Long Form, and 1348 objectively monitored their weekly PA using pedometers and recorded the type of PA. Boys ranked fitness PA third, after team and individual sports. For girls, the preference for fitness PA grew at the expense of dance and outdoor PA. Among Czech and Polish boys as well as Czech girls, those who preferred fitness PA were more likely to achieve the recommended weekly PA level than those who did not prefer fitness PA. We did not find a significant difference in other types of PA and rates of achieving the recommendation of 11,000 steps/day. Preference for fitness PA was associated with an increased likelihood (OR = 1.30; 95% CI = 1.12–1.52; p < 0.001) of achieving the recommendation for PA. When promoting adolescents' PA, it is necessary to consider preferred PA types. The PA recommendation was met by almost 33% of adolescents who indicated a preference for fitness PA, but only by 22% of those not preferring fitness activities. Organized PA is also important for meeting PA recommendations. [ABSTRACT FROM AUTHOR]

Infrequent bowel movements decrease the number of beneficial bacteria in the human intestines, thereby potentially increasing the individual's risk of colorectal cancer. The correction of such bowel problems could therefore make an important contribution to improving population health and quality-adjusted lifespan. We examined independent and interactive effects upon the fecal microbiota of two potentially favorable determinants of intestinal motility: the intake frequency of a fermented milk product containing Lactobacillus casei strain Shirota (LcS) and the quantity/quality of habitual physical activity in 338 community-living Japanese aged 65–92 years. Subjects were arbitrarily grouped on the basis of questionnaire estimates of LcS intake (0–2, 3–5, and 6–7 days/week) and pedometer/accelerometer-determined patterns of physical activity [<7000 and ≥7000 steps/day, or <15 and ≥15 min/day of activity at an intensity >3 metabolic equivalents (METs)]. After adjustment for potential confounders, the respective numbers of various beneficial fecal bacteria tended to be larger in more frequent consumers of LcS-containing products, this trend being statistically significant (mostly P < 0.001) for total Lactobacillus , the Lactobacillus casei subgroup, and the Atopobium cluster; in contrast, there were no statistically significant differences in fecal bacterial counts between the physical activity groups. A multivariate-adjusted logistic regression analysis estimated that the risk of infrequent bowel movements (arbitrarily defined as defecating ≤3 days/week) was significantly lower (P < 0.05) in subjects who ingested LcS-containing products 6–7 rather than 0–2 days/week [odds ratio (95% confidence interval) 0.382 (0.149–0.974)] and was also lower in those who took ≥7000 rather than <7000 steps/day [0.441 (0.201–0.971)] or spent ≥15 rather than <15 min/day of physical activity at an intensity >3 METs [0.412 (0.183–0.929)]. The risk of infrequent bowel movements in subjects who combined 6–7 days/week of LcS with ≥7000 steps/day or ≥15 min/day of activity at >3 METs was only a tenth of that for individuals who combined 0–2 days/week of LcS with <7000 steps/day or <15 min/day at >3 METs. These results suggest that elderly individuals can usefully ingest LcS-containing supplements regularly (≥6 days/week) and also engage in moderate habitual physical activity (≥7000 steps/day and/or ≥15 min/day at >3 METs) in order to enhance their gastrointestinal health. [ABSTRACT FROM AUTHOR]

In the recent times, issues like malnutrition, unhealthy diet, smoking, higher alcohol consumption, inadequate exercise, drug abuse and erratic sleeping patterns are on the rise and have an adverse effect on the health of people. Incidence rate of health problems like cardiovascular diseases, hypertension, type 2 diabetes and cancer has also increased drastically. Keeping this in mind, the present study was designed to study the effect of incentive-based step tracking app on fitness level of people. It was believed that incentives based on the principle of operant conditioning and behavioural economics can be instrumental in enhancing the physical activity of people. The study employed the repeated measures design wherein a sample consisting of ten participants were exposed to two treatment conditions. The study was carried out in two phases. In the first phase, weight and step count of the participants was recorded by using the apps already installed in the smart phones for this purpose. In the second phase of the study, the participants were asked to install a new app known as 'Step Set Go' (SSG) in their mobiles, which acted as an intervention or treatment condition for the participants. Step count and weight of people was recorded even after the installation of this app. Results were analysed using Wilcoxon matched pair test and Rank dilference correlation method. A significant difference was found between the two treatment groups and it was reported that incentive-based step tracking app leads to an increase in step count and decreases weight of people. However, no significant relation was found to exist between step count and weight. [ABSTRACT FROM AUTHOR]

Background: To examine the associations between objective physical activity measures and subsequent health care utilization.Methods: We studied 1,283 men (mean age 79.1 years, SD 5.3) participating in the Osteoporotic Fractures in Men Study. Participants wore a SenseWear® Pro Armband monitor for 1 week. Data was summarized as daily (i) step counts, (ii) total energy expenditure, (iii) active energy expenditure, and (iv) activity time (sedentary, ≥ light, ≥ moderate). The outcome measures of 1-year hospitalizations/duration of stay from Medicare data were analyzed with a two-part hurdle model. Covariates included age, clinical center, body mass index, marital status, depressive symptoms, medical conditions, cognitive function, and prior hospitalization.Results: Each 1 SD = 3,092 step increase in daily step count was associated with a 34% (95% confidence interval [CI]: 19%-46%) lower odds of hospitalization in base model (age and center) and 21% (95% CI: 4%-35%) lower odds of hospitalization in fully adjusted models. Similar but smaller associations held for other physical activity measures, but these associations were not significant in fully adjusted models. Among those hospitalized, higher step count was associated with shorter total duration of acute/postacute care stays in the base model only. There was a fourfold significant difference (from model-based estimates) in predicted care days comparing those with 2,000 versus 10,000 daily steps in the base model, but only a twofold difference (not significant) in the full model.Conclusion: Daily step count is an easily determined measure of physical activity that may be useful in assessment of future health care burden in older men. [ABSTRACT FROM AUTHOR]

Introduction: Mindful walking is a meditation practice that combines physical activity and mindfulness practice. Some mindful walking interventions expect four weeks of attendance (as compared with the traditional 8-week models of mindfulness-based interventions, or MBIs), a practice that could make MBIs more accessible to working-age adults. This study examined whether a 4-week mindful walking intervention increased physical activity and improved mental health outcomes.Methods: We conducted a randomized experiment among adults with inadequate physical activity (N = 38), whereby the intervention group received a four-week, one-hour-per-week mindful walking intervention and the control group received instructions to increase physical activity. Everyone in both groups received a wrist-worn step count device as participation incentive. Physical activity (as measured by the Rapid Assessment of Physical Activity questionnaire, RAPA) and other health outcomes were assessed with online surveys at baseline (T1), post-intervention (T2), and one month after the intervention (T3). Those mental health outcomes included perceived stress (Perceived Stress Scale), depression (Brief Edinburgh Depression Scale), and Mental Health Inventory (MHI). The primary outcome of device-measured step count was recorded at T1 and T2. Independent two-sample t-tests were used to compare the primary outcomes at T1. Generalized linear mixed models (GLMM) with a random intercept for each subject were used to compare the two groups on the primary outcomes at all time points. The independent variables in the model included a binary variable for group assignment (intervention vs. control), a 3-level categorical variable for time, and their interaction. Age, gender and race/ethnicity are used as covariates in the model. Estimated changes (either differences or ratios between outcomes at time points T1 and T2/T3) are reported to assess change within groups.Results: Both groups exhibited significant improvements in the RAPA measures of physical activity and depression. However, between-group differences were not statistically significant. There was no within-group or between-group difference on device-measured step count, though both groups yielded an average daily step count close to the recommended level of 8,000 steps per day for older adults. The intervention group exhibited a significant reduction in perceived stress, and this reduction was significantly greater than that of the control group at T2 (p = .025) although the difference was insignificant at T3. No significant difference in MHI was found.Discussion: While these adults with inadequate physical activity increased their physical activity, no significant between-group differences in physical activity were identified. Potential reasons for the lack of significant findings could be due to the ceiling effect (the step count device for everyone in both groups might have encouraged more activity in both groups), limited sample size and low-dose 4-week intervention used in this study. On the other hand, it is encouraging to see that this low-dose, short-duration 4-week intervention (as compared with those popular 8-week MBIs) achieved significantly greater stress reduction among the intervention group than among the control group, even though the between-group difference at one-month follow-up was statistically insignificant. Further studies with larger sample sizes and longer follow-up are needed to assess the possible benefits of these short-duration mindful walking interventions. [ABSTRACT FROM AUTHOR]

Objectives: To determine the relationship between objectively measured physical activity (PA) and the gut microbiome among community-dwelling older men. Design: Cross-sectional study. Setting: Osteoporotic Fractures in Men (MrOS) cohort participants at Visit 4 (2014-16). Participants: Eligible men (n=373, mean age 84 y) included participants with 5-day activity assessment with at least 90% wear time and analyzed stool samples. Measurements: PA was measured with the SenseWear Pro3 Armband and stool samples analyzed for 16S v4 rRNA marker genes using Illumina MiSeq technology. Armband data together with sex, height, and weight were used to estimate total steps, total energy expenditure, and level of activity. 16S data was analyzed using standard UPARSE workflow. Shannon and Inverse Simpson indices were measures of (within-participant) α-diversity. Weighted and unweighted Unifrac were measures of (between-participant) β-diversity. We used linear regression analysis, principal coordinate analysis, zero-inflated Gaussian models to assess association between PA and α-diversity, β-diversity, and specific taxa, respectively, with adjustments for age, race, BMI, clinical center, library size, and number of chronic conditions. Results: PA was not associated with α-diversity. There was a slight association between PA and β-diversity (in particular the second principal coordinate). Compared to those who were less active, those who had higher step counts had higher relative abundance of Cetobacterium and lower relative abundance of taxa from the genera Coprobacillus, Adlercreutzia, Erysipelotrichaceae CC-115 after multivariable adjustment including age, BMI, and chronic conditions. There was no consistent pattern by phylum. Conclusion: There was a modest association between levels of PA and specific gut microbes among community-dwelling older men. The observed associations are consistent with the hypothesis that underlying health status and composition of the host microbiome are related. [ABSTRACT FROM AUTHOR]

Objective: To determine the validity of the ActiGraph GT3X accelerometer in step count quantification when compared to observed step count in hospitalised adults recovering from critical illness. Setting: Large National Health Service (NHS) Hospitals Trust. Subjects: In total, 20 hospital ward-based adults (age: mean 62.3, SD 11.5) who had required greater than 48 hours of mechanical ventilation in the intensive care unit. Main measures: Participants walked self-selected distances and speeds as part of a semi-structured movement protocol not exceeding 3 hours. Two ActiGraph GT3X accelerometers were worn, one on the thigh and one on the ankle of the non-dominant leg. Accelerometer-recorded step counts were compared against observed step counts. Results: In total, 31 separate walking episodes were analysed. A mean (SD) of 45.87 (±19.72) steps was calculated for observed step count (range 15–90). Mean differences (95% limits of agreement) of −0.84 steps (−3.88 to 2.2) for the ankle placement and −17.7 steps (−40.63 to 5.25) for the thigh were calculated. Intraclass correlation coefficients (95% confidence intervals) of 0.99 (0.99 to 1.0) and 0.46 (−0.1 to 0.78) were determined for the ankle and thigh, respectively. Placement sites were well tolerated by 95% of participants. Conclusion: An ankle-mounted ActiGraph GT3X accelerometer demonstrates validity in quantification of step count in hospitalised adults recovering from critical illness. A thigh placement was not considered valid. [ABSTRACT FROM AUTHOR]

Background:: Reduced function and health in individuals with lower limb amputation is well documented. Step count measurement could facilitate rehabilitation and help monitor functional health outcomes.Objectives:: To determine whether mean daily step count changed between in-patient rehabilitation and consecutive leave periods.Study Design:: Observational study.Methods:: Nine individuals with bilateral traumatic amputations attending rehabilitation at the Defence Medical Rehabilitation Centre during a 4-month period were invited to participate in the study (two bilateral transfemoral, two bilateral transfemoral/knee disarticulation, two transfemoral/transtibial, one bilateral transfemoral plus transradial, one bilateral transfemoral plus transhumeral and one transfemoral/transtibial/transradial). Prostheses worn by each participant were fitted with an activity monitor (LAM2TM; PAL Technologies Ltd, Glasgow). Mean daily step count was analysed for each participant following 2 weeks in-patient rehabilitation and consecutive 2 weeks away from rehabilitation.Results:: Nine participants completed the study (time since injury: 19 ± 7 months, age: 26 ± 6 years). Mean daily step count significantly decreased from 2258 ± 192 during in-patient rehabilitation to 1387 ± 363 at home ( p < 0.01).Conclusion:: The step count decreased when away from rehabilitation, confirming the hypothesis that the mean daily step count would change between in-patient rehabilitation and consecutive leave period.Clinical Relevance: These data provide an indication of the step count achievable by young, military male personnel with bilateral lower limb amputations and highlights differences between intensive in-patient rehabilitation and consecutive leave periods. It is suggested that further investigation and support of clinical monitoring could facilitate rehabilitation tailored to the individual. [ABSTRACT FROM AUTHOR]

Exercise training is an important component of clinical exercise programs. Although there are recognized guidelines for the amount of exercise to be accomplished (≥70,000 steps per week or ≥150 min per week at moderate intensity), there is virtually no documentation of how much exercise is actually accomplished in contemporary exercise programs. Having guidelines without evidence of whether they are being met is of limited value. We analyzed both the weekly step count and the session rating of perceived exertion (sRPE) of patients (n = 26) enrolled in a community clinical exercise (e.g., Phase III) program over a 3-week reference period. Step counts averaged 39,818 ± 18,612 per week, with 18% of the steps accomplished in the program and 82% of steps accomplished outside the program. Using the sRPE method, inside the program, the patients averaged 162.4 ± 93.1 min per week, at a sRPE of 12.5 ± 1.9 and a frequency of 1.8 ± 0.7 times per week, for a calculated exercise load of 2042.5 ± 1244.9 AU. Outside the program, the patients averaged 144.9 ± 126.4 min, at a sRPE of 11.8 ± 5.8 and a frequency of 2.4 ± 1.5 times per week, for a calculated exercise load of 1723.9 ± 1526.2 AU. The total exercise load using sRPE was 266.4 ± 170.8 min per week, at a sRPE of 12.6 ± 3.8, and frequency of 4.2 ± 1.1 times per week, for a calculated exercise load of 3359.8 ± 2145.9 AU. There was a non-linear relationship between steps per week and the sRPE derived training load, apparently attributable to the amount of non-walking exercise accomplished in the program. The results suggest that patients in a community clinical exercise program are achieving American College of Sports Medicine guidelines, based on the sRPE method, but are accomplishing less steps than recommended by guidelines.

Chronic pain is associated with substantial impairment in physical function, which has been identified as a top concern among persons with pain. GetActive-Fitbit , a mind-body activity program, is feasible, acceptable, and associated with improvement in physical function among primarily White, sedentary individuals with pain. In preparation for a multisite efficacy trial, we must examine feasibility across multiple sites with diverse patient populations. Here we describe the protocol of a multisite, feasibility RCT comparing GetActive-Fitbit with a time- and attention-matched educational comparison (Healthy Living for Pain). We aim to 1) test multisite fidelity of clinician training; 2) evaluate multisite feasibility benchmarks, including recruitment of chronic pain patients taking <5000 steps/day and racial and ethnic minorities; and 3) optimize fidelity and study protocol in preparation for a future multisite efficacy trial. Clinician training fidelity was assessed via roleplays and mock group sessions. Feasibility (i.e., recruitment, acceptability, credibility, adherence, satisfaction), multimodal physical function (e.g., self-report, 6-Minute Walk Test, step-count), and other psychosocial outcomes are assessed at baseline, posttest, and 6 months. Protocol optimization will be assessed using exit interviews and cross-site meetings. The trial is ongoing. Clinician training is complete. 87 participants have been recruited. 54 completed baseline assessments and randomization, 44 are mid-intervention, and 9 have completed the intervention and posttest. This study addresses the critical need for feasible, acceptable mind-body-activity interventions for chronic pain that follow evidence-based guidelines and improve all aspects of physical function across diverse populations. Results will inform a future fully-powered multisite efficacy trial. Clinical Trial Registration: NCT05700383 [ABSTRACT FROM AUTHOR]

Wristband-placed physical activity monitors, as a convenient means for counting walking steps, assessing movement, and estimating energy expenditure, are widely used in daily life. There are many consumer-based wristband monitors on the market, but there is not an unified method to compare their performance. In this paper, we designed a series of experiments testing step counting performance under different walking conditions to evaluate these wristband activity monitors. Seven popular brands, including Huawei B1, Mi Band, Fitbit Charge, Polar Loop, Garmin Vivofit2, Misfit Shine, and Jawbone Up, were selected and evaluated with the proposed experiment method in this paper. These experiments include four parts, which are walking in a field at a different walking speed with and without arm swing, walking along a specified complex path, walking on a treadmill, and walking up and down stairs. Experiment results and analysis with nine healthy subjects were reported to show the step counting performance of these seven monitors.

Abstract Background This study focuses on the comparison of weekday/weekend parent-child behavioural patterns (step count (SC) and screen time (ST)) and answers the question of whether achieving the recommendations for daily SC (10,000) in parents also helps their preschool children achieve the recommended daily SC (11,500). Methods The participants (278 parents aged 30–45 and their 194 children aged 4–7) were randomly recruited from 10 Czech public kindergartens. The participants recorded SC (pedometer Yamax Digiwalker SW-200) and ST duration (proxy-report) for seven consecutive days (≥8 h/day) during September–October 2014 and April–May 2015. Differences between weekdays/weekends SC or ST were tested using a paired t-test. The odds of achieving the recommended daily SC for children were estimated using general logistic regression separately for weekdays and weekends. Results Only the mothers were found to have a significantly lower SC at weekends than on weekdays. All of the participants showed significantly more ST at weekends than on weekdays (daughters: 78.6 vs. 45.7 min/day, p

Abstract Background To explore the time trends (2005–2015) of pedometer-determined weekday and weekend physical activity (PA) and obesity prevalence in 4–7-year-old Czech preschool children and changes in proportion of kindergarten vs. leisure-time PA. Methods The study compared data of two cross-sectional cohorts of preschool children (2005: 92 boys and 84 girls; 2015: 105 boys and 87 girls) in the Czech Republic, using the same measurements and procedures in both cases. PA was monitored by the Yamax Digiwalker SW-200 pedometer for at least eight continuous hours a day over seven consecutive days. Body weight and height were measured using calibrated Tanita scales and anthropometry. The analysis of variance was conducted to examine the gender and cohort effect on step counts. The t-test was used to examine the difference in step counts in kindergarten (or leisure-time) between non-obese and obese children, and the chi-square test compared the prevalence of obesity between 2005 and 2015. Results The steps/day (mean ± standard deviation) of preschoolers was significantly higher (p

Different generations of consumer wearable activity trackers are prevalent with the increasing demands in health and physical activity monitor. This pilot study aims to validate one of the consumer wearable activity trackers, the Mi band 2 as a step measurement in free-living conditions. Thirty-one healthy volunteers, aged 23 to 45 with 16 female (52%), wore both Mi band 2 and ActiGraph GT9X Link on their dominant hand’s wrist for seven consecutive days. The validity of the electronic activity devices was assessed objectively by average steps/day using i) Paired sample t-tests; ii) Pearson correlation. In addition, Bland-Altman plots were constructed to visually inspect the data and to assess agreement with the ActiGraph accelerometer. There was a high correlation in steps/day between the reference device, Actigraph accelerometer and Mi Band 2 (r = 0.97, p < 0.001). No significant mean different in steps/ day and no apparent systematic biases in the Bland-Altman plots between step count measurements obtained using the Mi Band 2. Xiaomi Mi Band 2 provided valid step count measurement in the free-living conditions.

The use of wearable technologies for the monitoring of human movement has increased considerably in the past few years, with applications to sports and other physical activities. Energy expenditure, walking and running distance, step count, and heart rate are some of the metrics provided by such devices via smart phone applications. Most of the research studies have involved validating the accuracy and reliability of the activity monitors by using the post-processed data from the device. The aim of this preliminary study was to determine if we can trust sensor data obtained from an Apple watch. This study evaluated the pre-processed data from the watch through step counting and heart rate measurements, and compared it with known validated devices (in-house 9DOF inertial sensor and Polar H10TM). Repeated activities (walking, jogging, and stair climbing) of varying duration and intensity were conducted by participants of varying age and body mass index (BMI). Pearson correlation (r > 0.95) and Bland–Altman statistical analyses were applied to the data to determine the level of agreement between the validated devices and the watch. The sensors from the Apple watch counted steps and measured heart rate with a minimum error and performed as expected.

Accelerometers have the potential to provide objective, non-invasive methods for detecting changes in animal behavior and health. Our objectives were to: (1) determine the effects of micro-acceleration data loggers (accelerometers) and habituation to accelerometers on turkey gait and health status, (2) determine age-related changes in gait and health status, and (3) assess the validity and reliability of the accelerometers. Thirty-six male commercial turkeys were randomly assigned to one of five groups: accelerometer and habituation period (AH), accelerometer and no habituation period (AN), VetRap bandage (no accelerometer) and habituation period (VH), bandage (no accelerometer) and no habituation period (VN), and nothing on either leg (C). Health status and body condition were assessed prior to video-recording birds as they walked across a Tekscan® pressure pad at 8, 12, and 16 weeks to determine effects of treatment on number of steps, cadence, gait time, gait distance, gait velocity, impulse, gait cycle time, maximum force, peak vertical pressure, single support time, contact time, step length, step time, step velocity, stride length, total double support time, and duty factor. Accelerometer validity and reliability were determined by comparing the number of steps detected by the accelerometer to the number of steps determined from video recordings. Several age-related changes in turkey gait were found regardless of habituation including a slower cadence at 16 weeks, shorter gait distance at 8 weeks, and slower gait velocity at 16 weeks. When comparing bandaged vs. unbandaged limbs, both treatment and age-treatment interactions were found depending on the gait parameter. Accelerometer validity and reliability were affected by both age and treatment. False discovery rate increased, while accuracy and specificity decreased with age. Validity and reliability were lowest for non-habituated birds (AN and VN). Results demonstrated that micro-data loggers do not adversely affect turkey health status, but habituation to wearing accelerometers greatly affects accelerometer reliability and validity. Accelerometer validity and turkey gait are also greatly affected by the age of the turkeys.

Behavioral interventions targeting moderate- to vigorous-intensity physical activity (MVPA) to ensure health benefits can be strengthened by a simple metric that helps adults understand if they are exercising at the target intensity. Laboratory studies have established that a cadence of 100 steps/min is equivalent to MVPA, but intervention application is largely unexplored. The aim of this narrative review was to describe how cadence has been implemented in behavioral interventions. PubMed, PsychInfo, and SCOPUS were searched with a standardized search string. Studies were included if peer-reviewed interventions reporting on targeting MVPA increases for adults through cadence or if non-intervention programs directly targeting cadence. Of 232 unique studies identified, 6 were included in the final sample. Cadence was monitored using subjective cues (n = 3), time-oriented goals (n = 2), step-counting (n = 2), auditory cues (n = 2), and visual cues (n = 2), and measured by pedometers (n = 5) or mp3 player (n = 1). No studies reported detailed participant instructions to teach cadence. Results suggest that use of cadence in behavioral interventions is feasible but nascent. Reviewed studies provided insufficient detail to replicate methods and there was no consensus on best practices for implementing cadence. Results point to the potential utility of cadence and offer approaches for future refinement and standardization., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 The Author(s).)

Although walking has proven efficacy for glycemic control, patients struggle to meet daily step goals. This secondary analysis investigated the effect of step count measurement rate on glycemic control. Patients with type 2 diabetes from eight hospitals in Japan participated in a 12-month randomized controlled trial. The intervention group received DialBetesPlus, a self-management support system that allowed patients to monitor step count using a pedometer. We divided the intervention group into two groups based on whether daily step count measurement rate (the percentage of days with pedometer use) increased or decreased during the last three months of the intervention (month 10-12), relative to the first three months of the intervention (month 1-3). Patients with a reduced measurement rate experienced a worsening in glycemic control, with between-group difference of 0.516% in the amount of change in HbA1c (p=0.012). We conclude that step count measurement may lead to a better glycemic profile.

Background: Determining adherence with orthoses is important for clinicians prescribing devices. Measuring orthotic use often relies on patient recall which has poor agreement with objective measures. Measuring step count whilst wearing an orthosis could help objectively quantifying adherence. The Odstock Drop Foot Stimulator (ODFS) Pace, used in foot drop, has an integral activity logger which provides data on step count. The PALite, an accelerometer, measures step count and can be fixed to an ankle foot orthoses (AFO). Both have the potential to provide objective measures of adherence; however, their validity for this purpose has not been determined.Research Question: To determine the validity of the PALite and ODFS Pace activity logger in measuring total step count, by exploring their level of agreement.Methods: A convenience sample of sixteen healthy volunteers, aged 18-65, were recruited from Glasgow Caledonian University (GCU). Participants walked continuously for 5 min on a treadmill at three walking speeds; normal (1.3ms-1), slow (0.4 ms-1) and fast (1.7-2.0 ms-1), wearing both the PALite and ODFS Pace. All walks were video recorded, viewed by 2 raters, and observed step count was determined by a click counter. Step count from both devices was validated against observed step count using video recording. The level of agreement between the three methods was established.Results: There was no significant difference between the 3 methods of measuring step count at any walking speed (normal, p = 0.913; slow, p = 0.938; fast, p = 0.566). Good levels of agreement for both devices with observed step count at all 3 walking speeds, with mean percentage differences being between -1.2 and 2.1 % (maximum upper and lower levels of agreement = 19.5 and -18.8 %) was detected.Significance: Clinicians could consider both devices to objectively measure step count with people who are prescribed foot drop orthoses, thus quantifying orthotic use. [ABSTRACT FROM AUTHOR]

BACKGROUND: It is documented that parents have an essential influence on the physical activity (PA) of their children. More physically active parents bring up more physically active children in comparison with children of less physically active parents. However, the relationship between parents-child PA is not exactly quantified and little is known about whether the parents' PA helps their children achieve the currently recommended daily step count (SC) on weekdays and at weekends. PURPOSE: This study aimed to determine and quantify the relationship between parents' behaviour (SC and screen time [ST]) and children's SC on weekdays and at weekends. This study also investigates whether parents' level of SC helps children achieve the step count recommendations. METHODS: The participants (388 parents aged 35-45 and their 485 children aged 9-12) were randomly recruited from 21 Czech government-funded primary schools. The participants recorded their SC (The Yamax Digiwalker SW-200) and their ST duration for seven consecutive days (≥ 10 hours/day) during April-May and September-October of 2013. The associations between the parents' behaviour (SC and ST) and children's SC were estimated using general linear regression. Logistic regression (enter method) was used to examine the odds of achievement of the recommendations of 11,000 SC/day for girls and 13,000 SC/day for boys. RESULTS: Each 1,000 SC increase in the mothers' (fathers') SC/weekday was significantly (p < .05) associated with an extra 261 SC/day in their daughters and 413 (244) SC/day in their sons. Each 1,000 SC increase in mothers' (fathers') SC/weekend day was significantly (p < .05) associated with an extra 523 (386) SC/day in their daughters and 508 (435) SC/day in their sons. A reduction in the mothers' ST by 30 minutes per weekend day was significantly (p < .05) associated with an extra 494 SC/day in their daughters and 467 SC/day in their sons. The children of the mothers and fathers who met the weekend recommendation of 10,000 steps were 5.48 (95% CI: 1.65-18.19; p < .01) and 3.60 times, respectively (95% CI: 1.21-10.74; p < .05) more likely to achieve the weekend recommendation than the children of less active parents. The children of the mothers who reached the weekday recommendation of 10,000 steps were 4.94 times (95% CI: 1.45-16.82; p < .05) more likely to fulfil the SC recommendation on weekdays than the children of less active mothers. CONCLUSIONS: This study revealed a quantifiable relationship between the parent-child SC/day and mothers' ST and children's SC on the weekends. A replacement of at least 30 minutes of time that parents (especially mothers) and children spend together in sedentary pursuits with joint physical activity may result in increased weekend physical activity by a perceptible 500 steps/day.

In this work, we developed a smart wearable device for gait speed measurement with dual wireless communication on the feet by using an inertia measurement unit (IMU) sensor. To discover step counts and speed information, pitch and yaw angles were calculated successfully from IMU signals using a Kalman filter and a moving average algorithm. Walking step counts were calculated using the sensor; the results demonstrated almost zero errors and averaged more than 90% accuracy in walking and running measurements. The observable speed for two-foot indication and adapted variation can be implemented on the sensor to gauge walking and running speeds for different subjects. Step counts and the swing frequency were tested and compared with results over a treadmill using a commercial chip in the insole of a shoe. Experimental results were validated using fast Fourier transform from the acquired pitch angle history. The pitch and yaw angles of users' tibias can be used as controllable monitoring tags for personal health information in the future. [ABSTRACT FROM AUTHOR]

In its contemporary form, sport for development has been positioned as an important part of strategic policy for a variety of governmental and sporting organisations. One area that has been targeted by governments and a variety of sporting partners has been the impact of sport on non-communicable diseases (NCDs, sometimes colloquially referred to as 'lifestyle diseases' such as obesity). However, relatively little evidence exists for the impact of sport programmes on the reduction of NCDs and future health burden. This study sought to examine the physical activity levels of school-aged children in Papua New Guinea (PNG) during their participation in a targeted sport programme operating during school hours. Data collection methods employed were physical activity recall and pedometer counts, as well as perceptions, intentions, and knowledge of participants. Children in this study were found to have lower physical activity levels during the after-school period than has been reported in the literature for children in other countries. Overall, children were active during the sport programme, completing 1179 steps on average (which constitutes 10% of the suggested daily values for children of a similar age). No profound differences were observed in either the qualitative or quantitative data across different schools, regions, or genders. The responses from children regarding the sport programme were notably positive. [ABSTRACT FROM AUTHOR]

Introduction:The purpose of this study was to assess the validity of the step count measurement of commercial electronic activity monitor devices. Two popular models, Fitbit Charge HR and Mi Band 2, were selected for treadmill walking in a single session. Materials and Methods:Thirty healthy volunteers walked at five predetermined speeds (0.90, 1.12, 1.33, 1.54, and 1.78 m/s) on a treadmill with both Fitbit Charge HR and Mi Band 2 worn on their dominant hand's wrist. Observers counted the steps, with the aid of taped video, which was taken as the criterion measure for steps. The validity of the electronic activity devices was assessed by (1) Paired sample t test with the criterion measures and (2) Pearson's correlation coefficients and the corresponding p-values were calculated to compare the output of devices with manual step count. In addition, Bland-Altman plots were constructed to visually inspect the data and to assess agreement with the criterion measures. Results:There were no significant differences in step measurement between Fitbit Charge HR and Mi Band 2 with the criterion measures. Besides, there was a very strong agreement between step count measurements obtained using the Fitbit Charge HR (r = 0.99) and the Mi Band 2 (r = 0.99), at five predetermined speeds while comparing with the observed step counts. Conclusion:Both Fitbit Charge HR and Mi Band 2 provided accurate step count measurement in the treadmill walking test. [ABSTRACT FROM AUTHOR]

Background: Monitoring levels of physical activity, as an outcome or in guiding rehabilitation, is challenging for clinicians. Personal activity monitors are increasing in popularity and provide potential to enhance rehabilitation protocols. However, research to support the validity and reliability of these devices at jogging and running speeds is limited. Purpose: The purpose of this study was to evaluate the validity of the Fitbit Flex™ and ActiGraph GT3X+ for measuring step count at jogging and running speeds. A secondary purpose was to examine inter-device reliability of the Fitbit Flex™. Study Design: Cross-sectional study Methods: Thirty healthy participants aged between 19 and 50 years, completed a treadmill protocol at jogging and running speeds (8 km/h to 16 km/h). Treadmill speed was progressively increased by intervals of 2 km/h. Each interval was four minutes in duration with a two minute rest period between stages. Participants were encouraged to continue through the graded exercise test until they reached the maximum running speed that they felt they could maintain for four minutes. Step count data was collected for Fitbit Flex™ devices and the ActiGraph GT3X+. Video analysis of step count was used as the criterion measure. Results: At speeds of 8 to 14 km/h Mean Absolute Percentage Errors were ≤1% for the Fitbit Flex™ and the ActiGraph GT3X+ when compared to step count via video analysis. Standard Error of Measurement between the three Fitbit Flex™ devices was ≤7 steps for speeds of 8 to 14 km/h and varied between 9 to 19 steps at 16 km/h. Fitbit FlexTM devices showed good to excellent between device reliability at speeds of 8 to14 km/h (ICC 0.723 to 0.999; p ≤0.001). Greater variability was evident with the low participant numbers at 16 km/h (ICC 0.527 to 0.896; p ≥ 0.02). Conclusion: Both the Fitbit Flex™ and the ActiGraph GT3X+ provide a valid account of steps taken at jogging and running speeds up to 14 km/hr, attainable by non-elite runners on a treadmill. Fitbit Flex™ devices provide equivalent step count output to each other, enabling comparison between devices during treadmill jogging and running. Level of evidence: 2b [ABSTRACT FROM AUTHOR]

Wearable physical activity trackers are a popular and useful method to collect biometric information at rest and during exercise. The purpose of this systematic review was to summarize recent findings of wearable devices for biometric information related to steps, heart rate, and caloric expenditure for several devices that hold a large portion of the market share. Searches were conducted in both PubMed and SPORTdiscus. Filters included: humans, within the last 5 years, English, full-text, and adult 19+ years. Manuscripts were retained if they included an exercise component of 5-min or greater and had 20 or more participants. A total of 10 articles were retained for this review. Overall, wearable devices tend to underestimate energy expenditure compared to criterion laboratory measures, however at higher intensities of activity energy expenditure is underestimated. All wrist and forearm devices had a tendency to underestimate heart rate, and this error was generally greater at higher exercise intensities and those that included greater arm movement. Heart rate measurement was also typically better at rest and while exercising on a cycle ergometer compared to exercise on a treadmill or elliptical machine. Step count was underestimated at slower walking speeds and in free-living conditions, but improved accuracy at faster speeds. The majority of the studies reviewed in the present manuscript employed different methods to assess validity and reliability of wearable technology, making it difficult to compare devices. Standardized protocols would provide guidance for researchers to evaluate research-grade devices as well as commercial devices used by the lay public. [ABSTRACT FROM AUTHOR]

Background: Exercise programmes consisting of stepping were found to significantly reduce incidence of falls in the elderly. The aim of this case study was to evaluate the feasibility of step counts and to identify a specific dose, i.e. the amount and intensity of stepping during a multicomponent balance specific exercise programme. Material and methods: Thirty fit community-dwelling older adults (69.7 ±6.2 years) participated in the study. The number of steps and the intensity of stepping per training unit was recorded with StepWatch pedometers. Results: The average recorded number of steps per one-hour training unit was 1100 ±215. The intensity level of the activity was on average high for 43.6 ±16.6% of the unit time and moderate for 45.9 ±14.2% of the unit time, whereas only 9.9% ±3.9 of the unit time was in the low level range. Conclusions: The use of pedometers, i.e. step counts, is feasible to monitor the intensity of the training as well as the volume and progression if needed for the balance specific exercise programmes. Additionally, this case study demonstrates that balance specific exercise programme can be organised in the way to facilitate balance by means of volitional and reactive stepping. [ABSTRACT FROM AUTHOR]

The increasing prevalence of chronic heart failure requires new and more cost-efficient methods of chronic heart failure treatment. In the search for comprehensive and more costeffective disease management, the use of self-monitoring devices has become increasingly popular. However, the usability of these wireless self-trackers needs to be evaluated if they are to be successfully implemented within a healthcare system. The aim of this study is to evaluate the usability of six self-tracking devices for use in telerehabilitation of heart failure patients. The devices were evaluated by 22 healthy volunteers who used them for 48 hours. Based on structured interviews, the volunteers rated the devices for their user-friendliness, design, comfort, and motivation. Also, the devices' step count precision was assessed using a treadmill walking test. Of the six devices subject to user tests, the Fitbit One, Fitbit Charge HR, Garmin Vivofit 2, and Beddit Sleep Tracker received significantly higher average scores than the Jawbone UP3 and Jawbone UP24, based on the structured interviews, p < 0.001. The Fitbit One and the Garmin Vivofit 2 received the lowest error percentage rates during the walking tests. The results indicate that in terms of overall usability for telerehabilitation purposes, the most suitable self-tracking devices would be the Fitbit One, Garmin Vivofit 2, and the Fitbit Charge HR. [ABSTRACT FROM AUTHOR]

Contactless exercise monitoring is a new trend that makes people feel more comfortable and unconstrained. However, the decrease in accuracy of the pulse rate measurement caused by large motion artifacts is an urgent problem to be solved. In this paper, we proposed a novel approach to monitor step count and improve the accuracy of remote pulse rate measurement based on the image detection method. We designed a chrominance-based adaptive filter and normalization (CADN) method and a domain selection scheme (DSS) to enhance the accuracy of contactless pulse rate measurement during exercise. Various exercises such as biking, stepping, and treadmill running were conducted to evaluate motion robustness of the proposed CADN + DSS and the accuracy of step counts. The results reveal that the detection rates of the proposed step count method are 99.52% and 99.77% for stepping and treadmill exercise, respectively. The pulse rate accuracy is compared with two state-of-the-art algorithms—chrominance and chrominance-based adaptive filter. The results show the proposed CADN+DSS method provides a lower discrepancy between the detected pulse rate and a ground-truth device (Polar H7) for all activities. We expand the scope of contactless measurement for physical activity detection and develop an unfettered step count and pulse rate measurement method in exercise. Therefore, step count and pulse rate can be measured synchronously without relying on any contact sensors. [ABSTRACT FROM AUTHOR]

Pulmonary rehabilitation (PR) may not suit all individuals with chronic obstructive pulmonary disease (COPD) and may not result in increased physical activity. Higher levels of physical activity are associated with reduced mortality and morbidity. The aim of this study was to assess the feasibility of conducting a trial to investigate the effectiveness of a clinician-facilitated physical activity intervention (PAI) versus PR in improving physical activity in patients with COPD referred to PR. In this randomised controlled mixed methods feasibility study, all patients referred to PR who were eligible and willing were assessed at baseline and then randomised to the PAI or to PR. The assessments were repeated post-intervention and at 3-month follow-up. The main outcome was step count measured by Actigraph. Semi-structured interviews were conducted post-intervention. The N = 50 patients; mean (SD) age, 64.1(8.6) years, 24M were recruited and randomised; N = 23 (PAI) and n = 26 (PR): one patient was excluded from the analysis as that person did not meet the GOLD diagnostic criteria. Key feasibility criteria were met; recruitment was 11%, dropouts in PAI were 26% (n = 6) and 50% (n = 13/26) PR. Participants in both groups experienced a range of health benefits from their respective programmes. The PAI appears to be effective in increasing step counts in people with COPD: mean change (standard deviation) [confidence interval] for the PAI group was 972.0(3230.3)[-1080.3 to 3024.4], n = 12 and 4.3(662.7)[-440.9 to 449.5], n = 11 for the PR group. The PAI met all domains of fidelity. This study provides key information to inform a future-randomised controlled trial in physical activity. [ABSTRACT FROM AUTHOR]