JMIR Publications

ABSTRACT

Background:

Continuous tracking of ambulatory activity in real-world settings using step activity monitors (SAMs) has many potential uses but feasibility, accuracy, and correlation with performance measures in stroke patients has not been well-established.

Objective:

To assess the feasibility of monitoring step counts in patients with recent mild ischemic stroke using a consumer-grade SAM, the Fitbit Charge HR™.

Methods:

Fifteen participants with recent mild ischemic stroke wore a Fitbit Charge HR™ for the first 90-days after discharge home and completed three performance measures from the National Institutes of Health Toolbox at discharge and 30 days: standing balance test, 2-minute walk endurance test, and 4-meter walk gait speed test. Accuracy of SAM was assessed by calculating differences in steps recorded on the SAM and a manual tally during 2-minute walk tests.

Results:

Participants had mean age of 54 years; median modified Rankin scale score = 1. Mean daily adherence with SAM use was 83.6%. Mean daily step count in the first week after discharge was 4,376. Daily step counts increased slightly during the first 30 days after discharge (average increase 52.5 steps per day; 95% CI: 32.2-71.8), and remained stable during 30-90 day period after discharge. Mean step count difference between SAM and manual tally was -4.8 steps (-1.8%). Correlations with 2-minute walk, standing balance, and 4-meter gait speed at discharge were 0.41 (95% CI -0.14, 0.75), -0.12 (95% CI -0.67, 0.64), and 0.17 (95% CI -0.46, 0.66), respectively. They were similarly poor at 30-days.

Conclusions:

The use of consumer-grade Fitbit Charge HR™ in patients with recent mild stroke is feasible with reasonable adherence and accuracy. There was poor correlation between step counts and gait speed, balance, and endurance. Further research is needed to evaluate the association between step counts and other outcomes of relevance to patients.