Validity and Interinstrument Reliability of a Medical Grade Physical Activity Monitor in Older Adults

Abstract

Wearable physical activity monitors are associated with an increase in user’s habitual physical activity levels. Most of the older adult population do not meet the national moderate- to vigorous-intensity physical activity (MVPA) recommendations and may benefit from being prescribed a physical activity monitor. The PiezoRx is a class one medical grade device that uses step rate thresholds to measure MVPA. The validity and reliability of the PiezoRx in measuring MVPA has yet to be determined in older persons. We assessed the validity and interinstrument reliability of the PiezoRx to measure steps and MVPA in older adults. Participants (n = 19; 68.8 ± 2.3 years) wore an Omron HJ-320 pedometer, ActiGraph GT3X accelerometer, and four PiezoRx monitors during a five-stage treadmill walking protocol. The PiezoRx devices were set at moderate physical activity and vigorous physical activity step rate thresholds (steps per minute) of 100/120, 110/130, adjusted for height and adjusted for height + fitness. The PiezoRx exhibited a stronger correlation (intraclass correlation coefficient = .82) with manually counted steps than the ActiGraph (intraclass correlation coefficient = .53) and Omron (intraclass correlation coefficient = .54) and had a low absolute percentage error (3 ± 6%). The PiezoRx with moderate physical activity/vigorous physical activity step thresholds adjusted to 110/130 was strongly correlated to indirect calorimetry (0.84, p < .001) and best distinguished each walking stage as MVPA or not (sensitivity: 88%; specificity: 95%). The PiezoRx monitor is a valid and reliable measure of step count and MVPA among older adults. The device’s ability to measure MVPA in absolute terms was improved when step rate thresholds for moderate physical activity/vigorous physical activity were increased to 110/130 steps per minute in this population.