The Effect of Assistive Devices on the Accuracy of Fitbits in Healthy Individuals: A Brief Report

Our study explored the accuracy of Fitbit recorded step count during the use of an assistive device (two-wheeled walker and standard cane) at various body positions (wrists, hips, and ankles). Participants (<i>n</i> = 11) ambulated an obstacle course (50 m total, including turns and a step up/down) a total of three times (two-wheeled walker, standard cane, and a deviceless control trial). Fitbit generated step counts (at the wrists, hips, and ankles) were then compared to the individual's "actual" step count captured through video analysis. During the cane trial and the deviceless trial, all positions were significantly correlated (r = 0.764 to 0.984; <i>p</i> < 0.006) with the actual step count. However, increased variability (demonstrated by increased limits of agreement) was observed when the Fitbit was worn on the wrist (compared to the hips or ankles). During the walker trial, the step count was significantly correlated to the actual step count at the ankle and hip positions (r = 0.669 to 0.888; <i>p</i> < 0.017) with an average error of 1.5%, while it was not statistically correlated at the wrist with a 31.2% average error. Our study suggests that Fitbits are a good predictor of actual step count, with the caveat that the location of the Fitbit should be considered if an assistive device (e.g., two-wheeled rolling walker and single-point cane) is being used.