A Comparison of Commonly Used Accelerometer Based Activity Monitors in Controlled and Free-Living Environment

This dissertation was designed to determine the effects of body mass index (BMI) and walking speed on activity monitor outputs. A secondary purpose was to compare the activity monitors’ performance in a free-living environment. In the first experiment, 71 participants wore three waist-mounted activity monitors (Actical, ActiGraph, and NL-2000) and an ankle-mounted device (StepWatch 3) while walking on a treadmill (40, 67 and 94 m/min). The tilt angle of each device was measured. The Actical recorded 26% higher activity counts (P < 0.01) in obese persons with a tilt <10 degrees, compared to normal weight persons. The ActiGraph was unaffected by BMI or tilt angle. In the second experiment, the steps recorded by the devices were compared to actual steps. Speed had the greatest influence on the accuracy these devices. At 40 m/min, the ActiGraph was the least accurate device for normal weight (38%), overweight (46%) and obese (48%) individuals. The Actical, NL-2000 and StepWatch averaged 65%, 73% and 99% of steps taken, respectively. Lastly, several generations of the ActiGraph (7164, GT1M, and GT3X), and other research grade activity monitors (Actical; ActivPAL; and Digi-Walker) were compared to a criterion measure of steps. Fifty-six participants performed treadmill walking (40, 54, 67, 80 and 94 m/min) and wore the devices for 24-hours under free-living conditions. BMI did not affect step count accuracy during treadmill walking. The StepWatch, PAL, and the AG7164 were the most accurate across all speeds; the other devices were only accurate at the faster speeds. In the free-living environment, all devices recorded about 75% of StepWatch-determined steps, except the AG7164 (99%). Based on these findings, we conclude that BMI does not affect the output of these activity monitors. However, waist-borne activity monitors are highly susceptible to under-counting steps at walking speeds below 67 m/min, or stepping rates below 100 steps/min. An activity monitor worn on the ankle is less susceptible to these speed effects and provides the greatest accuracy for step counting.