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Published on: February 21, 2025
Comparison of daily step counts among wearable devices in free-living adults: A systematic review and network
Amanda E Paluch1, Kelly R Evenson2, Eric M Eberl3
1Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA 01003, USA; Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA 01003 USA.
Background:
Wearable activity monitors are widely used to measure daily step counts, a simple and health-relevant metric of physical activity. However, differences in sensor technologies, algorithms, and wear locations across devices can result in substantial variability in step count estimates, creating challenges for comparing and harmonizing data across studies and populations. This study aims to compare free-living daily step counts across commonly used activity monitoring devices in adults using network meta-analysis.
Methods:
We systematically searched PubMed, Scopus, and PsycINFO through November 2025 for studies reporting concurrent daily step measurements using at least 2 devices from our target list of 13 manufacturers of research- and consumer-grade accelerometers and pedometers. Network meta-analysis estimated the ratio of means (ROMs) and mean differences in daily steps between devices.
Results:
Across 59 studies, most consumer devices, pedometers, and the thigh (ActivPAL) and hip-worn research devices (ActiGraph GT, Axivity, and Actical) were within 10% ROM and <700 steps/day. Wear location was the primary source of variation, with wrist-worn and ankle-worn (StepWatch) research-grade accelerometers estimating 15‒30% more daily steps (+1000 to 2200 steps/day) than hip-worn devices, while consumer-grade wrist devices showed smaller differences (3‒15% higher or +200 to 1000 steps/day).
Conclusion:
These findings provide researchers with evidence-based guidance for selecting appropriate step devices, interpreting step count data across studies, and considerations when combining data from multiple device types and wear locations.
