Validating Accelerometry as a Measure of Physical Activity and Energy Expenditure in Chronic Stroke
Open accessAbstract
BACKGROUND: Accelerometers can objectively measure steps taken per day in individuals without gait deficits, but accelerometers also have the ability to estimate frequency, intensity, and duration of physical activity. However, thresholds to distinguish varying levels of activity intensity using the Actical brand accelerometer are standardized only for the general population and may underestimate intensity in stroke. OBJECTIVE: To derive Actical activity count thresholds specific to stroke disability for use in more accurately gauging time spent at differing activity levels. METHODS: ) participated in the study. Actical accelerometers were placed on the non-paretic hip to obtain accelerometry counts during eight activities of varying intensity: (1) watching TV; (2) seated stretching; (3) standing stretching; (4) floor sweeping; (5) stepping in place; (6) over-ground walking; (7) lower speed treadmill walking (1.0 mph at 4% incline); and (8) higher speed treadmill walking (2.0 mph at 4% incline). Simultaneous portable monitoring (Cosmed K4b2) enabled quantification of energy cost for each activity in metabolic equivalents (METs, or oxygen consumption in multiples of resting level). Measurements were obtained for 10 min of standard rest and 5 min during each of the eight activities. RESULTS: Regression analysis yielded the following new stroke-specific Actical minimum thresholds: 125 counts per minute (cpm) for sedentary/light activity, 667 cpm for light/moderate activity, and 1546 cpm for moderate/vigorous activity. CONCLUSION: Our revised cut points better reflect activity levels after stroke and suggest significantly lower thresholds relative to those observed for the general population of healthy individuals. We conclude that the standard, commonly applied Actical thresholds are inappropriate for this unique population.
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The accelerometers underestimate PAEE in stroke patients, probably slightly less for sedentary/light activities that are more typical for non-ambulatory stroke survivors.
“The accelerometers underestimate PAEE in stroke patients, probably slightly less for sedentary/light activities [76] that are more typical for non-ambulatory stroke survivors.”
From Physical Activity, Psychological and Functional Outcomes in Non-Ambulatory Stroke Patients during Rehabilitation—A Pilot Study (2022) · cites this paper as [76]
The Discussion (page not available) says that standard Actical thresholds somewhat adequately distinguish sedentary/light activity but drastically underestimate energy expenditure during more intense activity in stroke survivors with hemiparetic gait. It does not establish that energy expenditure is underestimated during sedentary/light activity, or test whether those activities are more typical of non-ambulatory survivors. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe PAEE for any given task is higher in stroke compared with the general non-disabled population.
“What is more, the PAEE for any given task is higher in stroke compared with the general non-disabled population.”
From Physical Activity, Psychological and Functional Outcomes in Non-Ambulatory Stroke Patients during Rehabilitation—A Pilot Study (2022) · cites this paper as [76]
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Błaszcz, M., Prucnal, N., Wrześniewski, K., Pasiut, S., Mika, P., Kucia, M., Stach, B., Woźniak, M., & Mirek, E. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11247260 · Cited by 12 · see citing works
“The accelerometers underestimate PAEE in stroke patients, probably slightly less for sedentary/light activities [76] that are more typical for non-ambulatory stroke survivors.”
Background
- Authors
- Serra, M. C., Balraj, E., DiSanzo, B. L., Ivey, F. M., Hafer-Macko, C. E., Treuth, M. S., & Ryan, A. S.
- Affiliations
- University of Maryland, Baltimore (US)
- University of Maryland Eastern Shore (US)
- Corresponding author
- Ryan, Alice S.
- Venue
- Topics in Stroke Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2016-06-20
- Volume
- 24
- Issue
- 1
- Pages
- 18-23
- ISSN
- 1074-9357 (ISSN-L)
- 1945-5119
- PMC
- PMC5125839
- OpenAlex
- W2470544830
- Cited by
- 46
- References
- 32
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 6 · 2023: 3 · 2022: 10 · 2021: 4 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 1
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Topics in Stroke Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R01-AG030075, P30-AG028747)
- Veterans Affairs (B7257R)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
- Keywords
- accelerometry, physical activity, energy expenditure, chronic stroke, cut points, metabolic equivalents, treadmill walking, sedentary behavior
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Body Composition, Calorimetry, Chronic Disease, Energy Metabolism, Female, Humans, Male, Middle Aged, Oxygen Consumption, Regression Analysis, Reproducibility of Results, Exercise, Absorptiometry, Photon, Stroke, Accelerometry
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