Validity and reliability of fitbit flex for step count, moderate to vigorous physical activity and activity energy expenditure

Journal article


Sushames, Ashleigh, Edwards, Andrew, Thompson, Fintan, McDermott, Robyn and Gebel, Klaus. (2016). Validity and reliability of fitbit flex for step count, moderate to vigorous physical activity and activity energy expenditure. PLoS ONE. 11(9), pp. 1 - 14. https://doi.org/10.1371/journal.pone.0161224
AuthorsSushames, Ashleigh, Edwards, Andrew, Thompson, Fintan, McDermott, Robyn and Gebel, Klaus
Abstract

Objectives: To examine the validity and reliability of the Fitbit Flex against direct observation for measuring steps in the laboratory and against the Actigraph for step counts in free-living conditions and for moderate-to-vigorous physical activity (MVPA) and activity energy expenditure (AEE) overall. Methods: Twenty-five adults (12 females, 13 males) wore a Fitbit Flex and an Actigraph GT3X+ during a laboratory based protocol (including walking, incline walking, running and stepping) and free-living conditions during a single day period to examine measurement of steps, AEE and MVPA. Twenty-four of the participants attended a second session using the same protocol. Results: Intraclass correlations (ICC) for test-retest reliability of the Fitbit Flex were strong for walking (ICC = 0.57), moderate for stair stepping (ICC = 0.34), and weak for incline walking (ICC = 0.22) and jogging (ICC = 0.26). The Fitbit significantly undercounted walking steps in the laboratory (absolute proportional difference: 21.2%, 95%CI 13.0–29.4%), but it was more accurate, despite slightly over counting, for both jogging (6.4%, 95%CI 3.7–9.0%) and stair stepping (15.5%, 95%CI 10.1–20.9%). The Fitbit had higher coefficients of variation (Cv) for step counts compared to direct observation and the Actigraph. In free-living conditions, the average MVPA minutes were lower in the Fitbit (35.4 minutes) compared to the Actigraph (54.6 minutes), but AEE was greater from the Fitbit (808.1 calories) versus the Actigraph (538.9 calories). The coefficients of variation were similar for AEE for the Actigraph (Cv = 36.0) and Fitbit (Cv = 35.0), but lower in the Actigraph (Cv = 25.5) for MVPA against the Fitbit (Cv = 32.7). Conclusion: The Fitbit Flex has moderate validity for measuring physical activity relative to direct observation and the Actigraph. Test-rest reliability of the Fitbit was dependant on activity type and had greater variation between sessions compared to the Actigraph. Physical activity surveillance studies using the Fitbit Flex should consider the potential effect of measurement reactivity and undercounting of steps.

Year2016
JournalPLoS ONE
Journal citation11 (9), pp. 1 - 14
PublisherPublic Library of Science
Digital Object Identifier (DOI)https://doi.org/10.1371/journal.pone.0161224
Open accessOpen access
Page range1 - 14
Research GroupSchool of Allied Health
Publisher's version
Additional information

© 2016 Sushames et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Place of publicationUnited Statesof America
Permalink -

https://acuresearchbank.acu.edu.au/item/8q96q/validity-and-reliability-of-fitbit-flex-for-step-count-moderate-to-vigorous-physical-activity-and-activity-energy-expenditure

  • 120
    total views
  • 99
    total downloads
  • 5
    views this month
  • 1
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

The 2018 physical activity guidelines for Americans: What’s new? Implications for clinicians and the public
Stamatakis, Emmanuel, Straker, Leon, Hamer, Mark and Gebel, Klaus. (2019). The 2018 physical activity guidelines for Americans: What’s new? Implications for clinicians and the public. Journal of Orthopaedic and Sports Physical Therapy. 49(7), pp. 487-490. https://doi.org/10.2519/jospt.2019.0609
Effects of new dock-less bicycle-sharing programs on cycling: A retrospective study in Shanghai
Jia, Yingnan, Ding, Ding, Gebel, Klaus, Chen, Lili, Zhang, Sen, Ma, Zhicong and Fu, Hua. (2019). Effects of new dock-less bicycle-sharing programs on cycling: A retrospective study in Shanghai. BMJ Open. 9(2), pp. 1 - 9. https://doi.org/10.1136/bmjopen-2018-024280
Associations of vigorous physical activity with all-cause, cardiovascular and cancer mortality among 64 913 adults
Lopez, Juan Pablo Rey, Gebel, Klaus, Chia, Debbie and Stamatakis, Emmanuel. (2019). Associations of vigorous physical activity with all-cause, cardiovascular and cancer mortality among 64 913 adults. BMJ Open Sport & Exercise Medicine. 5(1), pp. 1 - 8. https://doi.org/10.1136/bmjsem-2019-000596
Moving to an active lifestyle? A systematic review of the effects of residential relocation on walking, physical activity and travel behaviour
Ding, Ding, Nguyen, Binh, Learnihan, Vincent, Bauman, Adrian E., Davey, Rachel, Jalaludin, Bin and Gebel, Klaus. (2018). Moving to an active lifestyle? A systematic review of the effects of residential relocation on walking, physical activity and travel behaviour. British Journal of Sports Medicine. 52(12), pp. 789 - 799. https://doi.org/10.1136/bjsports-2017-098833
Walking lowers mortality risk in older US adults
Gebel, Klaus and Ding, Ding. (2018). Walking lowers mortality risk in older US adults. Evidence-Based Medicine. 23(5), pp. 187 - 188. https://doi.org/10.1136/bmjebm-2018-110902
Mobile bicycle sharing: The social trend that may change how we move
Ding, Ding, Jia, Yingnan and Gebel, Klaus. (2018). Mobile bicycle sharing: The social trend that may change how we move. The Lancet Public Health. 3(5), pp. 215 - 215. https://doi.org/10.1016/S2468-2667(18)30066-5
Sitting time and physical function in Australian retirees: An analysis of bidirectional relationships
Gardiner, Paul A., Reid, Natasha, Gebel, Klaus and Ding, Ding. (2018). Sitting time and physical function in Australian retirees: An analysis of bidirectional relationships. The Journals of Gerontology: Series A. 73(12), pp. 1675 - 1681. https://doi.org/10.1093/gerona/gly008
Removal of sugary drinks from vending machines: An Australian university case study
Tsai, Carrie, Slater, Scott, Ronto, Rimante, Gebel, Klaus and Wu, Jason H.Y.. (2018). Removal of sugary drinks from vending machines: An Australian university case study. Australian and New Zealand Journal of Public Health. 42(6), pp. 588 - 588. https://doi.org/10.1111/1753-6405.12827
Patterns and predictors of sitting time over ten years in a large population-based Canadian sample: Findings from the Canadian Multicentre Osteoporosis Study (CaMos)
Gebel, Klaus, Pont, Sarah, Ding, Ding, Bauman, Adrian E., Chau, Josephine Y., Berger, Claudie and Prior, Jerilynn C.. (2017). Patterns and predictors of sitting time over ten years in a large population-based Canadian sample: Findings from the Canadian Multicentre Osteoporosis Study (CaMos). Preventive Medicine Reports. 5, pp. 289 - 294. https://doi.org/10.1016/j.pmedr.2017.01.015
Perceived barriers and enablers to participation in a community-tailored physical activity program with Indigenous Australians in a regional and rural setting: A qualitative study
Sushames, Ashleigh, Engelberg, Terry and Gebel, Klaus. (2017). Perceived barriers and enablers to participation in a community-tailored physical activity program with Indigenous Australians in a regional and rural setting: A qualitative study. International Journal for Equity in Health. 16(1), pp. 1 - 9. https://doi.org/10.1186/s12939-017-0664-1
Do physical activity interventions in Indigenous people in Australia and New Zealand improve activity levels and health outcomes? A systematic review
Sushames, Ashleigh, van Ufffelen, Jannique and Gebel, Klaus. (2016). Do physical activity interventions in Indigenous people in Australia and New Zealand improve activity levels and health outcomes? A systematic review. International Journal of Behavioral Nutrition and Physical Activity. https://doi.org/10.1186/s12966-016-0455-x
Correcting bias in self-rated quality of life: An application of anchoring vignettes and ordinal regression models to better understand QoL differences across commuting modes
Crane, Melanie, Rissel, Chris, Greaves, Stephen and Gebel, Klaus. (2016). Correcting bias in self-rated quality of life: An application of anchoring vignettes and ordinal regression models to better understand QoL differences across commuting modes. Quality of Life Research. https://doi.org/10.1007/s11136-015-1090-8
Improving current practice in reviews of the built environment and physical activity
Gebel, Klaus, Ding, Ding, Foster, Charlie, Bauman, Adrian E. and Sallis, James F.. (2015). Improving current practice in reviews of the built environment and physical activity. Sports Medicine. 45(3), pp. 297 - 302. https://doi.org/10.1007/s40279-014-0273-8
Vigorous physical activity and all-cause mortality: A story that got lost in translation
Ding, Ding, Gebel, Klaus, Freeman, Becky and Bauman, Adrian. (2015). Vigorous physical activity and all-cause mortality: A story that got lost in translation. Journal of Physical Activity and Health. 12(4), pp. 445 - 446. https://doi.org/10.1123/jpah.2015-0291
Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial
Merom, Dafna, Gebel, Klaus, Fahey, Paul P., Astell-Burt, Thomas, Voukelatos, Alexander, Rissel, Chris and Sherrington, Catherine. (2015). Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial. Preventive Medicine Reports. 2, pp. 704 - 710. https://doi.org/10.1016/j.pmedr.2015.08.011
Effect of moderate to vigorous physical activity on all-cause mortality in middle-aged and older Australians
Gebel, Klaus, Ding, Ding, Chey, Tien, Stamatakis, Emmanuel, Brown, Wendy and Bauman, Adrian. (2015). Effect of moderate to vigorous physical activity on all-cause mortality in middle-aged and older Australians. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2015.0541
Co-benefits of designing communities for active living: An exploration of literature
Sallis, James F., Spoon, Chad, Cavill, Nick, Engelberg, Jessa K., Gebel, Klaus, Parker, Mike, Thornton, Christina M., Lou, Debbie, Wilson, Amanda, Cutter, Carmen L. and Ding, Ding. (2015). Co-benefits of designing communities for active living: An exploration of literature. International Journal of Behavioral Nutrition and Physical Activity. 12(1), pp. 1 - 10. https://doi.org/10.1186/s12966-015-0188-2
An early-stage epidemic: A systematic review of correlates of smoking among Chinese women
Ding, Ding, Gebel, Klaus, Oldenburg, Brian, Wan, Xia, Zhong, Xuefeng and Novotny, Thomas E.. (2014). An early-stage epidemic: A systematic review of correlates of smoking among Chinese women. International Journal of Behavioral Medicine. https://doi.org/10.1007/s12529-013-9367-1
Longer Term Impact of the Mass Media Campaign to Promote the Get Healthy Information and Coaching Service®: Increasing the Saliency of a New Public Health Program
O'Hara, Blythe J., Phongsavan, Philayrath, Gebel, Klaus, Banovic, Debbie, Buffett, Kym M. and Bauman, Adrian. (2014). Longer Term Impact of the Mass Media Campaign to Promote the Get Healthy Information and Coaching Service®: Increasing the Saliency of a New Public Health Program. Health Promotion Practice. https://doi.org/10.1177/1524839914524774
Driving: A road to unhealthy lifestyles and poor health outcomes
Ding, Ding, Gebel, Klaus, Phongsavan, Philayrath, Bauman, Adrian E. and Merom, Dafna. (2014). Driving: A road to unhealthy lifestyles and poor health outcomes. PLoS ONE. 9(6), pp. 1 - 5. https://doi.org/10.1371/journal.pone.0094602
Volume and intensity of physical activity in a large population-based cohort of middle-aged and older Australians: Prospective relationships with weight gain, and physical function
Gebel, Klaus, Ding, Ding and Bauman, Adrian E.. (2014). Volume and intensity of physical activity in a large population-based cohort of middle-aged and older Australians: Prospective relationships with weight gain, and physical function. Preventive Medicine. https://doi.org/10.1016/j.ypmed.2013.12.030
Self-efficacy, physical activity, and sedentary behavior in adolescent girls: Testing mediating effects of the perceived school and home environment
Plotnikoff, Ronald C., Gebel, Klaus and Lubans, David Revalds. (2014). Self-efficacy, physical activity, and sedentary behavior in adolescent girls: Testing mediating effects of the perceived school and home environment. Journal of Physical Activity and Health. https://doi.org/10.1123/jpah.2012-0414
Walkability parameters, active transportation and objective physical activity: moderating and mediating effects of motor vehicle ownership in a cross-sectional study
Eriksson, Ulf, Arvidsson, Daniel, Gebel, Klaus, Ohlsson, Henrik and Sundquist, Kristina. (2012). Walkability parameters, active transportation and objective physical activity: moderating and mediating effects of motor vehicle ownership in a cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity. https://doi.org/10.1186/1479-5868-9-123
Built environment, physical activity, and obesity: What have we learned from reviewing the literature?
Ding, Ding and Gebel, Klaus. (2012). Built environment, physical activity, and obesity: What have we learned from reviewing the literature? Health and Place. https://doi.org/10.1016/j.healthplace.2011.08.021
Does the environment moderate the impact of a mass media campaign to promote walking?
Gebel, Klaus, Bauman, Adrian, Reger-Nash, Bill and Leyden, Kevin M.. (2011). Does the environment moderate the impact of a mass media campaign to promote walking? American Journal of Health Promotion. https://doi.org/10.4278/ajhp.081104-ARB-269
The Toronto Charter for Physical Activity (Die Toronto-Charta fur Bewegung)
Siefken, Katja, Kahlmeier, Sonja, Titze, Sylvia and Gebel, Klaus. (2011). The Toronto Charter for Physical Activity (Die Toronto-Charta fur Bewegung). Pravention und Gesundheitsforderung. 6(3), pp. 212 - 215. https://doi.org/10.1007/s11553-011-0303-4
Mismatch between perceived and objectively assessed neighborhood walkability attributes: Prospective relationships with walking and weight gain
Gebel, Klaus, Bauman, Adrian E., Sugiyama, Takemi and Owen, Neville. (2011). Mismatch between perceived and objectively assessed neighborhood walkability attributes: Prospective relationships with walking and weight gain. Health and Place. 17(2), pp. 519 - 524. https://doi.org/10.1016/j.healthplace.2010.12.008