Measurement properties of device-based physical activity instruments in ambulatory adults with physical disabilities and/or chronic diseases: a scoping review

Brandenbarg, Pim; Hoekstra, Femke; Barakou, Ioulia; Seves, Bregje L.; Hettinga, Florentina J.; Hoekstra, Trynke; van der Woude, Lucas H. V; Dekker, Rienk; Krops, Leonie A.

doi:10.1186/s13102-023-00717-0

BMC Sports Science, Medicine and Rehabilitation

Table 2 Overview of research grade devices evaluated on their measurement properties in the 52 studies

From: Measurement properties of device-based physical activity instruments in ambulatory adults with physical disabilities and/or chronic diseases: a scoping review

								Result
Type	PA outcome	Population	Study	Measurement property	Criterion	Placement	Algorithm	Test	Outcome
ActiGraph
GT3	EE	Amputation	Ladlow [114]	CV	IC	Waist (SRL)	Cust	Pearson's r	r: 0.86—0.94
			Ladlow [115]	CV	IC	Waist (SRL)	Cust	Pearson's r	r: 0.92 – 0.96
		iSCI	Jayaraman [96]	CV	IC	Ankle	Prop (Freedson)	ANOVA	Sed: p < .05; low & high: p > .05
						U-arm	Prop (Freedson)	ANOVA	Sed & low: p < .05; high: p > .05
						Waist	Prop (Freedson)	ANOVA	Sed & low: p < .05; high: p > .05
			Jayaraman [51]	CV	IC	Ankle	Prop (Freedson)	Kruskal wallis	Lying, sitting & standing: p < 0.5
						U-arm	Prop (Freedson)	Kruskal wallis	Lying, sitting, standing & 50SWT: p < .05
						Waist	Prop (Freedson)	Kruskal wallis	All p < .05
		Stroke	Compagnat [45]	CV	IC	Ankle (ua)	N.R	Pearson's r	r = 0.41
						Waist	N.R	Pearson's r	r = 0.15
						Wrist (ua)	N.R	Pearson's r	r = 0.12
			Compagnat [43]	CV	IC	Waist	Prop	Pearson's r	r = 0.19
							Cust	Pearson's r	r = 0.44
			Compagnat [61]	CV	IC	Ankle	Cust (multiple)	LoA	-69.1 [-148.7; 10.5] -8.3 [-1.1; 17.8]
			Fairia [49]	CV	IC	Ankle (a)	Prop (work-energy teorem)	Pearson's r	r = 0.04
							Prop (Freedson)	Pearson's r	r = 0.04
							Prop (combined)	Pearson's r	r = 0.37
			Jayaraman [51]	CV	IC	Ankle (a)	Prop (Freedson)	Kruskal wallis	Lying, sitting, standing & STS: p < 0.5
						Ankle (ua)	Prop (Freedson)	Kruskal wallis	Lying, sitting, standing & STS: p < 0.5
						U-arm (a)	Prop (Freedson)	Kruskal wallis	Lying, sitting & standing: p < 0.5
						U-arm (ua)	Prop (Freedson)	Kruskal wallis	Lying, sitting & standing: p < 0.5
						Waist (a)	Prop (Freedson)	Kruskal wallis	Lying, sitting & standing: p < 0.5
						Waist (ua)	Prop (Freedson)	Kruskal wallis	Lying, sitting & standing: p < 0.5
			Mandigout [55]	CV	IC	Ankle (ua)	N.R	Spearman's rho	rho = 0.19
						Ankle (a)	N.R	Spearman's rho	rho = 0.21
						Waist	N.R	Spearman's rho	rho = 0.04
						Wrist (ua)	N.R	Spearman's rho	rho = 0.20
						Wrist (a)	N.R	Spearman's rho	rho = 0.08
	Steps	DM	Jao [95]	CV	DO	Waist	Prop	Accuracy (%)	43.0—81.4%
		Inflammatory myopathy	Rockette-Wagner [105]	Con V	F Tests & F SR	Waist	Prop	Pearson's r	r: -0.42—0.66
				TRT R		Waist	Prop	ICC	ICC = 0.92 (CI 0.86 – 0.96)
				Resp	SR	Waist	Prop	Pearson's r	r = 0.47 (CI 0.12—0.71)
		iSCI	Albaum [108]	CV	DO	Ankle (la)	Prop	ICC	ICC: 0.15 – 0.99
			Jayaraman [96]	CV	DO	Ankle	Prop (Freedson)	ANOVA	p > .05
						U-arm	Prop (Freedson)	ANOVA	P < .05
						Waist	Prop (Freedson)	ANOVA	p < .05
		MS	Block [84]	CV	DO	Waist	Prop	ICC	ICC = 0.76 (CI 0.63–0.85)
			Polhemus [81]	CV	DO	Waist	Prop	CCC	CCC = 0.68 (CI 0.37—0.82)
							Prop (+ LFE filter)	CCC	CCC = 0.73 (0.13—0.84)
		Multi	Treacy [23]	CV	DO	Waist	Prop	ICC	ICC = 0.123 (CI -0.071–0.355)
			Webber & John [89]	CV	DO	Ankle	Prop	ICC	ICC = 0.682 (CI -0.211–0.895)
							Prop (+ LFE filter)	ICC	ICC = 0.938 (CI 0.870–0.969)
						Waist	Prop	ICC	ICC = -0.051 (CI -0.191–0.153)
							Prop (+ LFE filter)	ICC	ICC = 0.829 (CI 0.329–0.936)
		Osteoarthritis	Collins [94]	CV	Acc	Wrist		ICC	ICC = 0.602
		PD	Cederberg [104]	CV	DO	Wrist (ua)	Prop	Mean difference	62—76 steps
						Wrist (a)	Prop	Mean difference	32—66 steps
		Polymyalgia rheumatica	Chandrasekar [112]	CV	DO	Waist	Prop	LoA	Walking: 141 + (0.5mean count) [110 + (0.5mean count)]
							Prop (+ LFE filter)	LoA	Walking: 20 [-40; 81]
							Prop	LoA	Stairs: 4 [-4; 12]
							Prop (+ LFE filter)	LoA	Stairs: 0 [-5; 5]
		RA	O'Brien [116]	CV	DO	Thigh	Prop	LoA	-30 [-116; 57]
		Stroke	Campos [40]	CV	Acc	Ankle	Prop	ICC	ICC = 0.80 (CI 0.63–0.90)
							Prop (+ LFE filter)	ICC	ICC = 0.76 (CI 0.56–0.87)
						Waist	Prop	ICC	ICC = 0.70 (CI 0.47–0.84)
							Prop (+ LFE filter)	ICC	ICC = 0.82 (CI 0.66–0.90)
			Henderson [64]	CV	DO	Ankle (a)	Prop	ICC	ICC: 0.57—0.81
							Prop (+ LFE filter)	ICC	ICC: 0.84—0.96
						Ankle (ua)	Prop	ICC	ICC: 0.84—0.86
							Prop (+ LFE filter)	ICC	ICC: 0.77—0.97)
	Intensity time	Osteoarthritis	Collins [94]	CV	Acc	Wrist	Cut off: counts < 200	% bias	Sed: -66%
							Cut off: 1924 counts/min, bouts of 10 min	Difference	MVPA: + 281 min
	Activity time	DM	Jao [95]	CV	DO	Waist	Prop	Accuracy (%)	41.8 – 100%
		RA	O'Brien [116]	CV	DO	Thigh	Prop	LoA	-0.3 [-1.2; 0.6] min—0.2 [-0.7; 1.1] min
	Distance walked	Stroke	Compagnat [44]	CV	DO	Ankle (ua)	Prop	Pearson's r	r = 0.95
						Ankle (a)	Prop	Pearson's r	r = 0.93
						Waist	Prop	Pearson's r	r = 0.86
						Wrist (ua)	Prop	Pearson's r	r = 0.79
						Wrist (a)	Prop	Pearson's r	r = 0.81
		Peripheral artery disease	Taoum [139]	CV	GPS	Hip	Cust	MAPE	11.9—18.8
	Counts	Amputation	Ladlow [114]	CV	IC	Waist (SRL)	Prop	Pearson's r	r: 0.82–0.92
						Waist (LRL)	Prop	Pearson's r	r: 0.76 – 0.80
						Waist (Sp)	Prop	Pearson's r	r: 0.68 – 0.80
	MET	Stroke	Jayaraman [51]	CV	IC	Ankle (a)	Prop (Freedson)	Kruskal wallis	STS: p < .05
						Ankle (ua)	Prop (Freedson)	Kruskal wallis	50SWT, 6MWT & STS: p < .05
						U-arm (a)	Prop (Freedson)	Kruskal wallis	All p > .05
						U-arm (ua)	Prop (Freedson)	Kruskal wallis	All p > 0.5
						Waist (a)	Prop (Freedson)	Kruskal wallis	All p > .05
						Waist (ua)	Prop (Freedson)	Kruskal wallis	All p > .05
		iSCI	Jayaraman [51]	CV	IC	Ankle	Prop (Freedson)	Kruskal wallis	Lying & STS p < .05
						U-arm	Prop (Freedson)	Kruskal wallis	50SWT p < .05
						Waist	Prop (Freedson)	Kruskal wallis	50SWT, 6MWT & STS p < .05
	Vector magnitude	Inflammatory myopathy	Rockette-Wagner [105]	Con V	F Tests & F SR	Waist	Prop	Pearson's r	r: -0.35—0.60
				TRT R		Waist	Prop	ICC	ICC = 0.80 (CI 0.62 – 0.89)
				Resp	SR	Waist	Prop	Pearson's r	r = 0.53 (CI 0.20—0.75)
GTX9	Steps	Amputation	Smith & Guerra [107]	CV	DO	Ankle	N.R	ICC	ICC = 0.111 (CI -0.202—0.418)
						Wrist	N.R	ICC	ICC = 0.005 (CI -0.256—0.299)
		MS	Anens [79]	CV	DO	Waist	Prop	Spearman's rho	rho: 0.74—0.79
							Prop (+ LFE filter)	Spearman's rho	rho: 0.85—0.93
		PAD	Ata [93]	CV	DO	Waist	Prop	% error	-3.1 ± 10.3%
	Sedentary time	COPD	Webster [76]	CV	Acc	Waist	Prop (multiple)	CCC	CCC: 0.614 -0.838
		MS	Anens [79]	CV	DO	Waist	Prop	Spearman's rho	rho: 0.18—0.39
							Prop (+ LFE filter)	Spearman's rho	rho: 0.16—0.38
Pal Technologies
ActivPAL	Steps	DM	Alothman [91]	TRT R		Thigh	Prop	ICC	ICC = 0.91
			Jao [95]	CV	DO	Thigh	Prop	Accuracy (%)	90.7 – 98.5%
		Multi	Treacy [23]	CV	DO	Thigh	Prop	ICC	ICC = 0.781 [CI 0.231; 0.911]
		RA	Larkin [131]	CV	DO	Thigh	Prop	Pearson's r	r = 0.94 [CI 0.86; 0.98]
		Stroke	Mahendran [54]	CV	DO	Thigh	Prop	ICC	ICC: 0.72 – 0.99
				TRT R		Thigh	Prop	ICC	ICC: 0.66 – 0.98
	Activity time	Amputation	Salih [138]	CV	DO	Thigh (a)	N.R	LoA	Walking: 0.11 [-0.43; 0.66] sec (ue)
						Thigh (ua)	N.R	LoA	Walking: 0.004 [-0.09; 0.10] sec (ue)
		DM	Alothman [91]	TRT R		Thigh	Prop	ICC	ICC: 0.74 – 0.90
			Jao [95]	CV	DO	Thigh	Prop	Accuracy (%)	96.6 – 100%
		RA	Larkin [131]	CV	DO	Thigh	Prop	Pearson's r	r: 0.74 – 0.93
		Stroke	Mahendran [54]	CV	DO	Thigh	Prop	ICC	ICC = 0.99
								APE	0.3 – 3.2%
				TRT R		Thigh	Prop	ICC	ICC: 0.66 – 0.98
								APE	3.3 – 6.5%
	MET	Stroke	Mahendran [54]	TRT R		Thigh	Prop	ICC	ICC: 0.65 – 0.99
ActivPAL3	Steps	MS	Coulter [86]	CV	DO	Thigh	Prop	LoA	-4.7 [-22.88; 13.47] (ue)
		RA	O'Brien [116]	CV	DO	Thigh	Prop	LoA	-30 [-116; 57] (ue)
	Activity time	MS	Coulter [86]	CV	DO	Thigh	Prop	LoA	-4.6 [-26.1; 17.0] – 1.1 [-1.12; 3.34] sec
		RA	O'Brien [116]	CV	DO	Thigh	Prop	LoA	-0.3 [-1.2; 0.6] – 0.2 [-0.7; 1.1] min
Modus Health
StepWatch 3	Steps	Amputation	Arch [92]	CV	DO	Ankle (a)	N.R	ICC	ICC: 0.90 – 0.99
		Multiple	Treacy [23]	CV	DO	Ankle	Prop	ICC	ICC = 0.982 [CI 0.975; 0.986]
			Webber & John [89]	CV	DO	Ankle	Prop	ICC	ICC = 0.960 [CI 0.924; 0.979]
		Stroke	Garcia Oliveira [63]	CV	DO	Ankle (la)	Prop	Spearman's rho	rho: 0.963—0.994
			Henderson [64]	CV	DO	Ankle (a)	Prop	ICC	ICC: 0.92—0.96
						Ankle (ua)	Prop	ICC	ICC: 0.97—0.97
	Distance walked	Peripheral artery disease	Taoum [139]	CV	GPS	Ankle	Cust	MAPE	16.7 ± 10.7
StepWatch 4	Steps	Amputation	Smith & Guerra [107]	CV	DO	Ankle	N.R	ICC	ICC = 0.967 (CI 0.929—0.984)
Body Media
Sensewear armband	EE	Chronic lung disease	Dhillon [70]	CV	IC	U-arm	Prop	LoA	-1.26 [-4.71; 2.19] – 0.56 [-1.68–2.80]
		MS	Stuart [82]	Con V	F Tests & F SR	Arm	Prop	Spearman's rho	rho: -.0412—0.365
				Resp	F Tests & F SR	Arm	Prop	Spearman's rho	rho: -0.196—0.168
		Stroke	Compagnat [42]	CV	IC	U-arm (ua)	Prop	Pearson's r	r: 0.48 – 0.81
			Mandigout [55]			U-arm (a)	N.R	Spearman's rho	rho = 0.61
						U-arm (ua)	N.R	Spearman's rho	rho = 0.45
	Steps	MS	Stuart [82]	Con V	F Tests & F SR	Arm	Prop	Spearman's rho	rho: -0.325—0.305
				Resp	F Tests & F SR	Arm	Prop	Spearman's rho	rho: -0.170—0.250
	Activity time	MS	Stuart [82]	Con V	F Tests & F SR	Arm	Prop	Spearman's rho	rho: -0.640—0.493
				Resp	F Tests & F SR	Arm	Prop	Spearman's rho	rho: -0.128—0.272
	Distance walked	Stroke	Compagnat [44]	CV	DO	U-arm (a)	Prop	Pearson's r	r = 0.72
						U-arm (ua)	Prop	Pearson's r	r = 0.68
	MET	MS	Stuart [82]	Con V	F Tests & F SR	Arm	Prop	Spearman's rho	rho: -0.343—0.316
				Resp	F Tests & F SR	Arm	Prop	Spearman's rho	rho: -0.191—0.295
	PA composite score	MS	Stuart [82]	Con V	F Tests & F SR	Arm	Prop	Spearman's rho	rho: -0.444—0.376
				Resp	F Tests & F SR	Arm	Prop	Spearman's rho	rho: -0.110—0.356
Sensewear Pro2	Steps	Stroke	Mahendran [54]	CV	DO	U-arm (a)	N.R	APE	21.9 – 66.8%
				TRT R		U-arm (a)	N.R	APE	2.2 – 38.5%
	MET	Stroke	Mahendran [54]	TRT R		U-arm (a)	N.R	APE	17.8 – 26.8%
Activ8
Activ8	Activity time	CP	Claridge [120]	CV	DO	Thigh (frontal) (la)	N.R	Spearman's rho	rho: -0.04 – 0.86
						Thigh (lateral 2 cm) (la)	N.R	Spearman's rho	rho: 0.49 – 0.99
						Pocket	N.R	Spearman's rho	rho: 0.14 – 0.79
		Stroke	Fanchamps [48]	CV	DO	Thigh (frontal)	N.R	% time difference	-3.8 – 6.5%
	Steps	Multi	Ummels [75]	CV	DO	Pocket	N.R	Pearson's r	r = 0.24
Philips
Actical	EE	Chronic lung disease	Dhillon [70]	CV	IC	Wrist	Prop	LoA	-3.4 [-6.4; -0.4]—-0.8 [-1.6; 0.0]
		Stroke	Mandigout [55]	CV	IC	Ankle (a)	N.R	Spearman's rho	rho = 0.30
						Ankle (ua)	N.R	Spearman's rho	rho = 0.20
						Waist	N.R	Spearman's rho	rho = -0.01
						Wrist (a)	N.R	Spearman's rho	rho = -0.19
						Wrist (ua)	N.R	Spearman's rho	rho = -0.27
	Activity kilocounts	SCI	Zbogar [111]	TRT R		Wrist	N.R	Pearson's r	r = 0.74 [CI 0.54; 0.86]
	Steps	SCI	Zbogar [111]	TRT R		Waist	N.R	Pearson's r	r = 0.84 [CI 0.70; 0.92]
Axivity
AX3/AX6	Steps	Cardiac rehab	Femiano [126]	CV	DO	Wrist	Cust	MAPE	4.1—143.0%
		Lumbar spinal stenosis	Gustafsson [128]	CV	DO	Lower back	Prop	ICC	ICC: -0.04—1.00
						Thigh	Prop	ICC	ICC: -0.16—1.00
						Waist	Prop	ICC	ICC: -0.10—1.00
						Wrist	Prop	ICC	ICC: -0.10—0.99
McRoberts
Dynaport	EE	Stroke	Daniel [62]	CV	IC	Lower back	Prop	ICC	ICC: 0.77—0.94
Dynaport Hybrid	Steps	PD	Pham [123]	CV	DO	Lower back	Cust	Kappa	k: 0.70 – 0.71
Vandrico Inc
Metria-IH1	EE	iSCI	Jayaraman [96]	CV	IC	U-arm	Prop	ANOVA	All p > .05
			Jayaraman [51]	CV	IC	U-arm	Prop	Kruskal wallis	All p > .05
		Stroke	Jayaraman [51]	CV	IC	U-arm (a)	Prop	Kruskal wallis	All p > .05
						U-arm (ua)	Prop	Kruskal wallis	STS: p < .05
	Steps	iSCI	Jayaraman [96]	CV	DO	U-arm	Prop	ANOVA	p < 0.05
	MET	iSCI	Jayaraman [51]	CV	IC	U-arm	Prop	Kruskal wallis	All p > .05
		Stroke	Jayaraman [51]	CV	IC	U-arm (a)	Prop	Kruskal wallis	50SWT & STS: p < .05
						U-arm (ua)	Prop	Kruskal wallis	STS: p < .05
Activinsight
GENEactive	Raw acceleration (ENMO—mg)	Myotonic dystrophy type 1	Jimenez-Moreno et al. [113]	TRT R		Wrist & Ankle	N.A	ICC	0.86 [95% CI 0.74; 0.93] to 0.97 [95% CI 0.95; 0.99]
CamNtech
Actiheart	EE	Amputation	Ladlow [115]	CV	IC	Chest	Branched-Model equation	Pearson's r	r 0.81 – 0.86
Espruino
Bangle.js	Steps	DM	Van Laerhoven [124]	CV	Acc	Wrist	Custom (open source)	LoA	-566.7 [-4111.5—2978.0]—17.48 [-211.5—246.5]
Garcia Oliveira et al
AMoR	Steps	Stroke	Garcia Oliveira [63]	CV	DO	Thigh	N.R	ICC	ICC: 0.999—0.999
					Acc	Thigh	N.R	ICC	ICC: 0.981—0.985
	Sedentary time	Stroke	Garcia Oliveira [63]	CV	DO	Thigh	N.R	ICC	ICC = 0.960 (CI 0.929—0.977)
Maastricht Instruments BV
MOX (1.01)	Counts	Multi	Van der Weegen [77]	CV	Acc	Lower back		Pearson's r	r = 0.98 (range 0.95—1.00)
						Lower back		Spearman's rho	rho = 0.82 (range 0.60—0.94)
	Intensity time	Multi	Van der Weegen [77]	CV	Acc	Lower back		LoA	-2.3—-0.5
Medtronic
ICD/CRT device	Activity time	Heart failure	Shoemaker [100]	CV	Acc	Chest (internal)	Prop	LoA	-0.77 [-2.71; 1.17] hours/day (ue)
ICD/CRT device				Resp	Acc	Chest (internal)	Prop	LoA	0.19 [-0.79; 1.17] hours/day (oe)
StepsCounts
PiezoRX	Steps	MS	Anens [79]	CV	DO	N.R	N.R	Spearman's rho	rho: 0.82—0.99
Xsens
MTw	EE	DM	Caron [119]	CV	IC	Lower back	Bouten's equation	LoA	-1.17 [-6.45; 4.14] W/kg (oe)
ZurichMOVE
JUMP	EE	iSCI	Popp [125]	CV	IC	Multiple	Cust	Pearson's r	r = 0.92

Ordering on number of studies evaluating manufacturer. This is a condensed version of the more detailed table in Supplementary file 5
EE Energy expenditure, MET Metabolic equivalent, PAL Physical activity level, CAD Coronay artery disease, COPD Chronic obstructive pulmonary disease, DM Diabetes mellitus, iSCI incomplete spinal cord injury, MS Multiple sclerosis, PAD Pulmonary artery disease, PD Parkinson's disease, RA Rheumatoid arthritis, SCI Spinal cord injury, CV Criterion validity, Con V Construct validity, Resp Responsiveness, TRT R Test–retest reliability, Acc Accelerometer, DLW Doubly labelled water, DO Direct observation, F Tests Functional tests, F SR Functional Self-report, IC Indirect calorimetry, SR Self-report, Q questionnaire, (a) Affected side, (b) both affected and unaffected side, (la) Less affected side, (LRL) Longest residual limb, (SRL) shortest residual limb, (ua) unaffected side, Cust Custom algorithm, LFE Low frequency effect, N.R. Not reported, Prop Proprietary algorithm, TEE Total energy expenditure, APE Absolute percentage error, CCC Concordance correlation coefficients, ICC Intraclass correlation coefficient, LoA = limits of agreement, MAPE = mean absolute percentage error, MPE Mean percentage error, [CI] 95% confidence intervals, (oe) Over estimation, (ue) Under estimation, MVPA Moderate to vigorous physical activity, MWT Minutes walking test, Sed Sedentary, STS Sit-to-stand test, SWT Steps walk test

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