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Updated: May 7, 2026
Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults
Published on: November 7, 2014
Validity of accelerometer-based analysis of step time and step time variability during treadmill walking in people
Meichan Zhu1, Paul Willems2, Rik Marcellis3
1Department of Otorhinolaryngology and Head and Neck Surgery, Division of Balance Disorders, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, the Netherlands; Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands; Department of Otorhinolaryngology, Guangzhou Twelfth People's Hospital (Guangzhou Otolarynology-Head and Neck Surgery Hospital), Guangzhou, Guangdong, China.
Background:
Gait and balance impairments, including increased gait variability, are prevalent in people with bilateral vestibulopathy (BVP). Wearable accelerometers may provide a clinically feasible method to objectively assess gait variability but have not yet been explored in BVP.
Research Question:
Is accelerometer-based assessment of step time variability during treadmill walking valid in people with BVP?
Methods:
Adults with BVP and age-sex-matched healthy controls walked at 0.6 m/s, 0.8 m/s, and 1.0 m/s on the treadmill of the Computer Assisted Rehabilitation Environment. We examined differences in step time means and coefficients of variation (CoV) between accelerometery (single lower back sensor; MOX1) and 3D motion capture and force plates (Vicon). Validity was assessed using intraclass correlation coefficients (ICC3,1), Pearson and Spearman correlation coefficients, and Bland-Altman analyses to determine agreement, association and consistency between the methods. Validity was additionally assessed by comparing statistical significant differences and the effect sizes between the groups using each method.
Results:
Mean step time showed moderate to excellent agreement between methods, while step time CoV showed poor agreement and proportional bias. Accelerometery showed consistent between-group significance and effect size values, particularly at 0.6 m/s, although effect sizes were larger in motion capture data than in accelerometer data.
Significance:
An accelerometer-based assessment is valid for assessing mean step time in people with BVP. For assessing step time variability, it can distinguish between known groups (particularly at slower speeds) but does not demonstrate criterion validity. Before clinical application, test-retest reliability and sensitivity to change should be assessed in BVP.
