Validation of Smartphones and Different Low-Cost Activity Trackers for Step Counting Under Free-Living Conditions

Background: Smartphones and wrist-worn activity trackers are increasingly popular for step counting purposes and physical activity promotion. Although trackers from popular brands have frequently been validated, the accuracy of low-cost devices under free-living conditions has not been adequately determined. Objective: To investigate the criterion validity of smartphones and low-cost wristworn activity trackers under free-living conditions. Methods: Participants wore a waist-worn Yamax pedometer and seven different low-cost wrist-worn activity trackers continuously over 3 days, and an activity log was completed at the end of each day. At the end of the study, the number of step counts reflected on the participants' smartphone for each of the 3 days was also recorded. To establish criterion validity, step counts from smartphones and activity trackers were compared with the pedometers using Pearson's correlation coefficient, mean absolute percentage error, and intraclass correlation coefficient. Results: Five of the seven activity trackers underestimated step counts and the remaining two and the smartphones overestimated step counts. Criterion validity was consistently higher for the activity trackers (r = .78-.92; mean absolute percentage error 14.5%-36.1%; intraclass correlation coefficient: .51-.91) than the smartphone (r = .37; mean absolute percentage error 55.7%; intraclass correlation coefficient: .36). Stratified analysis showed better validity of smartphones among female than for male participants. Phone wearing location also affected accuracy. Conclusions: Low-cost trackers demonstrated high accuracy in recording step counts and can be considered with confidence for research purposes or large-scale health promotion programs. The accuracy of using a smartphone for measuring step counts was substantially lower. Factors such as phone wear location and gender should also be considered when using smartphones to track step counts.