Abstract
IntroductionAlthough numerous activity trackers have been validated in healthy populations, validation is lacking in chronic heart failure patients who normally walk at a slower pace, making it difficult for researchers and clinicians to implement activity monitors during physical activity interventions.MethodsSix consumer-level activity monitors were validated in a 3-day field study in patients with chronic heart failure and healthy individuals under free living conditions. Furthermore, the same devices were evaluated in a lab-based study during treadmill walking at speeds of 2.4, 3.0, 3.6, and 4.2 km·h-1. Concordance correlation coefficients (CCC) were used to evaluate the agreement between the activity monitors and the criterion, and mean absolute percentage errors (MAPE) were calculated to assess differences between each device and the criterion (MAPE <10% was considered as a threshold for validity).ResultsIn the field study of healthy individuals, all but one of the activity monitors showed a substantial correlation (CCC ≥0.95) with the criterion device and MAPE <10%. In patients with heart failure, the correlation of only two activity monitors (Garmin vívofit 3 and Withings Go) was classified as at least moderate (CCC ≥0.90) and none of the devices had MAPE <10%. In the lab-based study at speeds 4.2 and 3.6 km·h-1, all activity monitors showed substantial to almost perfect correlations (CCC ≥0.95) with the criterion and MAPE in the range 1%-3%. However, at slower speeds of 3.0 and 2.4 km·h-1, the accuracy of all devices substantially deteriorated: their correlation with the criterion decreased below 90% and their MAPE increased to 4–8% and 10–45%, respectively.ConclusionsEven though none of the tested activity monitors fall within arbitrary thresholds for validity, most of them perform reasonably well enough to be useful tools that clinicians can use to simply motivate chronic heart failure patients to walk more.
Highlights
Numerous activity trackers have been validated in healthy populations, validation is lacking in chronic heart failure patients who normally walk at a slower pace, making it difficult for researchers and clinicians to implement activity monitors during physical activity interventions
Even though none of the tested activity monitors fall within arbitrary thresholds for validity, most of them perform reasonably well enough to be useful tools that clinicians can use to motivate chronic heart failure patients to walk more
Consumer-level activity monitors are frequently used as motivational tools to increase physical activity (PA) [6,7,8] and many of them have been previously shown to be valid devices for assessing daily step count both in lab-based and free-living settings [9,10,11]. Since those validation studies were conducted in healthy volunteers and didn’t examine the validity of the devices at slower walking speeds, it is not clear whether their results can be applied to patients with heart failure (HF), who typically walk at slower speeds and shuffle their feet [12]
Summary
Citation: Vetrovsky T, Siranec M, Marencakova J, Tufano JJ, Capek V, Bunc V, et al (2019) Validity of six consumer-level activity monitors for measuring steps in patients with chronic heart failure. PLoS ONE 14(9): e0222569. https://doi.org/10.1371/ journal.pone.0222569Although numerous activity trackers have been validated in healthy populations, validation is lacking in chronic heart failure patients who normally walk at a slower pace, making it difficult for researchers and clinicians to implement activity monitors during physical activity interventions.Editor: Belinda Parmenter, UNSW Sydney, AUSTRALIAReceived: March 22, 2019Accepted: September 3, 2019Published: September 13, 2019
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