title: Clinimetric properties of a novel feedback device for assessing gait parameters in stroke survivors.
abstract: BACKGROUND
  Community-dwelling stroke survivors tend to become less physically active over time. There is no 'gold standard' to measure walking activity in this population. Assessment of walking activity generally involves subjective or observer-rated instruments. Objective measuring with an activity monitor, however, gives more insight into actual walking activity. Although several activity monitors have been used in stroke patients, none of these include feedback about the actual walking activity. FESTA (FEedback to Stimulate Activity) determines number of steps, number of walking bouts, covered distance and ambulatory activity profiles over time and also provides feedback about the walking activity to the user and the therapist.
  
  
  OBJECTIVE
  To examine the criterion validity and test-retest-reliability of the FESTA as a measure of walking activity in patients with chronic stroke. To target the properties of the measurement device itself and thus exclude effects of behavioral variability as much as possible evaluation was performed in standardized activities.
  
  
  METHODS
  Community-dwelling individuals with chronic stroke were tested twice with a test-retest interval varying from two days to two weeks. They performed a six-minute walk test and a standardized treadmill test at different speeds on both testing days. Walking activity was expressed in gait parameters: steps, mean-step-length and walking distance. Output data of the FESTA on the treadmill was compared with video analysis as the criterion measurement. Intraclass Correlations Coefficients (ICCs) and Mean Relative Root Squared Error (MRRSE) were calculated.
  
  
  RESULTS
  Thirty-three patients were tested to determine criterion validity, 27 patients of this group were tested twice for test-retest reliability. ICC values for validity and reliability were high, ranging from .841 to .972.
  
  
  CONCLUSIONS
  This study demonstrated good criterion validity and test-retest-reliability of FESTA for measuring specific gait parameters in chronic stroke patients. FESTA is a valid and reliable tool for capturing walking activity measurements in stroke, and has applicability to both clinical practice and research.
authors.affiliation: Research group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands. Michiel.punt@hu.nl.
authors.forename: Michiel
authors.initials: M
authors.lastname: Punt
authors.forename: Belinda
authors.initials: B
authors.lastname: van Alphen
authors.forename: Ingrid G
authors.initials: IG
authors.lastname: van de Port
authors.forename: Jaap H
authors.initials: JH
authors.lastname: van Dieën
authors.forename: Kathleen
authors.initials: K
authors.lastname: Michael
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Outermans
authors.forename: Harriet
authors.initials: H
authors.lastname: Wittink
mesh_terms: D061725:Accelerometry / Q000295:instrumentation*; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D015203:Reproducibility of Results; D000071939:Stroke Rehabilitation; D017741:Survivors; D016138:Walking