All three objective activity monitors performed well at moderate and higher walking speeds, but at decreased gait speeds, the SAM seemed to be the most accurate.

Diabetes was associated with gait alterations in older adults. Slowed gait speed appears to be secondary to the peripheral effect of the disease on other body systems. The effect of diabetes on step width was not explained in the analyses and may be related to peripheral motor nerve function or central influences of the disease, which could not be assessed in this study.

Objective We examined the association between physical activity recorded by Actigraphy during therapy sessions (therapy) to therapist rated patient participation and self reported future functional outcomes. We hypothesized those participants who were more active during rehab would have higher participation scores and better functional outcomes following hip fracture compared to those who were less active. Design Longitudinal study with 3 and 6 month follow-up. Setting Participants were recruited from skilled nursing (SN) and inpatient rehabilitation (IR) facilities. Participants Participants included 18 community dwelling older adults admitted to SN or IR facilities after hip fracture. Participants were included if they were ≥ 60 years of age and ambulatory with or without assistance from a device or another person. Intervention Not Applicable Main Outcome Measure Physical activity was quantified during participants’ rehab using the Actigraph accelerometer worn consecutively over 5 days. The Pittsburgh Participation Rating Scale was used to quantify patient participation during their inpatient therapy sessions. Self reported functional outcomes were measured by the Hip Fracture Functional Recovery Scale (HFRS) at baseline, 3 and 6 months following fracture. Results Participants with higher Actigraphy counts during rehab were ranked by their therapists as having excellent participation compared to those who were less active. Participants who were more active reported better functional abilities at both 3 and 6 month time points and achieved 78% and 91% recovery of self reported pre-fracture function compared to those who were less active achieving 64% and 73% recovery. Conclusion Actigraphy provides an objective measure of physical activity exhibiting predictive validity for future functional outcomes and concurrent validity against patient participation in patients after hip fracture.

The measure of physical activity used in this study included only walking, not other low- to moderate-intensity activities that are common in older adults. Health and balance perception and gait speed were associated with walking activity more so than fall history or balance performance after controlling for potential confounding factors.

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