Digital assessment of real-world walking in people with impaired mobility: How many hours and days are needed?

Impaired mobility increases falls and mortality risk. However, guidelines to reliably assess real-world walking activity and gait remain undefined. We aimed to (i) determine the minimum daily wear time during waking hours (7:00–22:00) for a valid measurement day, (ii) identify the minimum number of valid days, and (iii) weekend days, to reliably assess weekly walking activity and gait parameters, and (iv) provide recommendations for reliable real-world walking assessments. Participants with chronic obstructive pulmonary disease (n = 565), multiple sclerosis (n = 558), Parkinson’s disease (n = 543) or proximal femoral fracture (n = 487) from 10 countries were asked to wear a single wearable device on the lower back, 24 h/day for seven days, resulting in 13,191 measurement days. The Mobilise-D processing pipeline was used to obtain 24 daily walking activity and gait parameters. Minimum daily wear time was determined as the highest wear time category that did not statistically change parameter values. Intraclass correlation coefficients ≥ 0.80 determined the minimum number of valid measurement and weekend days. The minimum daily wear time varied between “no requirement” (13% of parameter-condition combinations) and > 14 h (19%), with higher requirements for walking activity than gait parameters. The minimum number of days ranged from 1 (17%) to > 7 days (6%), and was higher for parameters that are yet to be clinically validated. There was no evidence of a weekend nor health condition effect on parameter reliability. For studies involving multiple walking activity and gait parameters or health conditions, expert consensus recommends a minimum of > 12 h of daily wear time across ≥ 3 days. For studies that involve specific parameters or health conditions, individual recommendations are provided within the manuscript.

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Publication Details

Journal
International Journal of Behavioral Nutrition and Physical Activity
Published
2025-11-21
DOI
https://doi.org/10.1186/s12966-025-01851-3
Citations
7
Primary Topic
Balance, Gait, and Falls Prevention
Type
article
Field-Weighted Citation Impact
33.32
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article

Digital assessment of real-world walking in people with impaired mobility: How many hours and days are needed?

Basil Sharrack, Michael Long, Julia Chernova, Jeffrey M. Hausdorff et al.
7 citations
International Journal of Behavioral Nutrition and Physical Activity
Balance, Gait, and Falls Prevention
33.32
article

Digital assessment of real-world walking in people with impaired mobility: How many hours and days are needed?

Basil Sharrack, Michael Long, Julia Chernova, Jeffrey M. Hausdorff, Thierry Troosters, Gavin Brittain, Joren Buekers, Judith García‐Aymerich, Anja Frei, Brian Caulfield, Silvia Del Din, Anisoara Paraschiv-Ionescu, Ellen Buckley, Lynn Rochester, Eran Gazit, Sarah Koch, Jochen Klenk, Clemens Becker, Tecla Bonci, Heleen Demeyer, Carl-Philipp Jansen, Alison Jane Yarnall, Jorge Lemos, David Singleton, Jose M. Marchena, Julia Braun
article en
7 citations

Abstract

Impaired mobility increases falls and mortality risk. However, guidelines to reliably assess real-world walking activity and gait remain undefined. We aimed to (i) determine the minimum daily wear time during waking hours (7:00–22:00) for a valid measurement day, (ii) identify the minimum number of valid days, and (iii) weekend days, to reliably assess weekly walking activity and gait parameters, and (iv) provide recommendations for reliable real-world walking assessments. Participants with chronic obstructive pulmonary disease (n = 565), multiple sclerosis (n = 558), Parkinson’s disease (n = 543) or proximal femoral fracture (n = 487) from 10 countries were asked to wear a single wearable device on the lower back, 24 h/day for seven days, resulting in 13,191 measurement days. The Mobilise-D processing pipeline was used to obtain 24 daily walking activity and gait parameters. Minimum daily wear time was determined as the highest wear time category that did not statistically change parameter values. Intraclass correlation coefficients ≥ 0.80 determined the minimum number of valid measurement and weekend days. The minimum daily wear time varied between “no requirement” (13% of parameter-condition combinations) and > 14 h (19%), with higher requirements for walking activity than gait parameters. The minimum number of days ranged from 1 (17%) to > 7 days (6%), and was higher for parameters that are yet to be clinically validated. There was no evidence of a weekend nor health condition effect on parameter reliability. For studies involving multiple walking activity and gait parameters or health conditions, expert consensus recommends a minimum of > 12 h of daily wear time across ≥ 3 days. For studies that involve specific parameters or health conditions, individual recommendations are provided within the manuscript.

International Journal of Behavioral Nutrition and Physical ActivityVol. 22(1)
University College Dublin (IE), Rush University Medical Center (US), Tel Aviv University (IL), Universitat Pompeu Fabra (ES), University of Basel (CH), Universität Ulm (DE), Heidelberg University (DE), Tel Aviv Sourasky Medical Center (IL), Universitair Ziekenhuis Leuven (BE), Ghent University Hospital (BE), Newcastle upon Tyne Hospitals NHS Foundation Trust (GB), Prevention Institute (US), Robert Bosch Stiftung (DE), University Hospital Heidelberg (DE), Zimmer Biomet (Germany) (DE), Sheffield Teaching Hospitals NHS Foundation Trust (GB), NIHR Newcastle Biomedical Research Centre (GB), Insigneo (GB), Barcelona Institute for Global Health (ES), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES), Bayer (United Kingdom) (GB), École Polytechnique Fédérale de Lausanne (CH), Newcastle University (GB), University of Sheffield (GB)
Openalex Percentile: Top 0%
Balance, Gait, and Falls Prevention
33.32
DOIOpen Access PDFOpenAlex
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