Microprocessor-based ambulatory activity monitoring in stroke patients

Richard F. Macko, Elaina Haeuber, Marianne Shaughnessy, Kim L. Coleman, David A. Boone, Gerald V. Smith, Kenneth H. Silver

Research output: Contribution to journalArticlepeer-review

147 Scopus citations


Purpose: 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. Methods: 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. Results: 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 < 0.01); fast pace (98 ± 2.3% vs 85 ± 15%, P < 0.01); and repeated 6-min walks performed on separate days (99 ± 1% vs 89 ± 12%, P < 0.01). Although SAM is highly reliable (r = 0.97, P < 0.0001) and accurate in all patients under every walking condition tested, the mechanical pedometer demonstrates this high level of accuracy in only half of stroke patients and has poor test-retest reliability (r = 0.64, P < 0.05). Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)394-399
Number of pages6
JournalMedicine and Science in Sports and Exercise
Issue number3
StatePublished - 2002
Externally publishedYes


  • Ambulation
  • Gait
  • Hemiplegia
  • Monitor
  • Outcomes assessment

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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