Comparative Analysis of ActiGraph Step Counting Methods in Adults: A Systematic Literature Review and Meta-Analysis

PURPOSE: The primary aim of this study was to compare steps/day across ActiGraph models, wear locations, and filtering methods. A secondary aim was to compare ActiGraph steps/day to those estimated by the ankle-worn StepWatch. METHODS: We conducted a systematic literature review to identify studies of adults published before May 12, 2022, that compared free-living steps/day of ActiGraph step-counting methods and studies that compared ActiGraph to StepWatch. Random effects meta-analysis compared ActiGraph models, wear locations, filter mechanisms, and ActiGraph to StepWatch steps/day. A sensitivity analysis of wear location by younger and older age was included. RESULTS: Twelve studies, with 46 comparisons, were identified. When worn on the hip, the AM-7164 recorded 123% of the GT series steps (no low-frequency extension (no LFE) or default filter). However, the AM-7164 recorded 72% of the GT series steps when the LFE was enabled. Independent of the filter used (i.e., LFE, no LFE), ActiGraph GT series monitors captured more steps on the wrist than on the hip, especially among older adults. Enabling the LFE on the GT series monitors consistently recorded more steps, regardless of wear location. When using the default filter (no LFE), ActiGraph recorded fewer steps than StepWatch (ActiGraph on hip 73% and ActiGraph on wrist 97% of StepWatch steps). When LFE was enabled, ActiGraph recorded more steps than StepWatch (ActiGraph on the hip 132% and ActiGraph on the wrist 178% of StepWatch steps). CONCLUSIONS: The choice of ActiGraph model, wear location, and filter all impacted steps/day in adults. These can markedly alter the steps recorded compared to a criterion method (StepWatch). This review provides critical insights for comparing studies using different ActiGraph step-counting methods