Subscribe to RSS
DOI: 10.1055/s-0041-1740236
Measurement Performance of Activity Measurements with Newer Generation of Apple Watch in Wheelchair Users with Spinal Cord Injury
Funding This work was funded by the German Federal Ministry of Education and Research (BMBF) in the context of the ParaReg project (grant number 01GY1904) and the G-BA (Gemeinsamer Bundesausschuss) in the context of the NeuroMoves project (grant number 01VSF18032).Abstract
Background The level of physical activity (PA) of people with spinal cord injury (SCI) has an impact on long-term complications. Currently, PA is mostly assessed by interviews. Wearable activity trackers are promising tools to objectively measure PA under everyday conditions. The only off-the-shelf, wearable activity tracker with specific measures for wheelchair users is the Apple Watch.
Objectives This study analyzes the measurement performance of Apple Watch Series 4 for wheelchair users and compares it with an earlier generation of the device.
Methods Fifteen participants with subacute SCI during their first in-patient phase followed a test course using their wheelchair. The number of wheelchair pushes was counted manually by visual inspection and with the Apple Watch. Difference between the Apple Watch and the rater was analyzed with mean absolute percent error (MAPE) and a Bland–Altman plot. To compare the measurement error of Series 4 and an older generation of the device a t-test was calculated using data for Series 1 from a former study.
Results The average of differences was 12.33 pushes (n = 15), whereas participants pushed the wheelchair 138.4 times on average (range 86–271 pushes). The range of difference and the Bland–Altman plot indicate an overestimation by Apple Watch. MAPE is 9.20% and the t-test, testing for an effect of Series 4 on the percentage of error compared with Series 1, was significant with p < 0.05.
Conclusion Series 4 shows a significant improvement in measurement performance compared with Series 1. Series 4 can be considered as a promising data source to capture the number of wheelchair pushes on even grounds. Future research should analyze the long-term measurement performance during everyday conditions of Series 4.
Notes
All patients gave permission according to the European General Data Protection Regulation for publication of their data in pseudonymized form. The data set supporting the conclusions of this article is available in the heiData repository of Heidelberg University: https://doi.org/10.11588/data/P1HEGO.
Publication History
Received: 14 July 2021
Accepted: 12 September 2021
Article published online:
02 December 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Burn D. Oxford Textbook of Movement Disorders. Oxford, UK: Oxford University Press; 2013
- 2 Martin Ginis KA, Ma JK, Latimer-Cheung AE, Rimmer JH. A systematic review of review articles addressing factors related to physical activity participation among children and adults with physical disabilities. Health Psychol Rev 2016; 10 (04) 478-494
- 3 Martin Ginis KA, van der Scheer JW, Latimer-Cheung AE. et al. Evidence-based scientific exercise guidelines for adults with spinal cord injury: an update and a new guideline. Spinal Cord 2018; 56 (04) 308-321
- 4 Rimaud D, Calmels P, Devillard X. Training programs in spinal cord injury [in French]. Ann Readapt Med Phys 2005; 48 (05) 259-269
- 5 Van Straaten MG, Cloud BA, Morrow MM, Ludewig PM, Zhao KD. Effectiveness of home exercise on pain, function, and strength of manual wheelchair users with spinal cord injury: a high-dose shoulder program with telerehabilitation. Arch Phys Med Rehabil 2014; 95 (10) 1810-1817.e2
- 6 Tweedy SM, Beckman EM, Geraghty TJ. et al. Exercise and sports science Australia (ESSA) position statement on exercise and spinal cord injury. J Sci Med Sport 2017; 20 (02) 108-115
- 7 Crespo-Ruiz B, del-Ama AJ, Jiménez-Díaz FJ, Morgan J, de la Peña-González A, Gil-Agudo ÁM. Physical activity and transcutaneous oxygen pressure in men with spinal cord injury. J Rehabil Res Dev 2012; 49 (06) 913-924
- 8 Soo Hoo J. Shoulder pain and the weight-bearing shoulder in the wheelchair athlete. Sports Med Arthrosc Rev 2019; 27 (02) 42-47
- 9 Shin G, Jarrahi MH, Fei Y. et al. Wearable activity trackers, accuracy, adoption, acceptance and health impact: a systematic literature review. J Biomed Inform 2019; 93 (October 2018): 103153
- 10 Apple Inc. Apple Watch Series 4: Beautifully redesigned with breakthrough communication, fitness and health capabilities. 2018. Accessed December 19, 2020 at: https://www.apple.com/newsroom/2018/09/redesigned-apple-watch-series-4-revolutionizes-communication-fitness-and-health/
- 11 Apple Inc. Apple Watch Series 4 - Technical Specifications. 2021. Accessed May 26, 2021 at: https://support.apple.com/kb/SP778
- 12 Karinharju KS, Boughey AM, Tweedy SM, Clanchy KM, Trost SG, Gomersall SR. Validity of the Apple Watch ® for monitoring push counts in people using manual wheelchairs. J Spinal Cord Med 2021; 44 (02) 212-220
- 13 Glasheen E, Domingo A, Kressler J. Accuracy of Apple Watch fitness tracker for wheelchair use varies according to movement frequency and task. Ann Phys Rehabil Med 2021; 64 (01) 101382
- 14 Kottner J, Audigé L, Brorson S. et al. Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were proposed. J Clin Epidemiol 2011; 64 (01) 96-106
- 15 Rupp R, Biering-Sørensen F, Burns SP. et al. International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019. Top Spinal Cord Inj Rehabil 2021; 27 (02) 1-22
- 16 Apple Inc. Get the most accurate measurements using your Apple Watch. 2019. Accessed March 4, 2020 at: https://support.apple.com/de-de/HT207941
- 17 Benning N-H, Knaup P, Rupp R. Comparison of accuracy of activity measurements with wearable activity trackers in wheelchair users: a preliminary evaluation. GMS Med Inf Biom Epidemiol 2020; 16 (02) Doc05
- 18 Latimer AE, Ginis KAM, Craven BC, Hicks AL. The physical activity recall assessment for people with spinal cord injury: validity. Med Sci Sports Exerc 2006; 38 (02) 208-216
- 19 Martin Ginis KA, Úbeda-Colomer J, Alrashidi AA. et al. Construct validation of the Leisure Time Physical Activity Questionnaire for People with SCI (LTPAQ-SCI). Spinal Cord 2021; 59 (03) 311-318
- 20 Ginis KAM, Latimer AE, Hicks AL, Craven BC. Development and evaluation of an activity measure for people with spinal cord injury. Med Sci Sports Exerc 2005; 37 (07) 1099-1111
- 21 Ma JK, McCracken LA, Voss C, Chan FHN, West CR, Martin Ginis KA. Physical activity measurement in people with spinal cord injury: comparison of accelerometry and self-report (the Physical Activity Recall Assessment for People with Spinal Cord Injury). Disabil Rehabil 2020; 42 (02) 240-246
- 22 Hossain MS, Islam MS, Rahman MA. et al. Health status, quality of life and socioeconomic situation of people with spinal cord injuries six years after discharge from a hospital in Bangladesh. Spinal Cord 2019; 57 (08) 652-661
- 23 Lui J, MacGillivray MK, Sawatzky BJ. Test-retest reliability and minimal detectable change of the SmartWheel clinical protocol. Arch Phys Med Rehabil 2012; 93 (12) 2367-2372
- 24 Marco-Ahulló A, Montesinos-Magraner L, Gonzalez L-M, Llorens R, Segura-Navarro X, García-Massó X. Validation of using smartphone built-in accelerometers to estimate the active energy expenditures of full-time manual wheelchair users with spinal cord injury. Sensors (Basel) 2021; 21 (04) 1498
- 25 Papadatou-Pastou M, Ntolka E, Schmitz J. et al. Human handedness: a meta-analysis. Psychol Bull 2020; 146 (06) 481-524
- 26 Sugden JA, Sniehotta FF, Donnan PT, Boyle P, Johnston DW, McMurdo MET. The feasibility of using pedometers and brief advice to increase activity in sedentary older women–a pilot study. BMC Health Serv Res 2008; 8: 169
- 27 Feehan LM, Geldman J, Sayre EC. et al. Accuracy of Fitbit devices: systematic review and narrative syntheses of quantitative data. JMIR Mhealth Uhealth 2018; 6 (08) e10527
- 28 Apple Inc. Calibrating your Apple Watch for improved Workout and Activity accuracy. 2019. Accessed March 4, 2021 at: https://support.apple.com/en-us/HT204516
- 29 Deutschsprachige Medizinische Gesellschaft für Paraplegiologie e. V. ParaReg. 2021. Accessed May 29, 2021 at: https://www.dmgp.de/die-dmgp/parareg