Loughborough University
journal.pone.0190753.pdf (2.09 MB)

Validation of the ADAMO care watch for step counting in older adults

Download (2.09 MB)
journal contribution
posted on 2018-02-15, 11:57 authored by Daniele Magistro, Paolo R. Brustio, Marco Ivaldi, Dale EsligerDale Esliger, Massimiliano ZeccaMassimiliano Zecca, Alberto Rainoldi, Gennaro Boccia
Background Accurate measurement devices are required to objectively quantify physical activity. Wearable activity monitors, such as pedometers, may serve as affordable and feasible instruments for measuring physical activity levels in older adults during their normal activities of daily living. Currently few available accelerometer-based steps counting devices have been shown to be accurate at slow walking speeds, therefore there is still lacking appropriate devices tailored for slow speed ambulation, typical of older adults. This study aimed to assess the validity of step counting using the pedometer function of the ADAMO Care Watch, containing an embedded algorithm for measuring physical activity in older adults. Methods Twenty older adults aged ≥ 65 years (mean ± SD, 75±7 years; range, 68–91) and 20 young adults (25±5 years, range 20–40), wore a care watch on each wrist and performed a number of randomly ordered tasks: walking at slow, normal and fast self-paced speeds; a Timed Up and Go test (TUG); a step test and ascending/descending stairs. The criterion measure was the actual number of steps observed, counted with a manual tally counter. Absolute percentage error scores, Intraclass Correlation Coefficients (ICC), and Bland–Altman plots were used to assess validity. Results ADAMO Care Watch demonstrated high validity during slow and normal speeds (range 0.5–1.5 m/s) showing an absolute error from 1.3% to 1.9% in the older adult group and from 0.7% to 2.7% in the young adult group. The percentage error for the 30-metre walking tasks increased with faster pace in both young adult (17%) and older adult groups (6%). In the TUG test, there was less error in the steps recorded for older adults (1.3% to 2.2%) than the young adults (6.6% to 7.2%). For the total sample, the ICCs for the ADAMO Care Watch for the 30-metre walking tasks at each speed and for the TUG test were ranged between 0.931 to 0.985. Conclusion These findings provide evidence that the ADAMO Care Watch demonstrated highly accurate measurements of the steps count in all activities, particularly walking at normal and slow speeds. Therefore, these data support the inclusion of the ADAMO Care Watch in clinical applications for measuring the number of steps taken by older adults at normal, slow walking speeds.


The development and validation of the ADAMO care watch is part of the SPRINTT (Sarcopenia & physical frailty in older people: multi-component treatment strategies) project (9th Call IMI 2013). Caretek S.r.l. Torino, Italy, contributed to the present submission by providing funding and materials.



  • Sport, Exercise and Health Sciences

Published in



MAGISTRO, D. ...et al., 2018. Validation of the ADAMO Care Watch for step counting in older adults. PLoS ONE, 13(2): e0190753.


© the Authors. Published by Public Library of Science (PloS)


  • VoR (Version of Record)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution 4.0 International (CC BY 4.0) licence. Full details of this licence are available at: http://creativecommons.org/licenses/ by/4.0/

Acceptance date


Publication date



This is an Open Access Article. It is published by PLoS under the Creative Commons Attribution 4.0 Unported Licence (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/




  • en

Usage metrics

    Loughborough Publications



    Ref. manager