Send to

Choose Destination
Mult Scler J Exp Transl Clin. 2019 Nov 21;5(4):2055217319888660. doi: 10.1177/2055217319888660. eCollection 2019 Oct-Dec.

Validation of a consumer-grade activity monitor for continuous daily activity monitoring in individuals with multiple sclerosis.

Author information

Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, USA.
Department of Epidemiology and Biostatistics, University of California San Francisco, USA.
Department of Medicine, University of California San Francisco, USA.
Weill Institute for Neurosciences, University of California San Francisco, USA.



Technological advancements of remote-monitoring used in clinical-care and research require validation of model updates.


To compare the output of a newer consumer-grade accelerometer to a previous model in people with multiple sclerosis (MS) and to the ActiGraph, a waist-worn device widely used in MS research.


Thirty-one individuals with MS participated in a 7-day validation by the Fitbit Flex (Flex), Fitbit Flex-2 (Flex2) and ActiGraph GT3X. Primary outcome was step count. Valid epochs of 5-min block increments, where there was overlap of ≥1 step/min for both devices were compared and summed to give a daily total for analysis.


Bland-Altman plots showed no systematic difference between the Flex and Flex2; mean step-count difference of 25 more steps-per-day more recorded by Flex2 (95% confidence intervals (CI) = 2, 48; p = 0.04),interclass correlation coefficient (ICC) = 1.00. Compared to the ActiGraph, Flex2 (and Flex) tended to record more steps (808 steps-per-day more than the ActiGraph (95% CI= -2380, 765; p < 0.01), although the ICC was high (0.98) indicating that the devices were likely measuring the same kind of activity.


Steps from Flex and Flex2 can be used interchangeably. Differences in total step count between ActiGraph and Flex devices can make cross-device comparisons of numerical step-counts challenging particularly for faster walkers.


Physical activity; accelerometry; motor activity; multiple sclerosis; validation studies as topic (mesh heading)

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center