The Use of Pedometers in Stroke Survivors: Are They Feasible and How Well Do They Detect Steps?

Objectives: To determine (1) the feasibility of pedometers for stroke patients and (2) the level of agreement between pedometers and actual step count.
Design: Observational agreement study.
Setting: Six stroke units.
Participants: Independently mobile stroke patients (N50) ready for hospital discharge.
Interventions: Patients were asked to apply 3 pedometers: 1 around the neck and 1 above each hip. Patients performed a short walk lasting 20 seconds, then a 6-minute walk test (6MWT). Video recordings determined the criterion standard
step count.
Main Outcome Measure: Agreement between the step count recorded by pedometers and the step count recorded by viewing the criterion standard video recordings of the 2 walks.
Results: Five patients (10%) needed assistance to put on the pedometers, and 5 (10%) could not read the step count. Thirty nine (78%) would use pedometers again. Below a gait speed of about 0.5m/s, pedometers did not generally detect steps. Agreement analyses showed that even above 0.5m/s, pedometers undercounted steps for both the short walk and 6MWT; for example, the mean difference between the video recorder and pedometer around the neck was 5.93 steps during the short walk and 32.4 steps during the 6MWT.
Conclusions: Pedometers are feasible but generally do not detect steps at gait speeds below about 0.5m/s, and they undercount steps at gait speeds above 0.5m/s.