Validation of gait characteristics extracted from raw accelerometry during walking against measures of physical function, mobility, fatigability, and fitness

Background. Wearable accelerometry devices allow collection of high-density activity data in large epidemiological studies both in-the-lab as well as in-the-wild (free-living). Such data can be used to detect and identify periods of sustained harmonic walking. This report aims to establish whether the micro- and macro-features of walking identified in the laboratory and free-living environments are associated with measures of physical function, mobility, fatigability, and fitness. Methods. Fifty-one older adults (median age 77.5) enrolled in the Developmental Epidemiologic Cohort Study in Pittsburgh, Pennsylvania were included in the analyses. The study included an in-the-lab component as well as 7 days of monitoring in-the-wild. Participants were equipped with hip-worn Actigraph GT3X+ activity monitors, which collect high-density raw accelerometry data. We applied a walking identification algorithm to the data and defined features of walking, such as participant-specific walking acceleration and cadence. The association between these walking features and physical function, mobility, fatigability, and fitness was quantified using linear regression analysis. Results. Micro-scale features of walking (acceleration and cadence) estimated from in-the-lab and in-the-wild data were associated with measures of physical function, mobility, fatigability, and fitness. In-the-lab median walking acceleration was strongly inversely associated with physical function, mobility, fatigability and fitness. Additionally, in-the-wild daily walking time was inversely associated with usual- and fast-paced 400m walking time. Conclusions. The proposed accelerometry-derived walking features are significantly associated with measures of physical function, mobility, fatigability, and fitness, which provides evidence of convergent validity.