title: Pedometer step counts in individuals with neurological conditions.
abstract: OBJECTIVE
  To examine the accuracy of measuring step counts using a pedometer in participants with neurological conditions and healthy volunteers in relation to a manual step count tally.
  
  
  METHODS
  Oxford Centre for Enablement, Nuffield Orthopaedic Centre NHS Trust, Oxford, UK.
  
  
  METHODS
  Healthy adults (n = 13, age: mean 29, SD = 12) and adults with neurological conditions (n=20 stroke, n=16 multiple sclerosis, n=5 muscular dystrophy, n=1 spinal cord injury, n=1 traumatic brain injury; age: mean 54, SD=13).
  
  
  METHODS
  Individuals walked for 2 minutes at self-selected walking speeds (SSWS) wearing a pedometer. Healthy individuals were then asked to walk at slow walking speeds (SWS). Step counts were recorded manually and using a pedometer.
  
  
  RESULTS
  In healthy individuals there was no difference between manually measured and pedometer counts during walking (P>0.05). In adults with neurological conditions the pedometers undercounted (P = 0.003); bias (random error): 27 (111); percentage variability 30% and intraclass correlation coefficient (ICC) 0.66. In neurological adults, from regression analysis the relationship between error and walking speed was cubic, with walking speed accounting for 29% of pedometer error. Healthy individuals showed greater variability and undercounting at SWS bias (random error): 10 (31), percentage variability 8% and ICC 0.73, compared with SSWS bias (random error): -3 (13), percentage variability 3% and ICC 0.84.
  
  
  CONCLUSIONS
  Pedometers may undercount when used for people with neurological conditions. There may be variability in pedometer accuracy but this was not strongly related to walking speed. The suitability of pedometer use for exercise monitoring should be individually determined.
authors.affiliation: School of Life Sciences, Oxford Brookes University, Oxford, UK. celsworth@brookes.ac.uk
authors.forename: Charlotte
authors.initials: C
authors.lastname: Elsworth
authors.forename: Helen
authors.initials: H
authors.lastname: Dawes
authors.forename: Charlotte
authors.initials: C
authors.lastname: Winward
authors.forename: Ken
authors.initials: K
authors.lastname: Howells
authors.forename: Johnny
authors.initials: J
authors.lastname: Collett
authors.forename: Andrea
authors.initials: A
authors.lastname: Dennis
authors.forename: Catherine
authors.initials: C
authors.lastname: Sackley
authors.forename: Derick
authors.initials: D
authors.lastname: Wade
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005081:Exercise Therapy / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods; D009422:Nervous System Diseases / Q000473:pathology / Q000534:rehabilitation*; D015203:Reproducibility of Results; D016138:Walking; D055815:Young Adult