The reliability and validity of a research-grade pedometer for children and adolescents with cerebral palsy

Measuring ambulation with wrist-based and hip-based activity trackers for children with cerebral palsy

AIM

To assess the accuracy of consumer available wrist-based and hip-based activity trackers in quantitatively measuring ambulation in children with cerebral palsy (CP).

METHOD

Thirty-nine children (23 males, 16 females; mean age [SD] 9y 7mo [3y 5mo]; range 4-15y) with CP were fitted with trackers both on their wrist and hip. Each participant stood for 3 minutes, ambulated in a hallway, and sat for 3 minutes. The number of steps and distance were recorded on trackers and compared to manually counted steps and distance. Pearson correlation coefficients were determined for the number of steps during ambulation from each tracker and a manual count. Mean absolute error (MAE) and range of errors were calculated for steps during ambulation for each tracker and a manual count and for distance for each tracker and hallway distance.

RESULTS

For the number of steps, a weak inverse relationship (r=-0.033) was found for the wrist-based tracker and a strong positive relationship (r=0.991) for the hip-based tracker. The MAE was 88 steps for the wrist-based and seven steps for the hip-based tracker. The MAE for distance was 0.06 miles for the wrist-based and 0.07 miles for the hip-based tracker.

INTERPRETATION

Only the hip-based tracker provided an accurate step count; neither tracker was accurate for distance. Thus, ambulation of children with CP can be accurately quantified with readily available trackers.

WHAT THIS PAPER ADDS

Consumer available activity trackers accurately measure ambulation in children with cerebral palsy (CP). The hip-based tracker is more accurate than the wrist-based tracker for children with CP. The hip-based Fitbit activity tracker accurately measures step counts of children with CP during ambulation.

Reliability of Using Motion Sensors to Measure Children's Physical Activity Levels in Exergaming

OBJECTIVES

This study examined the reliability of two objective measurement tools in assessing children’s physical activity (PA) levels in an exergaming setting.

METHODS

A total of 377 children (190 girls, Mage = 8.39, SD = 1.55) attended the 30-min exergaming class every other day for 18 weeks. Children’s PA levels were concurrently measured by NL-1000 pedometer and ActiGraph GT3X accelerometer, while children’s steps per min and time engaged in sedentary, light, and moderate-to-vigorous PA were estimated, respectively.

RESULTS

The results of intraclass correlation coefficient (ICC) indicated a low degree of reliability (single measures ICC = 0.03) in accelerometers. ANOVA did detect a possible learning effect for 27 classes (p < 0.01), and the single measures ICC was 0.20 for pedometers. Moreover, there was no significant positive relationship between steps per min and time spent in moderate-to-vigorous physical activity (MVPA). Finally, only 1.3% variance was explained by pedometer as a predictor using Hierarchical Linear Modeling to further explore the relationship between pedometer and accelerometer data.

CONCLUSIONS

The NL-1000 pedometers and ActiGraph GT3X accelerometers have low reliability in assessing elementary school children’s PA levels during exergaming. More research is warranted in determining the reliable and accurate measurement information regarding the use of modern devices in exergaming setting.

Validity of an Accelerometer Used to Measure Step Count in Children With Idiopathic Toe Walking

PURPOSE

To assess the validity of accelerometer use in children with idiopathic toe walking (ITW).

METHODS

Seventy-five children, 2 to 13 years old, with ITW were videotaped ambulating 50 ft wearing a NL-1000 accelerometer. Because of concerns for accelerometer accuracy in young children, 2 groups were created: 5 years or younger (n = 45) and 6 years or older (n = 30). Step counts recorded via accelerometer and video were compared and correlated.

RESULTS

There was a significant difference in accelerometer and video step counts for 2- to 5-year-olds (W = 72.00, P < .001). No significant difference was found for 6- to 13-year-olds (W = 65.00, P = .24). Spearman ρ values were 0.78 and 0.92 for the 5 years or younger and 6 years or older groups, respectively.

CONCLUSION

Accelerometers accurately count steps in 6- to 13-year-olds with ITW but are inaccurate in 2- to 5-year-olds.

The scope of pediatric physical therapy practice in health promotion and fitness for youth with disabilities

PURPOSE

The purpose of this report is to discuss the scope of pediatric physical therapy practice in health promotion and fitness for youth with disabilities.

SUMMARY OF KEY POINTS

Evidence is provided that supports integration of health promotion and fitness strategies in physical therapy clinical management. Physical therapists' roles in community-based adapted sports and fitness interventions and reimbursement considerations are discussed.

CONCLUSIONS

Physical therapists are in a unique position to provide expertise in the design and implementation of health promotion and fitness programs for youth with disabilities. These programs are important to promote active, healthy lifestyles and reduce comorbidities associated with sedentary behaviors and unhealthy weight, which are often seen in youth with disabilities.

RECOMMENDATIONS FOR CLINICAL PRACTICE

Pediatric physical therapists should incorporate health promotion and fitness strategies into practice.