{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T20:25:41Z","timestamp":1776284741036,"version":"3.50.1"},"reference-count":50,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,25]],"date-time":"2022-12-25T00:00:00Z","timestamp":1671926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004271","name":"Sapienza University of Rome","doi-asserted-by":"publisher","award":["AR120172B97AF626"],"award-info":[{"award-number":["AR120172B97AF626"]}],"id":[{"id":"10.13039\/501100004271","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Commercial smartwatches could be useful for step counting and monitoring ambulatory activity. However, in Parkinson\u2019s disease (PD) patients, an altered gait, pharmacological condition, and symptoms lateralization may affect their accuracy and potential usefulness in research and clinical routine. Steps were counted during a 6 min walk in 47 patients with PD and 47 healthy subjects (HS) wearing a Garmin Vivosmart 4 (GV4) on each wrist. Manual step counting was used as a reference. An inertial sensor (BTS G-Walk), placed on the lower back, was used to compute spatial-temporal gait parameters. Intraclass correlation coefficient (ICC) and mean absolute percentage error (MAPE) were used for accuracy evaluation and the Spearman test was used to assess the correlations between variables. The GV4 overestimated steps in PD patients with only a poor-to-moderate agreement. The OFF pharmacological state and wearing the device on the most-affected body side led to an unacceptable accuracy. The GV4 showed an excellent agreement and MAPE in HS at a self-selected speed, but an unacceptable performance at a slow speed. In PD patients, MAPE was not associated with gait parameters and clinical variables. The accuracy of commercial smartwatches for monitoring step counting might be reduced in PD patients and further influenced by the pharmacological condition and placement of the device.<\/jats:p>","DOI":"10.3390\/s23010214","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T03:03:31Z","timestamp":1672110211000},"page":"214","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Step-Counting Accuracy of a Commercial Smartwatch in Mild-to-Moderate PD Patients and Effect of Spatiotemporal Gait Parameters, Laterality of Symptoms, Pharmacological State, and Clinical Variables"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7955-3369","authenticated-orcid":false,"given":"Edoardo","family":"Bianchini","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8652-2480","authenticated-orcid":false,"given":"Bianca","family":"Cali\u00f2","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marika","family":"Alborghetti","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domiziana","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy"},{"name":"Santa Lucia Foundation, IRCCS, 00179 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4813-3868","authenticated-orcid":false,"given":"Clint","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kiel University, 24105 Kiel, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3773-393X","authenticated-orcid":false,"given":"Nicolas","family":"Vuillerme","sequence":"additional","affiliation":[{"name":"AGEIS, Universit\u00e9 Grenoble Alpes, 38000 Grenoble, France"},{"name":"LabCom Telecom4Health, Orange Labs & Universit\u00e9 Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, 38000 Grenoble, France"},{"name":"Institut Universitaire de France, 75005 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5945-4694","authenticated-orcid":false,"given":"Walter","family":"Maetzler","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kiel University, 24105 Kiel, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco E.","family":"Pontieri","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy"},{"name":"Santa Lucia Foundation, IRCCS, 00179 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/B978-0-444-63916-5.00001-X","article-title":"Sensorimotor Anatomy of Gait, Balance, and Falls","volume":"159","author":"MacKinnon","year":"2018","journal-title":"Handb. Clin. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1001\/jama.2010.1923","article-title":"Gait Speed and Survival in Older Adults","volume":"305","author":"Studenski","year":"2011","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1007\/s40279-016-0663-1","article-title":"Step Counting: A Review of Measurement Considerations and Health-Related Applications","volume":"47","author":"Bassett","year":"2017","journal-title":"Sport. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1001\/jamainternmed.2022.4000","article-title":"Prospective Associations of Daily Step Counts and Intensity With Cancer and Cardiovascular Disease Incidence and Mortality and All-Cause Mortality","volume":"182","author":"Ahmadi","year":"2022","journal-title":"JAMA Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.1038\/s41591-022-02012-w","article-title":"Association of Step Counts over Time with the Risk of Chronic Disease in the All of Us Research Program","volume":"28","author":"Master","year":"2022","journal-title":"Nat. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e2124516","DOI":"10.1001\/jamanetworkopen.2021.24516","article-title":"Steps per Day and All-Cause Mortality in Middle-Aged Adults in the Coronary Artery Risk Development in Young Adults Study","volume":"4","author":"Paluch","year":"2021","journal-title":"AMA Netw. Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e219","DOI":"10.1016\/S2468-2667(21)00302-9","article-title":"Daily Steps and All-Cause Mortality: A Meta-Analysis of 15 International Cohorts","volume":"7","author":"Paluch","year":"2022","journal-title":"Lancet Public Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1001\/jamaneurol.2022.2672","article-title":"Association of Daily Step Count and Intensity With Incident Dementia in 78 430 Adults Living in the UK","volume":"79","author":"Ahmadi","year":"2022","journal-title":"JAMA Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.maturitas.2018.03.016","article-title":"The Validity and Reliability of Consumer-Grade Activity Trackers in Older, Community-Dwelling Adults: A Systematic Review","volume":"112","author":"Straiton","year":"2018","journal-title":"Maturitas"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e10972","DOI":"10.2196\/10972","article-title":"The Accuracy of Smart Devices for Measuring Physical Activity in Daily Life: Validation Study","volume":"6","author":"Degroote","year":"2018","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1001\/jama.2019.22360","article-title":"Diagnosis and Treatment of Parkinson Disease: A Review","volume":"323","author":"Armstrong","year":"2020","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1002\/mds.27195","article-title":"Falls in Parkinson\u2019s Disease: A Complex and Evolving Picture","volume":"32","author":"Fasano","year":"2017","journal-title":"Mov. Disord."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1038\/nrn.2017.62","article-title":"Non-Motor Features of Parkinson Disease","volume":"18","author":"Schapira","year":"2017","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1038\/nrneurol.2017.27","article-title":"Cognitive Decline in Parkinson Disease","volume":"13","author":"Aarsland","year":"2017","journal-title":"Nat. Rev. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1002\/mds.21720","article-title":"The Role of Executive Function and Attention in Gait","volume":"23","author":"Hausdorff","year":"2008","journal-title":"Mov. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/S1474-4422(19)30044-4","article-title":"Gait Impairments in Parkinson\u2019s Disease","volume":"18","author":"Mirelman","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Welzel, J., Wendtland, D., Warmerdam, E., Romijnders, R., Elshehabi, M., Geritz, J., Berg, D., Hansen, C., and Maetzler, W. (2021). Step Length Is a Promising Progression Marker in Parkinson\u2019s Disease. Sensors, 21.","DOI":"10.3390\/s21072292"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"577435","DOI":"10.3389\/fnagi.2020.577435","article-title":"Gait Progression Over 6 Years in Parkinson\u2019s Disease: Effects of Age, Medication, and Pathology","volume":"12","author":"Wilson","year":"2020","journal-title":"Front. Aging Neurosci."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Varghese, J., van Alen, C.M., Fujarski, M., Schlake, G.S., Sucker, J., Warnecke, T., and Thomas, C. (2021). Sensor Validation and Diagnostic Potential of Smartwatches in Movement Disorders. Sensors, 21.","DOI":"10.20944\/preprints202103.0542.v1"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1682\/JRRD.2008.01.0002","article-title":"Daily Ambulatory Activity Levels in Idiopathic Parkinson Disease","volume":"45","author":"Skidmore","year":"2008","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/NPT.0000000000000169","article-title":"Factors Associated With Ambulatory Activity in De Novo Parkinson Disease","volume":"41","author":"Christiansen","year":"2017","journal-title":"J. Neurol. Phys."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1097\/NPT.0b013e318254ba7a","article-title":"Capturing Ambulatory Activity Decline in Parkinson\u2019s Disease","volume":"36","author":"Cavanaugh","year":"2012","journal-title":"J. Neurol. Phys."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"pzab174","DOI":"10.1093\/ptj\/pzab174","article-title":"Physical Activity in De Novo Parkinson Disease: Daily Step Recommendation and Effects of Treadmill Exercise on Physical Activity","volume":"101","author":"Handlery","year":"2021","journal-title":"Phys. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e14059","DOI":"10.2196\/14059","article-title":"Accuracy and Precision of Three Consumer-Grade Motion Sensors During Overground and Treadmill Walking in People With Parkinson Disease: Cross-Sectional Comparative Study","volume":"7","author":"Lai","year":"2020","journal-title":"JMIR Rehabil. Assist. Technol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.gaitpost.2018.04.034","article-title":"Accuracy of Wearable Physical Activity Trackers in People with Parkinson\u2019s Disease","volume":"63","author":"Lamont","year":"2018","journal-title":"Gait Posture"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1093\/ptj\/pzy054","article-title":"Accuracy of Activity Trackers in Parkinson Disease: Should We Prescribe Them?","volume":"98","author":"Wendel","year":"2018","journal-title":"Phys. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1249\/MSS.0000000000001146","article-title":"Reliability and Validity of Ten Consumer Activity Trackers Depend on Walking Speed","volume":"49","author":"Fokkema","year":"2017","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e9381","DOI":"10.7717\/peerj.9381","article-title":"The Validity of Activity Trackers Is Affected by Walking Speed: The Criterion Validity of Garmin Vivosmart\u00ae HR and StepWatchTM 3 for Measuring Steps at Various Walking Speeds under Controlled Conditions","volume":"8","author":"Svarre","year":"2020","journal-title":"PeerJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.gaitpost.2017.06.012","article-title":"Accuracy of Step Count Measured by Physical Activity Monitors: The Effect of Gait Speed and Anatomical Placement Site","volume":"57","author":"Chow","year":"2017","journal-title":"Gait Posture"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1002\/mdc3.12850","article-title":"A Comparison of Activity Monitor Data from Devices Worn on the Wrist and the Waist in People with Parkinson\u2019s Disease","volume":"6","author":"Kim","year":"2019","journal-title":"Mov. Disord. Clin. Pract."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS Clinical Diagnostic Criteria for Parkinson\u2019s Disease","volume":"30","author":"Postuma","year":"2015","journal-title":"Mov. Disord."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1212\/WNL.17.5.427","article-title":"Parkinsonism: Onset, Progression and Mortality","volume":"17","author":"Hoehn","year":"1967","journal-title":"Neurology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement Disorder Society-Sponsored Revision of the Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS): Scale Presentation and Clinimetric Testing Results","volume":"23","author":"Goetz","year":"2008","journal-title":"Mov. Disord."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/BF02260863","article-title":"The Development and Validation of a Short Measure of Functioning and Well Being for Individuals with Parkinson\u2019s Disease","volume":"4","author":"Peto","year":"1995","journal-title":"Qual. Life Res."},{"key":"ref_35","first-page":"6","article-title":"The Functional Independence Measure: A New Tool for Rehabilitation","volume":"1","author":"Keith","year":"1987","journal-title":"Adv. Clin. Rehabil."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1037\/h0054651","article-title":"Studies of Interference in Serial Verbal Reactions","volume":"18","author":"Stroop","year":"1935","journal-title":"J. Exp. Psychol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e8835","DOI":"10.7717\/peerj.8835","article-title":"Agreement between the GAITRite\u00ae System and the Wearable Sensor BTS G-Walk\u00ae for Measurement of Gait Parameters in Healthy Adults and Parkinson\u2019s Disease Patients","volume":"8","year":"2020","journal-title":"PeerJ"},{"key":"ref_38","unstructured":"(2022, October 19). CTA 2056-2016 (ANSI)\u2014Physical Activity Monitoring for Fitness Wearables: Step Counting. Available online: https:\/\/webstore.ansi.org\/Standards\/ANSI\/cta20562016ansi."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1123\/jmpb.2019-0035","article-title":"Review of Validity and Reliability of Garmin Activity Trackers","volume":"3","author":"Evenson","year":"2020","journal-title":"J. Meas Phys. Behav."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research","volume":"15","author":"Tk","year":"2016","journal-title":"J. Chiropr. Med. J. Chiropr. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1016\/j.medengphy.2016.09.023","article-title":"Beyond the Front End: Investigating a Thigh Worn Accelerometer Device for Step Count and Bout Detection in Parkinson\u2019s Disease","volume":"38","author":"Godfrey","year":"2016","journal-title":"Med. Eng. Phys."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jns.2018.08.001","article-title":"Motor Asymmetry over Time in Parkinson\u2019s Disease","volume":"393","author":"Buesa","year":"2018","journal-title":"J. Neurol. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.parkreldis.2021.06.009","article-title":"Accuracy and Precision of Wrist-Worn Actigraphy for Measuring Steps Taken during over-Ground and Treadmill Walking in Adults with Parkinson\u2019s Disease","volume":"88","author":"Cederberg","year":"2021","journal-title":"Park. Relat. Disord."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1942","DOI":"10.1249\/MSS.0000000000000984","article-title":"Accuracy of Wristband Activity Monitors during Ambulation and Activities","volume":"48","author":"Chen","year":"2016","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"S90","DOI":"10.1016\/S1353-8020(11)70029-3","article-title":"Epidemiology, Diagnosis and Differential Diagnosis in Parkinson\u2019s Disease Tremor","volume":"18","author":"Baumann","year":"2012","journal-title":"Park. Relat. Disord."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1038\/s41531-021-00235-1","article-title":"Arm Swing Responsiveness to Dopaminergic Medication in Parkinson\u2019s Disease Depends on Task Complexity","volume":"7","author":"Warmerdam","year":"2021","journal-title":"NPJ Park. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"17013","DOI":"10.1038\/nrdp.2017.13","article-title":"Parkinson Disease","volume":"3","author":"Poewe","year":"2017","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.parkreldis.2019.06.014","article-title":"Cognitive Associations with Comprehensive Gait and Static Balance Measures in Parkinson\u2019s Disease","volume":"69","author":"Morris","year":"2019","journal-title":"Park. Relat. Disord."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"852725","DOI":"10.3389\/fneur.2022.852725","article-title":"Does Executive Function Influence Walking in Acutely Hospitalized Patients With Advanced Parkinson\u2019s Disease: A Quantitative Analysis","volume":"13","author":"Geritz","year":"2022","journal-title":"Front. Neurol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s11556-019-0214-5","article-title":"Is Every-Day Walking in Older Adults More Analogous to Dual-Task Walking or to Usual Walking? Elucidating the Gaps between Gait Performance in the Lab and during 24\/7 Monitoring","volume":"16","author":"Hillel","year":"2019","journal-title":"Eur. Rev. Aging Phys. Act."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/1\/214\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:50:53Z","timestamp":1760147453000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/1\/214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,25]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["s23010214"],"URL":"https:\/\/doi.org\/10.3390\/s23010214","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,25]]}}}