{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:52:37Z","timestamp":1782456757356,"version":"3.54.5"},"reference-count":13,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T00:00:00Z","timestamp":1752278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>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 (n = 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\u2019s \u201cactual\u201d 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; p &lt; 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; p &lt; 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.<\/jats:p>","DOI":"10.3390\/ijerph22071100","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T07:54:23Z","timestamp":1752479663000},"page":"1100","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Effect of Assistive Devices on the Accuracy of Fitbits in Healthy Individuals: A Brief Report"],"prefix":"10.3390","volume":"22","author":[{"given":"John","family":"Jaworski","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Daemen University, Amherst, NY 14226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Makowski","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Daemen University, Amherst, NY 14226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Weaver","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Daemen University, Amherst, NY 14226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Seils","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Science, University at Buffalo, Buffalo, NY 14214, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2835-1470","authenticated-orcid":false,"given":"Jennifer L.","family":"Scheid","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Daemen University, Amherst, NY 14226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e18694","DOI":"10.2196\/18694","article-title":"Reliability and Validity of Commercially Available Wearable Devices for Measuring Steps, Energy Expenditure, and Heart Rate: Systematic Review","volume":"8","author":"Fuller","year":"2020","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref_2","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_3","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1186\/s12966-015-0314-1","article-title":"Systematic Review of the Validity and Reliability of Consumer-Wearable Activity Trackers","volume":"12","author":"Evenson","year":"2015","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"igz008","DOI":"10.1093\/geroni\/igz008","article-title":"Smartwatches Can Detect Walker and Cane Use in Older Adults","volume":"3","author":"Antos","year":"2019","journal-title":"Innov. Aging"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1177\/1460458217720399","article-title":"Fitness Band Accuracy in Older Community Dwelling Adults","volume":"25","author":"Madigan","year":"2019","journal-title":"Health Inform. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"830","DOI":"10.2340\/16501977-1993","article-title":"Capturing Step Counts at Slow Walking Speeds in Older Adults: Comparison of Ankle and Waist Placement of Measuring Device","volume":"47","author":"Simpson","year":"2015","journal-title":"J. Rehabil. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1177\/02692155211035293","article-title":"A Study of the Accuracy of the Fitbit Zip in Measuring Steps Both Indoors and Outdoors in a Mixed Rehabilitation Population","volume":"36","author":"Farmer","year":"2022","journal-title":"Clin. Rehabil."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Holubov\u00e1, A., Mal\u00e1, E., Hoidekrov\u00e1, K., P\u011btiok\u00fd, J., \u010euri\u0161, A., and Mu\u017e\u00edk, J. (2022). The Accuracy of Commercially Available Fitness Trackers in Patients after Stroke. Sensors, 22.","DOI":"10.3390\/s22197392"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e8","DOI":"10.2196\/rehab.7317","article-title":"Activity Recognition in Individuals Walking With Assistive Devices: The Benefits of Device-Specific Models","volume":"4","author":"Lonini","year":"2017","journal-title":"JMIR Rehabil. Assist. Technol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"100888","DOI":"10.1016\/j.dhjo.2020.100888","article-title":"Physical Activity Types among US Adults with Mobility Disability, Behavioral Risk Factor Surveillance System, 2017","volume":"13","author":"Hollis","year":"2020","journal-title":"Disabil. Health J."},{"key":"ref_11","unstructured":"World Health Organization (2025, May 22). Almost One Billion Children and Adults with Disabilities and Older Persons in Need of Assistive Technology Denied Access, According to New Report. Available online: https:\/\/www.who.int\/news\/item\/16-05-2022-almost-one-billion-children-and-adults-with-disabilities-and-older-persons-in-need-of-assistive-technology-denied-access--according-to-new-report."},{"key":"ref_12","first-page":"1","article-title":"Evaluation of the Effect of Gait Aids, Such as Canes, Crutches, and Walkers, on the Accuracy of Step Counters in Healthy Individuals","volume":"13","author":"Kooner","year":"2021","journal-title":"Orthop. Res. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1111\/dmcn.14207","article-title":"Measuring Ambulation with Wrist-based and Hip-based Activity Trackers for Children with Cerebral Palsy","volume":"61","author":"Sala","year":"2019","journal-title":"Dev. Med. Child. 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