Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0172535
Title: Comparison of wrist-worn Fitbit Flex and waist-worn ActiGraph for measuring steps in free-living adults
Authors: Chu A.H.Y. 
Ng S.H.X. 
Paknezhad M.
Gauterin A. 
Koh D. 
Brown M.S. 
Müller-Riemenschneider F. 
Keywords: adult
confidence interval
controlled study
female
gender
health promotion
human
kappa statistics
major clinical study
male
physical activity
practice guideline
wrist
accelerometry
actimetry
aged
ambulatory monitoring
comparative study
devices
energy metabolism
middle aged
physiology
running
standards
walking
wrist
Accelerometry
Actigraphy
Adult
Aged
Energy Metabolism
Female
Humans
Male
Middle Aged
Monitoring, Ambulatory
Running
Walking
Wrist
Issue Date: 2017
Publisher: Public Library of Science
Citation: Chu A.H.Y., Ng S.H.X., Paknezhad M., Gauterin A., Koh D., Brown M.S., Müller-Riemenschneider F. (2017). Comparison of wrist-worn Fitbit Flex and waist-worn ActiGraph for measuring steps in free-living adults. PLoS ONE 12 (2) : e0172535. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0172535
Abstract: Introduction: Accelerometers are commonly used to assess physical activity. Consumer activity trackers have become increasingly popular today, such as the Fitbit. This study aimed to compare the average number of steps per day using the wrist-worn Fitbit Flex and waist-worn Acti- Graph (wGT3X-BT) in free-living conditions. Methods: 104 adult participants (n = 35 males; n = 69 females) were asked to wear a Fitbit Flex and an ActiGraph concurrently for 7 days. Daily step counts were used to classify inactive (<10,000 steps) and active (?10,000 steps) days, which is one of the commonly used physical activity guidelines to maintain health. Proportion of agreement between physical activity categorizations from ActiGraph and Fitbit Flex was assessed. Statistical analyses included Spearman's rho, intraclass correlation (ICC), median absolute percentage error (MAPE), Kappa statistics, and Bland-Altman plots. Analyses were performed among all participants, by each step-defined daily physical activity category and gender. Results: The median average steps/day recorded by Fitbit Flex and ActiGraph were 10193 and 8812, respectively. Strong positive correlations and agreement were found for all participants, both genders, as well as daily physical activity categories (Spearman's rho: 0.76-0.91; ICC: 0.73-0.87). The MAPE was: 15.5% (95% confidence interval [CI]: 5.8-28.1%) for overall steps, 16.9% (6.8-30.3%) vs. 15.1% (4.5-27.3%) in males and females, and 20.4% (8.7-35.9%) vs. 9.6% (1.0-18.4%) during inactive days and active days. Bland-Altman plot indicated a median overestimation of 1300 steps/day by the Fitbit Flex in all participants. Fitbit Flex and ActiGraph respectively classified 51.5% and 37.5% of the days as active (Kappa: 0.66). Conclusions: There were high correlations and agreement in steps between Fitbit Flex and ActiGraph. However, findings suggested discrepancies in steps between devices. This imposed a challenge that needs to be considered when using Fibit Flex in research and health promotion programs. © 2017 Chu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/166019
ISSN: 19326203
DOI: 10.1371/journal.pone.0172535
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