Concurrent validity and accuracy of wrist-wearable devices to track heart rate during exercise in sedentary individuals

Main Article Content

Teerawat Nithiatthawanon
Phatcharaphol Saenkap
Supawadi Arnthong
Janista Satheanpong
Apisara Kumjai
Praitawan Phantachang
Nithinun Chaikeeree
Rumpa Boonsinsukh

Abstract

Background: Heart rate (HR) is commonly used as an indicator to represent a change in oxygen consumption and energy expenditure during activities. Nowadays, HR is easily measured by low-cost wrist-wearable devices, but a few studies examine the validity and accuracy of these devices in sedentary people.


Objective: The study aimed to explore the concurrent validity and accuracy of low-cost wrist-wearable HR devices (The GT2e: approx. 4000 THB and Red Mi watch 2 lite: approx. 1000 THB) for measuring HR during exercise on a treadmill in people with a sedentary lifestyle.


Materials and methods: Seventy-six sedentary participants (60 female; 78.95%) were instructed to wear a Polar H7 while randomly wearing a watch on each hand. Participants were asked to walk or run on the treadmill for 40 minutes, including free-living activities, exercise, and HR recovery phases. Pearson’s correlation coefficient was utilized to explain the levels of correlation (concurrent validity) of wrist wearable devices with the Polar H7. In contrast, the Bland-Altman method, Concordance correlation coefficient (CCC), and Mean Absolute Percentage Error (MAPE) were then used to determine the accuracy of wrist wearable devices.


Results: The GT2e had an excellent agreement with the Polar H7 in free-living activities, exercise sessions, and the HR recovery phase (CCC=0.88, 0.85 & 0.78, respectively) and strong correlation with the criterion measured; Polar H7 (r=0.79 - 0.88; p<0.001). While Red Mi watch 2 lite also had an excellent agreement and correlation in free-living activities and the HR recovery phase (CCC=0.88 - 0.85; r=0.79), but a moderate agreement was found in the exercise phase (CCC=0.55; r=0.61 [p><0.001]).


Conclusion: Both the GT2e and Red Mi watch 2 lite wrist-wearable devices could be used as alternative HR-measured devices to detect HR in sedentary people’s daily lives. However, the GT2e wrist-wearable device was more valid and accurate in detecting HR than the Red Mi watch 2 lite.

Article Details

How to Cite
Nithiatthawanon, T., Saenkap, P., Arnthong, S., Satheanpong, J., Kumjai, A., Phantachang, P., Chaikeeree, N., & Boonsinsukh, R. (2024). Concurrent validity and accuracy of wrist-wearable devices to track heart rate during exercise in sedentary individuals. Journal of Associated Medical Sciences, 58(1), 160–166. Retrieved from https://he01.tci-thaijo.org/index.php/bulletinAMS/article/view/274940
Section
Research Articles

References

Gillinov S, Etiwy M, Wang R, Blackburn G, Phelan D, Gillinov AM, et al. Variable accuracy of wearable heart rate monitors during aerobic exercise. Med Sci Sports Exerc. 2017; 49(8): 1697-703. doi:10.1249/ mss.0000000000001284

Hunt K, Saengsuwan J. Changes in heart rate variability with respect to exercise intensity and time during treadmill running. Biomed Eng Online. 2018; 17(1): 128. doi:10.1186/s12938-018-0561-x

Pasadyn SR, Soudan M, Gillinov M, Houghtaling P, Phelan D, Gillinov N, et al. Accuracy of commercially available heart rate monitors in athletes: a prospective study. Cardiovasc Diagn Ther. 2019; 9(4): 379-85. doi:10.21037/cdt.2019.06.05

Wojtasz I, Cofta S, Czudaj P, Jaracz K, Kazmierski R. Effect of face masks on blood saturation, heart rate, and well-being indicators in health care providers working in specialized COVID-19 center. Int J Environ Res Public Health. 2022; 19(3). doi:10.3390/ijerph 19031397

Sartor F, Gelissen J, van Dinther R, Roovers D, Papini GB, Coppola G. Wrist-worn optical and chest strap heart rate comparison in a heterogeneous sample of healthy individuals and in coronary artery disease patients. BMC Sports Sci Med Rehabil. 2018; 10: 10. doi:10.1186/s13102-018-0098-0

Damasceno V, Costa A, Campello M, Souza D, Gonçalves R, Campos E, Santos t. Criterion validity and accuracy of a heart rate monitor. Hum Mov. 2022; 23(1): 60–8.

Khushhal A, Nichols S, Evans W, Gleadall-Siddall DO, Page R, O’Doherty AF, et al. Validity and reliability of the Apple Watch for measuring heart rate during exercise. Sports Med Int Open. 2017; 1(6): E206-e11. doi:10.1055/s-0043-120195

Bai Y, Hibbing P, Mantis C, Welk GJ. Comparative evaluation of heart rate-based monitors: Apple Watch vs Fitbit Charge HR. J Sports Sci. 2018; 36(15): 1734-41. doi:10.1080/02640414.2017.1412235

Dooley EE, Golaszewski NM, Bartholomew JB. Estimating accuracy at exercise intensities: a comparative study of self-monitoring heart rate and physical activity wearable devices. JMIR Mhealth Uhealth. 2017; 5(3): e34. doi:10.2196/mhealth.7043

Powierza CS, Clark MD, Hughes JM, Carneiro KA, Mihalik JP. validation of a self-monitoring tool for use in exercise therapy. Pm r. 2017; 9(11): 1077-84. doi:10.1016/j.pmrj.2017.03.012

Nithiatthawanon T, Chaikeeree N, Boonsinsukh R. Concurrent validity and accuracy of arm-wearable devices to detect heart rate during exercise: a systematic review. J Med Health Sci. 2023; 30(1): 79 - 103. Available from: https://he01.tci-thaijo.org/index.php/jmhs/ article/ view/263324

WHO Guidelines Approved by the Guidelines Review Committee. WHO Guidelines on Physical Activity and Sedentary Behaviour. Geneva: World Health Organization © World Health Organization 2020.; 2020.

Mengesha MM, Roba HS, Ayele BH, Beyene AS. Level of physical activity among urban adults and the socio-demographic correlates: a population-based cross-sectional study using the global physical activity questionnaire. BMC Public Health. 2019; 19(1): 1160. doi:10.1186/s12889-019-7465-y

Chow HW, Yang CC. Accuracy of optical heart rate sensing technology in wearable fitness trackers for young and older adults: validation and comparison study. JMIR Mhealth Uhealth. 2020; 8(4): e14707. doi:10.2196/14707

Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005; 14(7): 798-804.

Woo J, Leung J, Kwok T. BMI, body composition, and physical functioning in older adults. Obesity (Silver Spring). 2007; 15(7): 1886-94. doi:10.1038/oby. 2007.223.

Thompson W, Medicine A, Gordon N, Pescatello L. ACSM’s guidelines for exercise testing and prescription: Lippincott Williams & Wilkins; 2010.

Fuller D, Colwell E, Low J, Orychock K, Tobin MA, Simango B, et al. Reliability and validity of commercially available wearable devices for measuring steps, energy expenditure, and heart rate: systematic review. JMIR Mhealth Uhealth. 2020; 8(9): e18694. doi:10.2196/18694

Düking P, Giessing L, Frenkel MO, Koehler K, Holmberg HC, Sperlich B. Wrist-worn wearables for monitoring heart rate and energy expenditure while sitting or performing light-to-vigorous physical activity: validation study. JMIR Mhealth Uhealth. 2020; 8(5): e16716. doi:10.2196/16716

Davis A, Convertino V. A comparison of heart rate methods for predicting endurance training intensity. Med Sci Sports Exerc. 1975; 7: 295-8.

Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg. 2018; 126(5): 1763-8. doi:10.1213/ ANE.0000000000002864

Giavarina D. Understanding bland altman analysis. Biochem Med (Zagreb). 2015; 25(2): 141-51. 10.11613/BM.2015.015

Fleiss JL. Reliability of measurement. The design and analysis of clinical experiments. New York: Wiley; 1986. p. 1-32.

Swanson D. On the relationship among values of the same summary measure of error when it is used across multiple characteristics at the same point in time: an examination of MALPE and MAPE 1. Review of Economics and Finance. 2015; 5: 1-14.

Maeda Y, Sekine M, Tamura T, Moriya A, Suzuki T, Kameyama K. Comparison of reflected green light and infrared photoplethysmography. Annu Int Conf IEEE Eng Med Biol Soc. 2008; 2008: 2270-2. doi:10.1109/ IEMBS.2008.4649649

Claes J, Buys R, Avila A, Finlay D, Kennedy A, Guldenring D, et al. Validity of heart rate measurements by the Garmin Forerunner 225 at different walking intensities. J Med Eng Technol. 2017; 41(6): 480-5. doi:10.1080/ 03091902.2017.1333166

Thomson EA, Nuss K, Comstock A, Reinwald S, Blake S, Pimentel RE, et al. Heart rate measures from the Apple Watch, Fitbit Charge HR 2, and electrocardiogram across different exercise intensities. J Sports Sci. 2019; 37(12): 1411-9. doi:10.1080/02640414.2018.1 560644