Evidence map›Paper›PMID 40088311›Full record

ArticleArchives of orthopaedic and trauma surgery2025

Wearable technology for mobility measurement in orthopedics and traumatology: a comparison of commercially available systems.

A M Keppler, R Zaccaria, M Weigert, L Keppler, W Böcker, C Neuerburg, R Schniepp, J Fürmetz

Abstract readComparative Study
In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

A M KepplerDepartment for Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistrasse 15, Munich, 81377, Germany. alexander.keppler@med.uni-muenchen.de.ORCID http://orcid.org/0000-0002-1800-5278
R ZaccariaDepartment for Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistrasse 15, Munich, 81377, Germany.
M WeigertDepartment for Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistrasse 15, Munich, 81377, Germany.
L KepplerDepartment for Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistrasse 15, Munich, 81377, Germany.
W BöckerDepartment for Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistrasse 15, Munich, 81377, Germany.
C NeuerburgDepartment for Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistrasse 15, Munich, 81377, Germany.
R SchnieppDepartment of Neurology, University Hospital, LMU Munich, Marchioninistrasse 15, Munich, 81377, Germany.
J FürmetzDepartment for Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistrasse 15, Munich, 81377, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWearable activity sensors offer valuable insights into physical activity and are increasingly used in clinical and rehabilitation settings. However, most are designed for healthy individuals, necessitating a thorough evaluation of their applicability for pathological gait patterns. This study aims to assess the accuracy of commercially available wearables in measuring gait patterns among patients with lower limb injuries compared to healthy individuals.

methodsA prospective cohort study enrolled 40 participants divided into four groups: Group A (younger patients with lower limb injuries with age < 75y), Group B (younger healthy individuals with age 75y), Group C (elderly patients with lower limb injuries and age 75y), and Group D (elderly healthy individuals with age > 75y). Mobility was assessed in real-world scenarios using four wearable devices (Apple Watch Series 4, Fitbit Charge 3, ActivPal 4, and StappOne Insoles V1.0) across three gait speeds in a gait laboratory, with GAITrite mats and video as gold standards.

resultsAccuracy varied significantly between devices. The accelerometer-based wearables (Apple Watch Series 4, Fitbit Charge 3 and ActivPal 4™) underestimated cumulative step count compared to pressure-based Stappone v1. 0, especially for slow and restricted gait patterns (Groups C and D). Relative Difference of Wearables Measurements to the true numbers of steps (Group C: AW -21.83%, FB -28.99%, AP -20.00% versus SO 0.00% - Group D: AW -8.51%, FB -14.29%, AP -20.00% versus SO 4.55%). Zero measurements occurred frequently with wrist-worn devices, highlighting their limitations in detecting slow or restricted movements. In contrast, pressure-based StappOne Insoles demonstrated superior accuracy, with minimal deviations across all groups and gait speeds. The inaccuracy was exacerbated by factors such as the use of mobility aids, partial weight-bearing, and postoperative restrictions, which altered arm and leg movements.

conclusionsAccelerometer-based wearables require algorithmic improvements to address the challenges of slow and pathological gait patterns. The frequent occurrence of zero measurements with wrist-worn devices underscores their limited utility in clinical populations. Practical challenges, such as altered movement patterns due to mobility aids and partial weight-bearing, further limit their accuracy. Pressure-based systems, while accurate, face practicality issues for daily use. These findings emphasize the need for tailored wearable technologies for orthopedic and trauma patients. LEVEL OF EVIDENCE: Prospective cohort study, Level of Evidence 2.

Indexed as

GaitLeg InjuriesWearable Electronic DevicesAccelerometryAdultAgedFemaleHumansMaleMiddle AgedOrthopedicsProspective StudiesTraumatologyGaitLower limb injuriesMobilityOrthogeriatric

Identifiers

PMID40088311
PMCPMC11910393

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.