Effect of ActiGraph GT3X+ Position and Algorithm Choice on Step Count Accuracy in Older Adults

Accelerometer step count accuracy may be affected by gait speed, device positioning, and analysis algorithm selection. We assessed ActiGraph GT3X+ step count accuracy related to device placement and analysis algorithm in older adults with walking aids (n = 13) and without walking aids (n = 22). Participants (81.5 ± 5.0 years of age) completed a timed 100-m walk wearing five GT3X+ monitors (hips, ankles, lumbar spine). Individuals with walking aids had slower gait speeds (0.8 ± 0.20 m/s versus 1.2 ± 0.20 m/s without walking aids, p < .001). Intraclass correlation coefficient values for observed versus monitored steps were highest when ankle placement and the low frequency extension (LFE) algorithm were used (left ankle ICC = .989, right ankle ICC = .998). Using the GT3X+ ankle placement and analyzing data with the LFE algorithm resulted in the most accurate step counts in older adults.