Microprocessor-based ambulatory activity monitoring in stroke patients

Abstract
MACKO, R. F., E. HAEUBER, M. SHAUGHNESSY, K. L. COLEMAN, D. A. BOONE, G. V. SMITH, and K. H. SILVER. Microprocessor-based ambulatory activity monitoring in stroke patients. Med. Sci. Sports Exerc., Vol. 34, No. 3, pp. 394–399, 2002. Recovery of ambulatory function after stroke is routinely assessed using standardized subject- or observer-rated instruments that do not directly measure ambulatory activities in the home-community setting. Accuracy of conventional pedometers in stroke patients is not established, limiting their application in mobility outcomes monitoring. This study investigates the accuracy and reliability of a mechanical pedometer versus microprocessor-based step activity monitoring (SAM) in gait-impaired hemiparetic stroke patients. Accuracy and test-retest reliability of ankle-worn SAM and belt-worn pedometer were tested directly against hand tallied stride counts and cadence during a battery of timed walks in 16 chronic hemiparetic stroke patients. Patients performed replicate 1-min floor walks at self-selected and fastest comfortable paces, and two 6-min walks on separate days. SAM cadence and total stride counts are more accurate than pedometers during 1-min walks at self-selected (99 ± 1 vs 87 ± 11.3%, mean ± SD, P P SAM, but not the conventional pedometer, provides accurate and reliable measures of cadence and total stride counts in hemiparetic stroke patients. Portable microprocessor-based gait monitoring offers potential to quantitatively measure home-community-based ambulatory activity levels in this population.