title: Influence of Pedometer Position on Pedometer Accuracy at Various Walking Speeds: A Comparative Study.
abstract: Demographic growth in conjunction with the rise of chronic diseases is increasing the pressure on health care systems in most OECD countries. Physical activity is known to be an essential factor in improving or maintaining good health. Walking is especially recommended, as it is an activity that can easily be performed by most people without constraints. Pedometers have been extensively used as an incentive to motivate people to become more active. However, a recognized problem with these devices is their diminishing accuracy associated with decreased walking speed. The arrival on the consumer market of new devices, worn indifferently either at the waist, wrist, or as a necklace, gives rise to new questions regarding their accuracy at these different positions.
  
  
  
  Our objective was to assess the performance of 4 pedometers (iHealth activity monitor, Withings Pulse O2, Misfit Shine, and Garmin vívofit) and compare their accuracy according to their position worn, and at various walking speeds.
  
  
  
  We conducted this study in a controlled environment with 21 healthy adults required to walk 100 m at 3 different paces (0.4 m/s, 0.6 m/s, and 0.8 m/s) regulated by means of a string attached between their legs at the level of their ankles and a metronome ticking the cadence. To obtain baseline values, we asked the participants to walk 200 m at their own pace.
  
  
  
  A decrease of accuracy was positively correlated with reduced speed for all pedometers (12% mean error at self-selected pace, 27% mean error at 0.8 m/s, 52% mean error at 0.6 m/s, and 76% mean error at 0.4 m/s). Although the position of the pedometer on the person did not significantly influence its accuracy, some interesting tendencies can be highlighted in 2 settings: (1) positioning the pedometer at the waist at a speed greater than 0.8 m/s or as a necklace at preferred speed tended to produce lower mean errors than at the wrist position; and (2) at a slow speed (0.4 m/s), pedometers worn at the wrist tended to produce a lower mean error than in the other positions.
  
  
  
  At all positions, all tested pedometers generated significant errors at slow speeds and therefore cannot be used reliably to evaluate the amount of physical activity for people walking slower than 0.6 m/s (2.16 km/h, or 1.24 mph). At slow speeds, the better accuracy observed with pedometers worn at the wrist could constitute a valuable line of inquiry for the future development of devices adapted to elderly people.
authors.affiliation: Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland. frederic.ehrler@hcuge.ch.
authors.forename: Frederic
authors.identifier: 0000-0001-9734-3242
authors.initials: F
authors.lastname: Ehrler
authors.forename: Chloé
authors.identifier: 0000-0003-4411-917X
authors.initials: C
authors.lastname: Weber
authors.forename: Christian
authors.identifier: 0000-0002-2681-8076
authors.initials: C
authors.lastname: Lovis
mesh_terms: D056044:Actigraphy / Q000295:instrumentation* / Q000379:methods; D000328:Adult; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D017216:Telemedicine; D016138:Walking / Q000502:physiology*; D000072797:Walking Speed / Q000502:physiology*
keywords: frail elderly; mHealth; motor activity; walking