Accuracy of the Actigraph wGT3x-BT for step counting during inpatient spinal cord rehabilitation

Abstract

Study design

Cross-sectional.

Objectives

(1) Assess the accuracy of the Actigraph wGT3x-BT accelerometer to count steps taken by inpatients with incomplete spinal cord injury (iSCI) in physical therapy (PT) sessions and self-directed activities, and (2) compare the number of steps/min taken in PT sessions to that in self-directed activities during inpatient rehabilitation.

Setting

Inpatient spinal cord injury rehabilitation.

Methods

Seventeen individuals with subacute motor iSCI were observed for up to 45-min of both PT and self-directed activities, during which steps were simultaneously tracked by the Actigraph wGT3x-BT and a researcher using a hand tally counter. Accuracy was evaluated with an intraclass correlation coefficient (ICC) for the entire PT session and self-directed activities, as well as for periods of walking.

Results

There was excellent agreement between the Actigraph wGT3x-BT and manually counted steps for entire PT sessions (ICC = 0.86) and walking periods (PT walking, ICC = 0.99; self-directed walking, ICC = 0.99). There was poor agreement for entire self-directed sessions (ICC = 0.15). Visual analysis of Bland–Altman plots supported these findings. Participants took more steps/min in PT sessions compared to self-directed activities (p = 0.023).

Conclusion

The Actigraph wGT3x-BT accurately counts steps during PT sessions and walking periods in individuals with subacute motor iSCI. Clinically, this may enable physical therapists to track walking repetitions during inpatient rehabilitation more effortlessly.

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Acknowledgements

The authors would like to thank the participants that took part in this study, the physiotherapy staff at Toronto Rehabilitation Institute—University Health Network—Lyndhurst Centre and specifically Sarah Fingland PT for her help with participant recruitment.

Funding

This study was supported by the Toronto Rehabilitation Institute—University Health Network.

Author information

EA was responsible for conducting a literature review, designing and writing the research protocol, data collection and analysis, interpretation of results, writing the manuscript, generating tables and figures and updating reference lists. EQ was responsible for conducting a literature review, designing and writing the research protocol, screening eligible participants, data collection and writing the manuscript. SS was responsible for screening eligible participants, data collection and analysis and generating tables and figures. PS was responsible for conducting a literature review, designing and writing the research protocol, data collection and analysis, interpretation of results and statistical analysis. AW was responsible for conducting a literature review, designing and writing the research protocol, screening eligible participants, data collection, and writing the manuscript. KM was responsible for designing and writing the research protocol, interpretation of results, statistical analysis and writing the manuscript. JW was responsible for designing and writing the research protocol, interpretation of results and writing the manuscript.

Correspondence to Josh Williams.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was performed in accordance with the Declaration of Helsinki and was approved by the Research Ethics Boards of the University Healthy Network (#17-5980) and the University of Toronto. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.

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