TY  - JOUR
AU  - Suzuki, Takuya
AU  - Kono, Yuji
AU  - Ogasawara, Takayuki
AU  - Mukaino, Masahiko
AU  - Aoshima, Yasushi
AU  - Furuzawa, Shotaro
AU  - Fujita, Yurie
AU  - Matsuura, Hirotaka
AU  - Yamaguchi, Masumi
AU  - Tsukada, Shingo
AU  - Otaka, Yohei
PY  - 2025
DA  - 2025/4/8
TI  - Moving Standard Deviation of Trunk Acceleration as a Quantification Index for Physical Activities: Validation Study
JO  - JMIR Form Res
SP  - e63064
VL  - 9
KW  - smart clothing
KW  - step count
KW  - moving standard deviation of acceleration
KW  - MSDA
KW  - wheelchair
KW  - activity quantification
KW  - physical activities
KW  - validation study
KW  - accelerometer
KW  - regular gait patterns
KW  - older people
KW  - aging
KW  - motor impairments
KW  - step detection
KW  - stroke
KW  - hemiparesis
KW  - measurement system
KW  - walking
KW  - mobility
KW  - rehabilitation
AB  - Background: Step count is used to quantify activity in individuals using accelerometers. However, challenges such as difficulty in detecting steps during slow or irregular gait patterns and the inability to apply this method to wheelchair (WC) users limit the broader utility of accelerometers. Alternative device-specific measures of physical activity exist, but their specificity limits cross-applicability between different device sensors. Moving standard deviation of acceleration (MSDA), obtained from truncal acceleration measurements, is proposed as another alternative variable to quantify physical activity in patients. Objective: This study aimed to evaluate the validity and feasibility of MSDA for quantifying physical activity in patients with stroke-induced hemiparesis by comparing it with the traditional step count. Methods: We enrolled 197 consecutive patients with stroke hemiparesis admitted to a convalescent rehabilitation ward. Using the hitoe system, a smart clothing–based physical activity measurement system, we measured the MSDA of trunk movement and step count. The correlation between MSDA and step count was examined in all participants. Based on their daily living mobility levels, measured using the Functional Independence Measure (FIM), participants were categorized into 6 subgroups: FIM1-4, FIM5 (WC), FIM5 (walking), FIM6 (WC), FIM6 (walking), and FIM7 (walking). Intersubgroup differences in MSDA were analyzed. Results: A strong correlation was observed between MSDA and step count (r=0.78; P<.001), with a stronger correlation in the walking group (r=0.79; P<.001) compared with the WC group (r=0.55; P<.001). The Shapiro-Wilk test indicated no significant results for MSDA across all subgroups, supporting a normal distribution within these groups. In contrast, the step count data for the WC subgroups showed significant results, indicating a deviation from a normal distribution. Additionally, 10.2% (20/197) of participants recorded zero steps, demonstrating a floor effect in the step count data. The median MSDA values for the 6 subgroups (FIM1-4, FIM5 WC, FIM5 walking, FIM6 WC, FIM6 walking, and FIM7) were 0.006, 0.007, 0.010, 0.011, 0.011, and 0.014, respectively, reflecting their levels of independence based on the FIM mobility scores. The median step counts for these subgroups were 68, 233, 1386, 367, 2835, and 4462, respectively. FIM5 participants who walked had higher step counts than FIM6 participants using WCs, though the difference was marginally but not statistically significant (P=.07), highlighting the impact of mobility type (walking vs WC). Conclusions: The results suggest the validity of MSDA as a variable for physical activity in patients with stroke, applicable to patients with stroke irrespective of their mobility measures. This finding highlights the potential of MSDA for use in individuals with motor impairments, including WC users, underscoring its broad utility in rehabilitation clinical practice. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2025/1/e63064
UR  - https://doi.org/10.2196/63064
DO  - 10.2196/63064
ID  - info:doi/10.2196/63064
ER  -