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Concurrent validation of activity monitors in patients with rheumatoid arthritis

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Backhouse, Michael, Hensor, Elizabeth M.A., White, Derrick, Keenan, Anne-Maree, Helliwell, Philip S. and Redmond, Anthony C. (2013) Concurrent validation of activity monitors in patients with rheumatoid arthritis. Clinical Biomechanics, 28 (4). pp. 473-479. doi:10.1016/j.clinbiomech.2013.02.009 ISSN 0268-0033.

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Official URL: http://dx.doi.org/10.1016/j.clinbiomech.2013.02.00...

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Abstract

Background
Physical activity is frequently reported in rheumatology but it is difficult to measure objectively outside the gait laboratory. A new generation of activity monitors offers this potential but it has not yet been evaluated in patients with rheumatoid arthritis. This study aimed to evaluate three types of activity monitors in patients with rheumatoid arthritis.

Methods
The Step-N-Tune, Activ4Life Pro V3.8, and the Intelligent Device for Energy Expenditure and Activity activity monitors were tested concurrently in 12 patients with rheumatoid arthritis as well as in a healthy control group of 12 volunteers. Participants walked at a self selected speed for two minutes and were filmed for later review. Temporal and spatial gait parameters were also validated against the GAITRite walkway and the total number of steps recorded by each activity monitor was compared to a gold standard derived from half speed video replays.

Findings
Activity monitor performance varied between devices but all showed poorer performance when used in the group with rheumatoid arthritis. Bland–Altman plots demonstrated wider 95% limits of agreement in the group with rheumatoid arthritis and a systematic decrease in agreement between activity monitors and the gold standard with decreasing functional ability.

Interpretation
Despite some variation between devices, all the activity monitors tested performed reasonably well in healthy young volunteers. All except the Activ4Life showed a marked decrease in performance in patients with rheumatoid arthritis, suggesting Activ4Life could be the most suitable for use in this patient group. The marked between group difference in functional ability, and systematic decrease in device performance with deteriorating gait, indicate that activity monitors require specific validation in target clinical populations.

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Clinical Biomechanics
Publisher: Elsevier
ISSN: 0268-0033
Official Date: April 2013
Dates:
DateEvent
April 2013Published
21 March 2013Available
27 February 2013Accepted
Volume: 28
Number: 4
Page Range: pp. 473-479
DOI: 10.1016/j.clinbiomech.2013.02.009
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)

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