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Objective: To assess (1) step count accuracy of the Fitbit Zip, compared to manual step count, in people receiving outpatient rehabilitation, in indoor and outdoor conditions, and (2) impact of slow walking speed on Fitbit accuracy. Design: Observational study. Setting: A metropolitan rehabilitation hospital. Subjects: Adults (n = 88) attending a subacute rehabilitation outpatient clinic with walking speeds of between 0.4 and 1.0 m/s. Interventions: Two 2-minute walk tests, one indoors and one outdoors, completed in random order. Main measures: Step count recorded manually by observation and by a Fitbit Zip, attached to the shoe on the dominant or non-affected side. Subgroup analysis included assessment accuracy for those considered limited community walkers (slower than 0.8 m/s) and those considered community walkers (faster than 0.8 m/s). Results: The Fitbit significantly (P < 0.05) undercounted steps compared to manual step count, indoors and outdoors, with percentage agreement slightly higher outdoors (mean 92.4%) than indoors (90.1%). Overall, there was excellent consistent agreement between the Fitbit and manual step count for both indoor (ICC 0.83) and outdoor (ICC 0.88) walks. The accuracy of the Fitbit was significantly (P < 0.05) reduced in those who walked slower than 0.8 m/s outdoors (ICC 0.80) compared to those who walk faster than 0.8 m/s (ICC 0.90). Conclusions: The Fitbit Zip shows high step count accuracy with manual step count in a mixed subacute rehabilitation population. However, accuracy is affected by walking speed, with decreased accuracy in limited community walkers. [ABSTRACT FROM AUTHOR]

Edited by Richard Griffiths. Aldershot, U.K.: Ashgate, 2001. xvii + 204 pp. $84.95 cloth. From a conference held in London in 1998, Richard Griffiths brings together nine cleanly edited papers [...]

Background: Activity monitoring is used for motivation and assessing patients in the rehabilitation setting. Monitors available on the market have not been assessed for accuracy at walking patterns seen in the clinical setting., Objectives: To assess the accuracy of the Fitbit Zip device at different anatomical locations at walking speeds, step length, and cadence similar to those seen in clinical rehabilitation populations., Methods: Ten healthy participants completed 3 sets of 12 combinations of speed and cadence ranging from 0.2 m/s at 48 steps per minute to 1.0 m/s at 120 steps per minute along a 20 m walkway. Step length was controlled by ground markings and cadence was controlled by a metronome. Five Fitbit Zip devices were concurrently worn at the chest, hip, shin, ankle and forefoot. Percent accuracy for each location and walking condition combination were calculated., Results: At the chest and hip the Fitbit has poor accuracy below 0.7 m/s, however when worn distally, can be accurate to 5.5% at speeds as slow as 0.5 m/s., Conclusions: For patient populations with slow walking speed, activity monitoring with the Fitbit can be achieved provided the device is located distally on the lower limb., (Copyright © 2016 Elsevier Inc. All rights reserved.)