Validation of Step Detection and Distance Calculation Algorithms for Soccer Performance Monitoring.

This study focused on developing and evaluating a gyroscope-based step counter algorithm using inertial measurement unit (IMU) readings for precise athletic performance monitoring in soccer. The research aimed to provide reliable step detection and distance estimation tailored to soccer-specific movements, including various running speeds and directional changes. Real-time algorithms utilizing shank angular data from gyroscopes were created. Experiments were conducted on a specially designed soccer-specific testing circuit performed by 15 athletes, simulating a range of locomotion activities such as walking, jogging, and high-intensity actions. The algorithm outcome was compared with manually tagged data from a high-quality video camera-based system for validation, by assessing the agreement between the paired values using limits of agreement, concordance correlation coefficient, and further metrics. Results returned a step detection accuracy of 95.8% and a distance estimation Root Mean Square Error (RMSE) of 17.6 m over about 202 m of track. A sub-sample (N = 6) also wore two pairs of devices concurrently to evaluate inter-unit reliability. The performance analysis suggested that the algorithm was effective and reliable in tracking diverse soccer-specific movements. The proposed algorithm offered a robust and efficient solution for tracking step count and distance covered in soccer, particularly beneficial in indoor environments where global navigation satellite systems are not feasible. This advancement in sports technology widens the spectrum of tools for coaches and athletes in monitoring soccer performance.

Objective Methods of Monitoring Usage of Orthotic Devices for the Extremities: A Systematic Review.

Orthoses are commonly prescribed to relieve symptoms for musculoskeletal and neurological conditions; however, patients stop wearing orthoses as recommended for many reasons. When considering the effectiveness of orthoses, there needs to be an objective way to monitor whether participants wear the orthosis as instructed, because if this is not followed, the orthoses will not work as intended. This review aimed to identify, summarise, and compare objective methods used to measure compliance with orthoses applied to the extremities. Databases (Scopus, Web of Science, Embase, CINAHL, and MEDLINE) were searched for eligible studies. Twenty-three studies were accepted in the final review, including five studies that employed upper limb orthoses, two that employed hip orthoses, and fifteen that employed lower limb orthoses. To measure compliance objectively, studies utilised temperature sensors, pressure sensors, accelerometers, a step counter, or a combination of sensors. All sensor types have their own advantages and disadvantages and should be chosen based on study-specific parameters. Sensor-derived monitoring provides quantitative, objective data that are beneficial in both clinical and research settings. The ideal solution to monitoring compliance would consist of both objective and user-reported aspects that, in combination, would provide an all-encompassing picture of the orthotic treatment prescribed.

Effects of a three-armed randomised controlled trial using self-monitoring of daily steps with and without counselling in prediabetes and type 2 diabetes-the Sophia Step Study.

BACKGROUND: This aimed to evaluate the effects of self-monitoring of daily steps with or without counselling support on HbA1c, other cardiometabolic risk factors and objectively measured physical activity (PA) during a 2-year intervention in a population with prediabetes or type 2 diabetes. METHODS: The Sophia Step Study was a three-armed parallel randomised controlled trial. Participants with prediabetes or type 2 diabetes were recruited in a primary care setting. Allocation (1:1:1) was made to a multi-component intervention (self-monitoring of steps with counselling support), a single-component intervention (self-monitoring of steps without counselling support) or standard care. Data were collected for primary outcome HbA1c at baseline and month 6, 12, 18 and 24. Physical activity was assessed as an intermediate outcome by accelerometer (ActiGraph GT1M) for 1 week at baseline and the 6-, 12-, 18- and 24-month follow-up visits. The intervention effects were evaluated by a robust linear mixed model. RESULTS: In total, 188 subjects (64, 59, 65 in each group) were included. The mean (SD) age was 64 (7.7) years, BMI was 30.0 (4.4) kg/m2 and HbA1c was 50 (11) mmol/mol, 21% had prediabetes and 40% were female. The dropout rate was 11% at 24 months. Effect size (CI) for the primary outcome (HbA1c) ranged from -1.3 (-4.8 to 2.2) to 1.1 (-2.4 to 4.6) mmol/mol for the multi-component vs control group and from 0.3 (-3.3 to 3.9) to 3.1 (-0.5 to 6.7) mmol/mol for the single-component vs control group. Effect size (CI) for moderate-to-vigorous physical activity ranged from 8.0 (0.4 to 15.7) to 11.1 (3.3 to 19.0) min/day for the multi-component vs control group and from 7.6 (-0.4 to 15.6) to 9.4 (1.4 to 17.4) min/day for the single-component group vs control group. CONCLUSION: This 2-year intervention, including self-monitoring of steps with or without counselling, prevented a decrease in PA but did not provide evidence for improved metabolic control and cardiometabolic risk factors in a population with prediabetes or type 2 diabetes. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02374788 . Registered 2 March 2015-Retrospectively registered.

Physician step prescription and monitoring to improve ARTERial health (SMARTER): A randomized controlled trial in patients with type 2 diabetes and hypertension.

AIMS: There are few proven strategies to enhance physical activity and cardiometabolic profiles in patients with type 2 diabetes and hypertension. We examined the effects of physician-delivered step count prescriptions and monitoring. METHODS: Participants randomized to the active arm were provided with pedometers and they recorded step counts. Over a 1-year period, their physicians reviewed their records and provided a written step count prescription at each clinic visit. The overall goal was a 3000 steps/day increase over 1 year (individualized rate of increase). Control arm participants were advised to engage in physical activity 30 to 60 min/day. We evaluated effects on step counts, carotid femoral pulse wave velocity (cfPWV, primary) and other cardiometabolic indicators including haemoglobin A1c in diabetes (henceforth abbreviated as A1c) and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) in participants not receiving insulin therapy. RESULTS: A total of 79% completed final evaluations (275/347; mean age, 60 years; SD, 11). Over 66% of participants had type 2 diabetes and over 90% had hypertension. There was a net 20% increase in steps/day in active vs control arm participants (1190; 95% CI, 550-1840). Changes in cfPWV were inconclusive; active vs control arm participants with type 2 diabetes experienced a decrease in A1c (-0.38%; 95% CI, -0.69 to -0.06). HOMA-IR also declined in the active arm vs the control arm (ie, assessed in all participants not treated with insulin; -0.96; 95% CI, -1.72 to -0.21). CONCLUSIONS: A simple physician-delivered step count prescription strategy incorporated into routine clinical practice led to a net 20% increase in step counts; however, this was below the 3000 steps/day targeted increment. While conclusive effects on cfPWV were not observed, there were improvements in both A1c and insulin sensitivity. Future studies will evaluate an amplified intervention to increase impact.

Lifesource XL-18 pedometer for measuring steps under controlled and free-living conditions.

The primary aim was to examine the criterion and construct validity and test-retest reliability of the Lifesource XL-18 pedometer (A&D Medical, Toronto, ON, Canada) for measuring steps under controlled and free-living activities. The influence of body mass index, waist size and walking speed on the criterion validity of XL-18 was also explored. Forty adults (35-74 years) performed a 6-min walk test in the controlled condition, and the criterion validity of XL-18 was assessed by comparing it to steps counted manually. Thirty-five adults participated in the free-living condition and the construct validity of XL-18 was assessed by comparing it to Yamax SW-200 (YAMAX Health & Sports, Inc., San Antonio, TX, USA). During the controlled condition, XL-18 did not significantly differ from criterion (P > 0.05) and no systematic error was found using Bland-Altman analysis. The accuracy of XL-18 decreased with slower walking speed (P = 0.001). During the free-living condition, Bland-Altman analysis revealed that XL-18 overestimated daily steps by 327 ± 118 than Yamax (P = 0.004). However, the absolute percent error (APE) (6.5 ± 0.58%) was still within an acceptable range. XL-18 did not differ statistically between pant pockets. XL-18 is suitable for measuring steps in controlled and free-living conditions. However, caution may be required when interpreting the steps recorded under slower speeds and free-living conditions.

The impact of online classes on sleep, physical activity, and cognition functioning among physical education students.

Introduction: Online education has become a crucial component of teachers' professional development, and universities incorporate innovative pedagogical approaches to enhance teachers' training. These approaches have proven invaluable, particularly during the COVID-19 pandemic. This study investigates the impact of online versus face-to-face learning environments on sleep quality, physical activity, and cognitive functioning among physical education students. Methods: Utilizing a unique methodological approach that combines wrist actigraphy, the Pittsburgh Sleep Quality Index, and the Cambridge Neuropsychological Test Automated Battery, we provide a comprehensive assessment of these variables. Over 4 weeks, 19 male students participated in alternating online and face-to-face class formats. Results: Our results reveal no significant differences in sleep quality or cognitive function between learning environments. However, notable findings include significant differences in Paired Associates Learning and weekday step counts in the face-to-face setting. Discussion: These insights suggest that while online learning environments may not adversely affect sleep or cognitive functions, they could impact certain aspects of physical activity and specific cognitive tasks. These findings contribute to the nuanced understanding of online learning's implications and can inform the design of educational strategies that promote student well-being.

Effects of Pedometer-Based Step-Feedback on Physical Activity of Severe COPD Patients.

Purpose: This study investigated whether adding step-feedback (step-FB) from a pedometer to pulmonary rehabilitation (PR) programs could increase the physical activity (PA) of low-activity patients with severe chronic obstructive pulmonary disease (COPD). Patients and Methods: We included low-activity patients with severe COPD (step-FB group: 14 patients; control group: 17 patients) who underwent PR for the first time. The usual PR program for patients with severe COPD consisted of two 8-week sessions (PR session 1: PR1, PR session 2: PR2). The step-FB group was provided a program with step-FB added to PR2 (PR2+step-FB). Furthermore, all patients were evaluated at pre-intervention (baseline), PR1, and PR2. The primary outcome of this study was the number of daily steps (steps) and energy expenditure from activity (energy expenditure), as measured by a pedometer. The secondary outcomes were dyspnea and exercise tolerance. Results: In PR1, dyspnea, exercise tolerance, steps, and energy expenditure were significantly improved as compared to baseline, in both groups. During PR2, dyspnea and exercise tolerance were significantly improved as compared to PR1, in both groups. Steps and energy expenditure were significantly improved in the step-FB group, but not in the control group. Conclusion: PR improved PA by improving physical function in severe COPD patients. Adding step-FB improved PA in severe COPD patients by presenting an activity goal for improving PA. Therefore, pedometer-based step-FB is a viable addition to PR and has the potential to improve PA continuously in these patients.

An Exploration of the Application of Step Counter-Based Physical Activity Promotion Programs in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review.

Objective: This paper aimed to systematically review the application methods and components of step counter-based physical activity (PA) promotion programs in patients with chronic obstructive pulmonary disease (COPD). The effects of longer-duration (≥12 weeks) programs on PA, exercise capacity, quality of life, and dyspnea were discussed. Methods: This review was performed in accordance with the preferred reporting items for systematic reviews and meta-analysis. Online data resources PubMed, Web of Science, Embase, and EBSCO were searched. The publication year was limited between January 2000 to August 2020. All randomized controlled trials with ≥12-week duration of step counter-based PA promotion programs of COPD were included. Two researchers independently assessed the quality of the included studies and extracted their characteristics. Results: Nine studies involving 1,450 participants were included. Step counters, counseling, exercise goals, diaries, and tele-communicational approaches were common components of these programs. The PA feedback tools were mostly pedometers (n = 8), whereas accelerometers were often used as assessment tools of PA (n = 5). All studies implemented counseling: five applied behavioral change theories, and three reported motivational interview techniques simultaneously. Six studies reported detailed exercise goals. The usual exercise goal was to reach a total of 8,000-10,000 steps/day. Three research studies used diaries, and five applied tele-communication approaches to deliver interventions. The programs could be implemented alone (n = 4), in combination with exercise training (n = 2), or with pulmonary rehabilitation (n = 2). All studies showed a significant increase in the PA (≥793 steps/day). Three studies observed a significant improvement in exercise capacity (≥13.4 m), and two reported a significant increase in the quality of life (p < 0.05). No study showed significant between-group differences in dyspnea. Conclusion: There are a few studies assessing the impact of long-duration (≥12 weeks) step counter-based interventions in COPD, with different methodologies, although all studies included counseling and exercise goal setting. These interventions seem to have a positive effect on PA. A few studies also showed benefit on exercise capacity and quality of life.

Using an Accelerometer-Based Step Counter in Post-Stroke Patients: Validation of a Low-Cost Tool.

Monitoring the real-life mobility of stroke patients could be extremely useful for clinicians. Step counters are a widely accessible, portable, and cheap technology that can be used to monitor patients in different environments. The aim of this study was to validate a low-cost commercial tri-axial accelerometer-based step counter for stroke patients and to determine the best positioning of the step counter (wrists, ankles, and waist). Ten healthy subjects and 43 post-stroke patients were enrolled and performed four validated clinical tests (10 m, 50 m, and 6 min walking tests and timed up and go tests) while wearing five step counters in different positions while a trained operator counted the number of steps executed in each test manually. Data from step counters and those collected manually were compared using the intraclass coefficient correlation and mean average percentage error. The Bland-Altman plot was also used to describe agreement between the two quantitative measurements (step counter vs. manual counting). During walking tests in healthy subjects, the best reliability was found for lower limbs and waist placement (intraclass coefficient correlations (ICCs) from 0.46 to 0.99), and weak reliability was observed for upper limb placement in every test (ICCs from 0.06 to 0.38). On the contrary, in post-stroke patients, moderate reliability was found only for the lower limbs in the 6 min walking test (healthy ankle ICC: 0.69; pathological ankle ICC: 0.70). Furthermore, the Bland-Altman plot highlighted large average discrepancies between methods for the pathological group. However, while the step counter was not able to reliably determine steps for slow patients, when applied to the healthy ankle of patients who walked faster than 0.8 m/s, it counted steps with excellent precision, similar to that seen in the healthy subjects (ICCs from 0.36 to 0.99). These findings show that a low-cost accelerometer-based step counter could be useful for measuring mobility in select high-performance patients and could be used in clinical and real-world settings.

Using step counters to promote physical activity and exercise capacity in patients with chronic obstructive pulmonary disease: a meta-analysis.

BACKGROUND: Although step counters are popularly employed for physical rehabilitation in chronic obstructive pulmonary disease (COPD) patients, their effectiveness is inconsistent and even questioned. This meta-analysis aimed to investigate whether step counter use increases physical activity or improves exercise capacity in COPD patients. METHODS: Electronic databases were searched for randomized controlled trials that assessed the efficacy of step counter use in increasing physical activity or in improving exercise capacity. Data were aggregated using a random-effects model to get the overall effect sizes [standard mean difference (SMD) with 95% confidence interval (CI)], and subgroup analyses were performed. RESULTS: A total of 15 trials enrolling 1316 patients with moderate to severe COPD were included. Step counter use increased physical activity compared with controls (SMD = 0.57, 95% CI 0.31-0.84), which is equal to a magnitude of 1026 steps/day in daily steps. It also enhanced exercise capacity with an effect size of 0.30 (95% CI 0.16-0.45), approximating to a magnitude of 11.6 m in the 6-min walking distance. Step counter use could augment physical activity (SMD = 0.64, 95% CI 0.19-1.08) and exercise capacity (SMD = 0.32, 95% CI 0.01-0.62) for patients receiving pulmonary rehabilitation. Yet it cannot enhance physical activity or exercise capacity in patients with severe COPD or among studies with intervention durations ⩾6 months (both p > 0.50). CONCLUSIONS: Step counter use increases physical activity and improves exercise capacity in COPD patients, at least in the short term, which supports the notion of recommending step counter use in COPD management.

Step count accuracy and reliability of two activity tracking devices in people after stroke.

BACKGROUND/PURPOSE: The increasing popularity of activity tracking devices presents an opportunity to monitor physical activity in patients after stroke. We sought to determine the reliability and accuracy of the Garmin Vivofit and Fitbit Zip for adults after stroke. METHODS: Twenty-four participants with stroke-induced hemiparesis wore a Fitbit Zip on the nonparetic hip and Garmin Vivofits on both wrists during a 6-minute walk test to determine the accuracy of the devices against video-determined step counts. Participants also wore the devices during two trials of exactly 50 steps to determine the reliability of the devices. RESULTS: Fitbit Zip showed excellent reliability (ICC2,1 = 0.974) and accuracy (4.2% error) for participants who walked faster than 0.35 m/s. Garmin Vivofit (nonparetic side) had excellent reliability (ICC2,1 = 0.964) but poor accuracy (≤-16.0%) for all participants. Garmin Vivofit (paretic side) had excellent reliability (ICC2,1 = 0.858) and accuracy (-4.0% error) for faster walkers (>0.48 m/s) but poor accuracy (-68.2%) for slower walkers. CONCLUSION: Fitbit Zip was more accurate and reliable for persons with stroke than Garmin Vivofit, but slower walking speeds were associated with greater undercounting of steps for both devices. The Fitbit Zip is appropriate for counting steps in adults poststroke who range from household to community ambulators.

Accuracy of a step counter during treadmill and daily life walking by healthy adults and patients with cardiac disease.

BACKGROUND: Step counters have been used to observe activity and support physical activity, but there is limited evidence on their accuracy. OBJECTIVE: The purpose was to investigate the step accuracy of the Fitbit Zip (Zip) in healthy adults during treadmill walking and in patients with cardiac disease while hospitalised at home. METHODS: Twenty healthy adults aged 39±13.79 (mean ±SD) wore four Zips while walking on a treadmill at different speeds (1.7-6.1 km/hour), and 24 patients with cardiac disease (age 67±10.03) wore a Zip for 24 hours during hospitalisation and for 4 weeks thereafter at home. A Shimmer3 device was used as a criterion standard. RESULTS: At a treadmill speed of 3.6 km/hour, the relative error (±SD) for the Zips on the upper body was -0.02±0.67 on the right side and -0.09 (0.67) on the left side. For the Zips on the waist, this was 0.08±0.71 for the right side and -0.08 (0.47) on the left side. At a treadmill speed of 3.6 km/hour and higher, the average per cent of relative error was <3%. The 24-hour test for the hospitalised patients showed a relative error of -47.15±24.11 (interclass correlation coefficient (ICC): 0.60), and for the 24-hour test at home, the relative error was -27.51±28.78 (ICC: 0.87). Thus, none of the 24-hour tests had less than the expected 20% error. In time periods of evident walking during the 24 h test, the Zip had an average per cent relative error of <3% at 3.6 km/hour and higher speeds. CONCLUSIONS: A speed of 3.6 km/hour or higher is required to expect acceptable accuracy in step measurement using a Zip, on a treadmill and in real life. Inaccuracies are directly related to slow speeds, which might be a problem for patients with cardiac disease who walk at a slow pace.

A comparison of two motion sensors for the assessment of free-living physical activity of adolescents.

This study assessed and compared the daily step counts recorded by two different motion sensors in order to estimate the free-living physical activity of 135 adolescent girls. Each girl concurrently wore a Yamax pedometer and an ActiGraph accelerometer (criterion measure) every day for seven consecutive days. The convergent validity of the pedometer can be considered intermediate when used to measure the step counts in free-living physical activity; but should be considered with caution when used to classify participants' step counts into corresponding physical activity categories because of a likelihood of 'erroneous' classification in comparison with the accelerometer.