Accuracy of Physical Activity Monitors for Steps and Calorie Measurement During Pregnancy Walking

Purpose: This purpose of this study was to validate consumer-based and research-grade PA monitors for step counting and Calorie expenditure during treadmill walking. Methods: Participants (n = 40, 24 in second trimester and 16 in third trimester) completed five 2-minute walking activities (1.5–3.5 miles/hour in 0.5 mile/hour increments) while wearing five PA monitors (right hip: ActiGraph Link [AG]; left hip: Omron HJ-720 [OM]; left front pants pocket: New Lifestyles NL 2000 [NL]; non-dominant wrist: Fitbit Flex [FF]; right ankle: StepWatch [SW]). Mean absolute percent error (MAPE) was used to determine device accuracy for step counting (all monitors) and Calorie expenditure (AG with Freedson equations and FF) compared to criterion measures (hand tally for steps, indirect Calorimetry for Calories). Results: For step counting, the SW had MAPE ≤ 10% at all walking speeds, and the OM and NL had MAPE ≤ 10% for all speeds but 1.5 miles/hour. The AG had MAPE ≤ 10% for only 3.0–3.5 miles/hour speeds, and the FF had high MAPE for all speeds. For Calories, the FF and AG had MAPE > 10% for all speeds, with the FF overestimating Calories expended. Trimester did not affect PA monitor accuracy for step counting but did affect accuracy for Calorie expenditure. Conclusion: The ankle-worn SW and hip-worn OM had high accuracy for measuring step counts at all treadmill walking speeds, whereas the NL had high accuracy for speeds ≥2.0 miles/hour. Conversely, the monitors tested for Calorie expenditure have poor accuracy and should be interpreted cautiously for walking behavior.