Objective: The aim of this study is to investigate predictors of adherence to wearing the Fitbit activity monitor in patients with Parkinson disease (PD) and stroke.
Background: Exercise and activity improve symptoms of PD and stroke and aid in primary and secondary stroke prevention. However, adherence to physical activity programs is low, and little is known about adherence to daily activity monitoring.
Methods: Patients (N = 19; age, 58.8 +/- 11 years; range, 37-83 years) with PD (n = 12) and stroke (n = 8) participated in a pilot study to investigate feasibility of and adherence to Fitbit monitoring to track activity between clinical office visits.
Results: Comparing PD and stroke, patients with PD were more disabled (Rankin; P = .004) but more likely to be employed (P = .03). Patients with stroke were more depressed (PROMIS; P = .045) and more cognitively impaired (Montreal Cognitive Assessment; P = .02) and had lower numeracy (Subjective Numeracy Scale; P = .03). Fitbit data were collected for 28 to 53 days (mean, 32.9 days). Patients used the Fitbit for 86% of days and 13.5 h/d on average. Average steps per day were 6041 +/- 2797. The only significant predictor of adherence to the Fitbit (percentage of days used) was medical comorbidity (r = -0.46, P = .047) such that those with greater comorbidity (Cumulative Illness Rating Scale) wore the Fitbit less. Other high correlations with adherence (but nonsignificant) were as follows: PROMIS Self-Efficacy for Managing Medications (r = 0.57), Self-Efficacy for Managing Social Interactions (r = 0.46), greater e-Health Literacy (eHEALs; r = 0.39), and less pain (r = -0.37). Adherence showed a low correlation (r < 0.2) with disease severity, disability, cognition, depression, age, and socioeconomic status.
Conclusions: The strongest predictor of adherence to daily activity monitoring was level of medical comorbidity. Other determinants of adherence were self-efficacy for managing conditions, e-Health literacy, and pain. Age and level of disability did not affect daily use of small wireless monitors to track activity in stroke and PD.