Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Monday, March 11, 2019 at 4:00 PM to 4:30 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?


Currently submitted to: JMIR Rehabilitation and Assistive Technologies

Date Submitted: Mar 30, 2020
Open Peer Review Period: Mar 30, 2020 - May 25, 2020
(closed for review but you can still tweet)

NOTE: This is an unreviewed Preprint

Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).

Peer-review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer-Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.

Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).

Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.

Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.

Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Feasibility and Convergent Validity of an Activity Tracker in a Clinical Study of Low Back Pain

  • Linda Xiaoqian Zhuo; 
  • Luciana Gazzi Macedo; 



Low back pain (LBP) is a highly prevalent condition affecting individuals of all ages. To manage the symptoms and prevent recurrences and flare-ups, physical activity in conjunction with self-management education is recommended. Tools such as diaries and questionnaires have been the gold standard for tracking physical activity in clinical studies. However, there are issues with consistency, accuracy, and recall with the use of these outcome measures. Given the growth of technology in today’s society, consumer-grade activity monitors have become a common and convenient method of recording physical activity data.


To test the feasibility and convergent validity a Garmin Vivo 3 activity tracker in evaluating physical activity levels in a clinical trial of LBP patients.


We recruited 17 individuals with non-specific LBP referred from health care professionals or self-referred through advertisements in the community. The participants entered into a 12-week physical activity and self-management program. Physical activity was assessed using a self-reported questionnaire and the Garmin activity tracker. Activity tracker data (e.g. steps taken, distance walked, intensity minutes, etc.) were extracted weekly from the Garmin Connect online platform. Outcomes of pain and activity limitation were assessed weekly using a mobile app. Linear regression was conducted to evaluate if demographic factors (i.e. age, gender, pain level) affected the adherence rates to the activity monitor. We also used Pearson’s correlations to evaluate the convergent validity of the Garmin activity tracker with the physical activity questionnaire.


The daily adherence rate for activity monitors was 70% (SD 31%) over the 26 weeks of study. The daily response rate for the text messaging system over the first 12 weeks of the study was 81% (SD 28%). The response rate for the weekly physical activity measures using REDCap was 91% (SD 17%). None of the hypothesized variables or questionnaires were predictors of response rate.


No correlations were found between the International Physical Activity Questionnaire Short Form (IPAQ-SF) and the activity monitor. Demographic factors were not found to be predictors of adherence to wearing the device. However, the majority of participants were compliant with wearing the tracker and thus, activity monitors may still be a useful tool in scientific research.


Please cite as:

Zhuo LX, Macedo LG

Feasibility and Convergent Validity of an Activity Tracker in a Clinical Study of Low Back Pain

JMIR Preprints. 30/03/2020:18942

DOI: 10.2196/preprints.18942


Download PDF

Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.