Digi-Walker SW-200 Research Articles

Validity of Activity Monitor Step Detection Is Related to Movement Patterns.

There is a need to examine step-counting accuracy of activity monitors during different types of movements. The purpose of this study was to compare activity monitor and manually counted steps during treadmill and simulated free-living activities and to compare the activity monitor steps to the StepWatch (SW) in a natural setting. Fifteen participants performed laboratory-based treadmill (2.4, 4.8, 7.2 and 9.7 km/h) and simulated free-living activities (eg, cleaning room) while wearing an activPAL, Omron HJ720-ITC, Yamax Digi- Walker SW-200, 2 ActiGraph GT3Xs (1 in "low-frequency extension" [AGLFE] and 1 in "normal-frequency" mode), an ActiGraph 7164, and a SW. Participants also wore monitors for 1-day in their free-living environment. Linear mixed models identified differences between activity monitor steps and the criterion in the laboratory/free-living settings. Most monitors performed poorly during treadmill walking at 2.4 km/h. Cleaning a room had the largest errors of all simulated free-living activities. The accuracy was highest for forward/rhythmic movements for all monitors. In the free-living environment, the AGLFE had the largest discrepancy with the SW. This study highlights the need to verify step-counting accuracy of activity monitors with activities that include different movement types/directions. This is important to understand the origin of errors in step-counting during free-living conditions.

Validity of the SenseWear armband step count measure during controlled and free-living conditions

Background/ObjectiveAdvances in technology continue to provide numerous options for physical activity assessment. These advances necessitate evaluation of the validity of newly developed activity monitors being used in clinical and research settings. The purpose of this study was to validate the SenseWear Pro3 Armband (SWA) step counts during treadmill walking and free-living conditions. MethodsStudy 1 observed 39 individuals (17 males, 22 females) wearing an SWA and a Yamax Digiwalker SW-701 pedometer (DIGI) during treadmill walking, utilizing manually counted steps as the criterion. Study 2 compared free-living step count data from 35 participants (17 males, 18 females) wearing the SWA and DIGI (comparison) for 3 consecutive days. ResultsDuring Study 1, the SWA underestimated steps by 16.0%, 10.7%, 5.6%, 6.1%, and 6.5% at speeds of 54 m/min, 67 m/min, 80 m/min, 94 m/min, and 107 m/min, respectively, compared to manually counted steps. During Study 2, the intraclass correlation (ICC) coefficient of mean steps/d between the SWA and DIGI was strong (r = 0.98, p < 0.001). Unlike Study 1, the SWA overestimated step counts during the 3-day wear period by an average of 1028 steps/d (or +11.3%) compared to the DIGI. When analyzed individually, the SWA consistently overestimated step counts for each day (p < 0.05). ConclusionThe SWA underestimates steps during treadmill walking and appears to overestimate steps during free-living compared to the DIGI pedometer. Caution is warranted when using the SWA to count steps. Modifications are needed to enhance step counting accuracy.

Concurrent validation of the Actigraph gt3x+, Polar Active accelerometer, Omron HJ-720 and Yamax Digiwalker SW-701 pedometer step counts in lab-based and free-living settings

Activity monitors are frequently used to assess activity in many settings. But as technology advances, so do the mechanisms used to estimate activity causing a continuous need to validate newly developed monitors. The purpose of this study was to examine the step count validity of the Yamax Digiwalker SW-701 pedometer (YX), Omron HJ-720 T pedometer (OP), Polar Active accelerometer (PAC) and Actigraph gt3x+ accelerometer (AG) under controlled and free-living conditions. Participants completed five stages of treadmill walking (n = 43) and a subset of these completed a 3-day free-living wear period (n = 37). Manually counted (MC) steps provided a criterion measure for treadmill walking, whereas the comparative measure during free-living was the YX. During treadmill walking, the OP was the most accurate monitor across all speeds (±1.1% of MC steps), while the PAC underestimated steps by 6.7–16.0% per stage. During free-living, the OP and AG counted 97.5% and 98.5% of YX steps, respectively. The PAC overestimated steps by 44.0%, or 5,265 steps per day. The Omron pedometer seems to provide the most reliable and valid estimate of steps taken, as it was the best performer under lab-based conditions and provided comparable results to the YX in free-living. Future studies should consider these monitors in additional populations and settings.

Pedometer Accuracy in Persons Using Lower-Limb Prostheses

It is important that all individuals obtain sufficient physical activity to increase health and fitness for the reduction of risk factors associated with cardiovascular disease. Pedometers are a means by which one can monitor and assess physical activity levels. The objective of this study was to assess the accuracy of three commercially available pedometers in persons with lower-limb amputations. Thirty-nine participants were fitted with an Omron HJ-112, a New Lifestyles 800, and a Digiwalker SW-701 on the right side of the hip, then walked at a self-selected pace on a carpeted level surface for 200 m. Repeated-measures (RM) analysis of variance (ANOVA) indicated a significant difference between the pedometers and the actual counts (ACs). Whereas the HJ-112 (mean [SD], 312.5 [38.3] steps) and the NL-800 (307.2 [35.1] steps) were not significantly different from AC (314.7 [73.9] steps), the SW-701 (255.57 [8.5] steps) significantly underestimated step counts, p < 0.05. Bland-Altman plots indicated the HJ-112 had the best agreement with AC, followed by the NL-800. Percentage error was lowest in the HJ-112 (0.69%), followed by NL-800 (2.4%), with the SW-701 eliciting the greatest error (18.8%). The HJ-12 and the NL-800 are viable options for persons with lower-limb amputations seeking to assess and/or monitor their physical activity levels.

Social Cognitive Beliefs Predicting Children’s Physical Activity and Cardiovascular Fitness in Physical Education

Purpose: This study examined the predictive utility of children’s self-efficacy, outcome expectancy, and satisfaction on their perceived persistence/effort, physical activity (PA) levels, and cardiovascular fitness. Method: Participants were 307 sixth through eighth grade students enrolled in a 90-minute physical education class on alternate days. Participants completed questionnaires assessing self-efficacy, outcome expectancy, satisfaction, and perceived persistence/effort during the second to last week of the school year. During the last week of school the Progressive Aerobic Cardiovascular Endurance Run (PACER) test was administered and in-class PA levels were measured via pedometers (Yamax Digi-Walker SW-701). Multiple regression analyses were used to determine how self-efficacy, outcome expectancy, and satisfaction predicted children’s persistence/effort, PA levels, and cardiovascular fitness. Results: Correlation analysis indicated all variables were significantly associated with one another (rs = .17 to . 59, ps < .01) while regression analyses showed outcome expectancy (s = .36, p <.01) and satisfaction (s = .34, p <. 01) were significant predictors for persistence/effort, accounting for 25.48% and 9.54% of the variance, respectively. Further, children’s self-efficacy (s = .28, p <.01), satisfaction (s = .18, p <.01), and outcome expectancy (s = .13, p <.05) significantly predicted their in-class PA levels, and explained 20.14%, 2.72% and 1.00% of the variance, respectively. Finally, self-efficacy (s = .35, p <.01) was the only significant predictor for cardiovascular fitness accounting for 12.16% of the variance. Conclusion: Results indicate that children who perceive the benefits of physical education, enjoy the sense of satisfaction physical education provides, and have higher self-efficacy persist and put forth greater effort during class while also displaying higher in-class PA levels and better cardiovascular fitness.

PACE-UP (Pedometer and consultation evaluation--UP)--a pedometer-based walking intervention with and without practice nurse support in primary care patients aged 45-75 years: study protocol for a randomised controlled trial.

BackgroundMost adults do not achieve the 150 minutes weekly of at least moderate intensity activity recommended for health. Adults’ most common physical activity (PA) is walking, light intensity if strolling, moderate if brisker. Pedometers can increase walking; however, most trials have been short-term, have combined pedometer and support effects, and have not reported PA intensity. This trial will investigate whether pedometers, with or without nurse support, can help less active 45–75 year olds to increase their PA over 12 months.Methods/designDesign: Primary care-based 3-arm randomized controlled trial with 12-month follow-up and health economic and qualitative evaluations.Participants: Less active 45–75 year olds (n = 993) will be recruited by post from six South West London general practices, maximum of two per household and households randomised into three groups. Step-count and time spent at different PA intensities will be assessed for 7 days at baseline, 3 and 12 months by accelerometer. Questionnaires and anthropometric assessments will be completed.Intervention: The pedometer-alone group will be posted a pedometer (Yamax Digi-Walker SW-200), handbook and diary detailing a 12-week pedometer-based walking programme, using targets from their baseline assessment. The pedometer-plus-support group will additionally receive three practice nurse PA consultations. The handbook, diary and consultations include behaviour change techniques (e.g., self-monitoring, goal-setting, relapse prevention planning). The control group will receive usual care.Outcomes: Changes in average daily step-count (primary outcome), time spent sedentary and in at least moderate intensity PA weekly at 12 months, measured by accelerometry. Other outcomes include change in body mass index, body fat, self-reported PA, quality of life, mood and adverse events. Cost-effectiveness will be assessed by the incremental cost of the intervention to the National Health Service and incremental cost per change in step-count and per quality adjusted life year. Qualitative evaluations will explore reasons for trial non-participation and the interventions’ acceptability.DiscussionThe PACE-UP trial will determine the effectiveness and cost-effectiveness of a pedometer-based walking intervention delivered by post or practice nurse to less active primary care patients aged 45–75 years old. Approaches to minimise bias and challenges anticipated in delivery will be discussed.Trial registrationISRCTN98538934

Physical activity monitoring in stroke: SenseWear Pro2 Activity accelerometer versus Yamax Digi-Walker SW-200 Pedometer

Purpose: Determine validity and reliability of SenseWear Pro2 Armband (SWP2A) and Yamax Digi-Walker SW-200 Pedometer (YDWP) in stroke and healthy adults. Methods: Fifteen stroke patients and 15 healthy participants wore SWP2A on upper arm and YDWP at hip/knee. Different activities were performed: treadmill walking, walking up/down a step, cycling and walking on an even surface. Steps and Energy Expenditure (EE) were measured and compared to steps counted manually and indirect calorimetry. Repeated measurements were compared to determine reliability of both devices. Results: Spearman correlation coefficients between knee-worn YDWP and counted steps while walking on an even surface was ≥0.89 in healthy and ≥0.95 in stroke. Treadmill walking revealed high Spearman correlation coefficients in healthy individuals (rs ≥ 0.90) and at 1.5 km/h in stroke (rs = 0.69). During other activities YDWP often underestimated steps. SWP2A data revealed inconsistent results in EE and steps. Reliability tested by repeated measurements varied between 0.66 and 0.98 for YDWP and 0.61 and 0.97 for SWP2A. Conclusion: YDWP and SWP2A are both reliable. Only knee-worn YDWP is a valid device to measure steps except high intensity walking in stroke. YDWP systematically undercounts steps during other activities of short duration. This study could not demonstrate valid measurement of steps/EE in stroke using SWP2A.Implications for RehabilitationStroke is a disabling disease with residual neurologic deficits, which impairs mobility and predisposes them to sedentary behavior.A Yamax Digi-Walker SW-200 knee-worn pedometer showed to be a valid and reliable technique to measure ambulatory activity in stroke.A valid instrument to measure energy expenditure in stroke needs to be explored.

Accuracy of 2 Activity Monitors in Detecting Steps in People With Stroke and Traumatic Brain Injury

Advances in sensor technologies and signal processing techniques provide a method to accurately measure walking activity in the home and community. Activity monitors geared toward consumer or patient use may be an alternative to more expensive monitors designed for research to measure stepping activity. The objective of this study was to examine the accuracy of 2 consumer/patient activity monitors, the Fitbit Ultra and the Nike+ Fuelband, in identifying stepping activity in people with stroke and traumatic brain injury (TBI). Secondarily, the study sought to compare the accuracy of these 2 activity monitors with that of the StepWatch Activity Monitor (SAM) and a pedometer, the Yamax Digi-Walker SW-701 pedometer (YDWP). A cross-sectional design was used for this study. People with chronic stroke and TBI wore the 4 activity monitors while they performed the Two-Minute Walk Test (2MWT), during which they were videotaped. Activity monitor estimated steps taken were compared with actual steps taken counted from videotape. Accuracy and agreement between activity monitor estimated steps and actual steps were examined using intraclass correlation coefficients (ICC [2,1]) and the Bland-Altman method. The SAM demonstrated the greatest accuracy (ICC [2,1]=.97, mean difference between actual steps and SAM estimated steps=4.7 steps) followed by the Fitbit Ultra (ICC [2,1]=.73, mean difference between actual steps and Fitbit Ultra estimated steps=-9.7 steps), the YDWP (ICC [2,1]=.42, mean difference between actual steps and YDWP estimated steps=-28.8 steps), and the Nike+ Fuelband (ICC [2,1]=.20, mean difference between actual steps and Nike+ Fuelband estimated steps=-66.2 steps). Walking activity was measured over a short distance in a closed environment, and participants were high functioning ambulators, with a mean gait speed of 0.93 m/s. The Fitbit Ultra may be a low-cost alternative to measure the stepping activity in level, predictable environments of people with stroke and TBI who can walk at speeds ≥0.58 m/s.

Are children meeting any of the suggested daily step recommendations?

Summary Study aim: Over the past decade there have been numerous efforts to identify how many steps/day children should accumulate. Recommendations range from 10,000 to 16,500 steps/day. The purpose of this article was to examine the percentage of elementary school aged children meeting nine different sets of steps/day recommendations. Material and methods: 786 Southwestern US children (410 girls, BMI 19.3±4.2) wore the Yamax Digiwalker SW-200 pedometer and recorded their steps/day for 7 consecutive days. Mean steps/day was calculated and the percent-age of students meeting each of the various steps/day recommendations was determined. Results: Children averaged 11,113±3,666 steps/day. Sixty-one percent of all children met a minimum of 10,000 steps/day. Thirty-six percent met the most widely used recommendation of 11,000 and 13,000 steps/day for boys and girls, respectively. Using BMI referenced recommendations, between 10-52% of children met various guidelines. Conclusions: Southwestern US children in the current sample are not getting enough daily activity to meet the ma-jority of step recommendations. Findings suggest that less than 33% of children are active for 60 minutes of physical activity (inferred from one of the guidelines) a day and only 36% would qualify for the Presidential Active Life-styles Award. Additional school and home-based physical activity programming is clearly needed.

Functional and psychological variables both affect daily physical activity in COPD: A structural equations model

Daily physical activity (DPA) level is reduced in patients with COPD. The aim of this study was to investigate the association of DPA with functional and psychological variables in these patients. 155 COPD patients (102 males, median (IQR) age 62 years (54-69 years), predicted FEV1 60% (40-75%) were included. We assessed DPA (DigiWalker SW-200), functional capacity and psychological factors. DPA level was significantly associated with all functional capacity variables and two psychological variables (Perceived Physical Ability Subscale, depression subscale of the Hospital Anxiety and Depression Scale). The six-minute walking distance and St. George Respiratory Questionnaire activity score explained 37% of the variance of DPA in a regression analysis. A structural equations model revealed that psychological variables indirectly explained DPA through functional capacity variables. DPA was stronger associated with functional capacity variables and weaker with psychological variables in patients with lower functional status than in patients with higher functional status. Higher levels of DPA are associated with better functional capacity, but interestingly, DPA is also affected by psychological factors, though only indirectly, via functional capacity. The effect of specific treatment addressing psychological factors on DPA level and exercise tolerance needs further investigation. ClinicalTrials.gov, NCT00614796.

Effect of BMI on Pedometers in Early Adolescents under Free-Living Conditions

Pedometers may provide valuable information regarding the ambulatory patterns of adolescents, but the effects of body mass index (BMI) on pedometer accuracy in this population are unknown.The purpose of this study was twofold: 1) to determine whether the New Lifestyles NL-2000 (NL) and the Digi-Walker SW-200 (DW) (New Lifestyles, Inc., Lees Summit, MO) yield similar step counts as compared with an ankle-mounted criterion, StepWatch 3, when worn by early adolescents in a free-living environment and 2) to study whether BMI percentile affects the accuracy of waist-mounted pedometers in adolescents. Seventy-four early adolescents (13.0 ± 1.1 yr) wore the devices during one weekday. The study population included 33 normal weight, 21 overweight, and 20 obese participants. Two-way repeated-measures ANOVA was used to determine whether the BMI and the device were related to the number of steps per day and percentage of actual steps. The NL and DW recorded fewer steps than the StepWatch 3 in each BMI category (P < 0.05). In the obese group, the DW underestimated the steps more than the NL (P < 0.001). For the normal weight, overweight, and obese groups, the NL counted 89.1%, 89.1%, and 91.6% of the steps, respectively, whereas the DW counted 86.7%, 84.6%, and 72.7%, respectively. Researchers must be cognizant of the limitations of waist-mounted pedometers and carefully choose a device that suits the needs of their investigations. Because of the inaccuracies of the DW when measuring steps in obese adolescents, careful consideration must be given before choosing this device for research and interventions. The NL is a better device for assessment of adolescents' steps than the DW, especially for those who are obese.

Daily Physical Activity Patterns of Children Living in an American Indian Community

Embracing a physically active lifestyle is especially important for American Indian (AI) children who are at a greater risk for hypokinetic diseases, particularly Type 2 diabetes. The purpose of this study was to describe AI children's pedometer-determined physical activity (PA) segmented into prominent daily activity patterns. Participants included 5th- and 6th-grade children (N = 77) attending school from 1 Southwestern US AI community. Children wore a pedometer (Yamax Digiwalker SW-200) for 7 consecutive days. Boys accumulated 12,621 (± 5385) steps/weekday and girls accumulated 11,640 (± 3695) steps/weekday of which 38% (4,779 ± 1271) and 35% (4,027 ± 1285) were accumulated at school for boys and girls, respectively. Physical education (PE) provided the single largest source of PA during school for both boys (25% or 3117 steps/day) and girls (23% or 2638 steps/day). Lunchtime recess provided 1612 (13%) and 1241 (11%) steps/day for boys and girls, respectively. Children were significantly less active on weekend days, accumulating 8066 ± 1959 (boys) and 6676 ± 1884 (girls). Although children accumulate a majority of their steps outside of school, this study highlights the important contribution of PE to the overall PA accumulation of children living in AI communities. Further, PA programming during the weekend appears to be important for this population.

P79 Quantifying Physical Activity For 30 Days Via Pedometry in COPD Patients

IntroductionPhysical activity and exercise capacity are among the important patient-relevant parameters in COPD. COPD patients are less active and less likely to go outside when compared with the general population...

P76 The effect of outside temperature on daily physical activity in COPD patients

IntroductionCOPD is characterised by breathlessness, leading to reduced physical activity. Breathlessness varies dependent upon the degree and intensity of physical activity (1). Common logic dictates that weather variation such as...

Accuracy of a New Time-Resolved Step Counter in Children

Most pedometers record cumulative steps, limiting ability to assess level of physical activity or nonwear periods. The SportBrain iStep X1 has potential to overcome this limitation by recording and storing step count data in 60-s epochs. We evaluated accuracy of this instrument in children and the duration of consecutive zero step count minutes that indicated nonwear time periods. Seventeen children walked or ran on a treadmill at 2, 3, 4 and 5 miles/hour and walked around a track while wearing the SportBrain and Digiwalker SW-701 pedometer. We compared percent error in step counts for each pedometers relative to observer counts. A subsample wore a SportBrain pedometer during up to 5 days of usual activity. The SportBrain pedometer performed with acceptable accuracy at all evaluated treadmill speeds and during self-paced walking, recording steps within an average of 4% of observed step counts. It outperformed the Digiwalker, especially at slower speeds and in overweight children. During normal wear only 1% of zero count periods were more than 60 min. We conclude that the SportBrain iStep X1 pedometer provides a valid measure of step counts in short averaging times useful for assessing patterns of physical activity in population studies and periods of nonwear.

Health Promotion in Older Chinese

Aging, in conjunction with decreasing physical activity, is associated with a range of health problems. Simple, low-maintenance, population-based means of promoting activity to counteract the age-associated decline are required. We therefore assessed the effect of pedometry and buddy support to increase physical activity. We undertook a clustered randomized trial (HKCTR-346) of 24 community centers involving 399 older Chinese participants (≥ 60 yr). Centers were randomly allocated to 1) pedometry and buddy, 2) pedometry and no buddy, 3) no pedometry and buddy, and 4) no pedometry and no buddy with a 2 × 2 factorial design. The trial simultaneously tested the individual and combined effects of the interventions. The intervention groups also received monthly organized group activities to provide encouragement and support. Outcome measures were assessed at 6 and 12 months, including physical fitness and activity and cardiovascular disease risk factors (anthropometry and blood pressure). From the 24 centers, 356 volunteers (89.2%) completed the study. Those receiving the interventions had higher mean physical activity levels at 12 months of 1820 (95% confidence interval (CI) = 1360-2290) and 1260 (95% CI = 780-1740) MET·min·wk(-1), respectively relative to the decrease in the control groups. The buddy peer support intervention significantly improved mean aerobic fitness (12% [95% CI = 4%-21%]) and reduced both body fat (-0.6% [95% CI = -1.1% to 0.0%]) and time to complete the 2.5-m get-up-and-go test (-0.27 [95% CI = -0.53 to -0.01] s). No other improvements in the cardiovascular disease risk factors were observed. The combination of motivational tools was no better than the individual interventions. Both motivational interventions increased physical activity levels, and the buddy style improved fitness. These tools could be useful adjuncts in the prevention of obesity and age-related complications.

Seasonal variation of American Indian children’s school-day physical activity

Seasonal variation of American Indian children’s school-day physical activity Study aim: To examine the pedometer steps taken during the school-day by American Indian children during all four seasons. Material and methods: Participants included third-sixth grade children (n = 157) aged 9.6±1.07 (boys) and 9.7±1.2 (girls) attending school from one Southwestern US American Indian community. Children had a mean BMI of 23.9±7.7 with 70% being classified as overweight or obese. Children wore a pedometer (Yamax Digiwalker SW-200) for 20 days (5 days per season). Results: Children accumulated 4762±1544 (boys) and 4408±1194 (girls) steps/day across the four seasons with the highest totals occurring during the Fall (4899, males; 4796, females) and the lowest totals during the Winter (4463, males; 4043, females). Repeated measures ANOVA showed no significant differences in daily school-day steps across seasons. Children classified as normal weight averaged 5146±1688 steps/day, overweight children averaged 5020±1333 steps/day, and obese children accumulated 4275±1123 steps/day. Conclusions: PA stayed relatively consistent across seasons in this sample of children. However, children were the least active during Winter months. With 70% of the current sample being classified as overweight and with American Indian children at greater risk for numerous hypokinetic diseases there is a clear need for additional school-day PA opportunities.

Examining the validity of the ActivPAL monitor in measuring posture and ambulatory movement in children

BackgroundDecreasing sedentary activities that involve prolonged sitting may be an important strategy to reduce obesity and other physical and psychosocial health problems in children. The first step to understanding the effect of sedentary activities on children’s health is to objectively assess these activities with a valid measurement tool.PurposeTo examine the validity of the ActivPAL monitor in measuring sitting/lying, standing, and walking time, transition counts and step counts in children in a laboratory setting.MethodsTwenty five healthy elementary school children (age 9.9 ± 0.3 years; BMI 18.2 ± 1.9; mean ± SD) were randomly recruited across the Auckland region, New Zealand. Children were fitted with ActivPAL monitors and observed during simulated free-living activities involving sitting/lying, standing and walking, followed by treadmill and over-ground activities at various speeds (slow, normal, fast) against video observation (criterion measure). The ActivPAL sit-to-stand and stand-to-sit transition counts and steps were also compared with video data. The accuracy of step counts measured by the ActivPAL was also compared against the New Lifestyles NL-2000 and the Yamax Digi-Walker SW-200 pedometers.ResultsWe observed a perfect correlation between the ActivPAL monitor in time spent sitting/lying, standing, and walking in simulated free-living activities with direct observation. Correlations between the ActivPAL and video observation in total numbers of sit-to-stand and stand-to-sit transitions were high (r = 0.99 ± 0.01). Unlike pedometers, the ActivPAL did not misclassify fidgeting as steps taken. Strong correlations (r = 0.88-1.00) between ActivPAL step counts and video observation in both treadmill and over-ground slow and normal walking were also observed. During treadmill and over-ground fast walking and running, the correlations were low (r = 0.21-0.46).ConclusionThe ActivPAL monitor is a valid measurement tool for assessing time spent sitting/lying, standing, and walking, sit-to-stand and stand-to-sit transition counts and step counts in slow and normal walking. The device did not measure accurately steps taken during treadmill and over-ground fast walking and running in children.

P44 Validation of a pedometer to measure daily physical activities in COPD patients

Introduction Physical activity is reduced at COPD exacerbation but there is little information on the quantification of this activity. Activity can be assessed using walking tests or questionnaires or with expensive accelerometer based monitoring devices that require regular clinic visits to download data. Both approaches are not well suited to prospectively capturing activity during an exacerbation in a large observational cohort as patients will need to be monitored continuously in order to capture the prodrome and early stages of these events. The aim of this study was to determine whether step-counts measured by a pedometer (Yamax Digi-Walker SW-200) were sufficiently correlated with other measures of physical activity prospectively, to show that the device can be used in COPD patients. Methods Patients with COPD (n=33) wore the pedometer and a SenseWear Armband (BodyMedia, Inc.) during a 6-min walk test (6MWT). FEV 1 , height, age and gender were recorded prior to the test. The pedometer was worn on a belt on the left-hand side and a SenseWear device on the left arm. Patients performed a 6MWT according to ATS protocols when stable and while having an exacerbation. Results The 33 patients had a mean age (±SD) 71.5 (±6.2) and FEV 1 % predicted 48.2% (±13.2); 26 were men. The patients walked a mean 415 (±117) metres in 6 min, taking 587 (±132) steps and expending 26.3 calories (±9.8). Twenty-four patients completed the 6MWT when stable and five completed it during an exacerbation. Four patients were assessed at both baseline and exacerbation. Abstract P44 figure 1 shows that there was a strong correlation between steps counted by the pedometer and distance covered [r=0.82; p Conclusion Step count correlates well with 6 min walking distance and energy expenditure in COPD patients. Thus pedometers may be a useful way to prospectively monitor and quantify physical activity during COPD exacerbations in a large observational cohort.

Physical Activity Among Amish and Non-Amish Adults Living in Ohio Appalachia

To understand the behavioral lifestyle factors that may contribute to lower cancer incidence rates among the Amish population, this study evaluated differences in physical activity (PA) levels between Amish and non-Amish adults living in Ohio Appalachia. Amish (n=134) and non-Amish (n=154) adults completed face-to-face interviews as part of a cancer-related lifestyle study. Self-report of PA level was measured by the International Physical Activity Questionnaire (IPAQ) and by a diary of steps/day (pedometer: Digi-Walker SW-200). Total metabolic equivalent tasks (MET) minutes was calculated from the IPAQ and average number of steps/day from a pedometer diary. Amish males walked more steps/day (mean±standard error (SE): 11,447±611 vs. 7,605±643; P<0.001) and had a higher IPAQ score (MET min/week) (mean±SE: 8,354±701 vs. 5,547±690; P<0.01) than non-Amish males. In addition, Amish farmers walked significantly more steps/day than Amish non-farmers (mean±SE: 15,278±1,297 vs. 10,742±671; P<0.01). There was a trend for Amish females to walk more steps/day (mean±SE: 7,750±477 vs. 6,547±437; P=0.06) and to have higher IPAQ scores (mean±SE: 4,966±503 vs. 3,702±450; P=0.06) compared to non-Amish females. Two measures of PA demonstrated a higher PA level among Amish males, especially farmers, and a trend for higher PA level among Amish females. Higher levels of PA warrants further investigation as one factor potentially contributing to lower cancer incidence rates documented among the Amish.