Abstract
Background Mainstream wearable technology has potential to measure walking in real-world settings in children with cerebral palsy. It can determine the pattern of physical activity and give insight into the trajectory of change following treatments, where the goal is to improve functional mobility. The primary objective of this study was to determine the feasibility and accuracy of using Fitbit Alta activity monitors in children with cerebral palsy.
Methods Patient and Public Involvement activities with children with cerebral palsy and their parents explored the acceptability of using a fitness tracker for 3-6 weeks within a proposed research study to investigate change in physical data following an intervention. The wrist-based Fitbit monitor was preferred over the research-grade accelerometer. Fifteen children with ambulatory cerebral palsy wore Fitbit on their wrist during the 6-Minute Walk test (6-MWT). GMFCS level II= 10 and III= 5. Age range 4y 9m to 10y 10m. All children were asked about their experience of wearing Fitbit.
Results Children aged seven years and above were enthusiastic about wearing Fitbit over longer durations. Younger children (under 7yrs) were less keen or did not tolerate it. In children with GMFCS level III, who walked using a posterior walker with short step length, the step count on Fitbit was less than the distance walked. Fitbit was more reliable in capturing step counts in children with mild difficulties in walking. However, compared to the distance walked in the 6-MWT, the Fitbit step count appeared to be an underestimation. Furthermore, due to technical issues, in 4 children, the step count was not recorded.
Conclusion The use of Fitbit in children with ambulatory cerebral palsy did not seem feasible in children who use walking aids, especially in younger children. Further longitudinal exploration in children with cerebral palsy who can walk without using walking aids is indicated.
Acknowledgements for funding or support This project was carried out as part of the NIHR Pre-doctoral Clinical Academic Fellowship, funded by the HEE/NIHR Integrated Clinical and Practitioner Academic programme.
