Accuracy of wrist-worn activity monitors during common daily physical activities and types of structured exercise

Evaluation study

Ravi Kondama Reddy, Rubin Pooni, Dessi P. Zaharieva, Brian Senf, Joseph El Youssef, Eyal Dassau, Francis J. Doyle, Mark A. Clements, Michael R. Rickels, Susana R. Patton, Jessica Castle, Michael C. Riddell, Peter Jacobs

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Wrist-worn activity monitors are often used to monitor heart rate (HR) and energy expenditure (EE) in a variety of settings including more recently in medical applications. The use of real-time physiological signals to inform medical systems including drug delivery systems and decision support systems will depend on the accuracy of the signals being measured, including accuracy of HR and EE. Prior studies assessed accuracy of wearables only during steady-state aerobic exercise. Objective: The objective of this study was to validate the accuracy of both HR and EE for 2 common wrist-worn devices during a variety of dynamic activities that represent various physical activities associated with daily living including structured exercise. Methods: We assessed the accuracy of both HR and EE for two common wrist-worn devices (Fitbit Charge 2 and Garmin vívosmart HR+) during dynamic activities. Over a 2-day period, 20 healthy adults (age: mean 27.5 [SD 6.0] years; body mass index: mean 22.5 [SD 2.3] kg/m2; 11 females) performed a maximal oxygen uptake test, free-weight resistance circuit, interval training session, and activities of daily living. Validity was assessed using an HR chest strap (Polar) and portable indirect calorimetry (Cosmed). Accuracy of the commercial wearables versus research-grade standards was determined using Bland-Altman analysis, correlational analysis, and error bias. Results: Fitbit and Garmin were reasonably accurate at measuring HR but with an overall negative bias. There was more error observed during high-intensity activities when there was a lack of repetitive wrist motion and when the exercise mode indicator was not used. The Garmin estimated HR with a mean relative error (RE, %) of −3.3% (SD 16.7), whereas Fitbit estimated HR with an RE of −4.7% (SD 19.6) across all activities. The highest error was observed during high-intensity intervals on bike (Fitbit: −11.4% [SD 35.7]; Garmin: −14.3% [SD 20.5]) and lowest error during high-intensity intervals on treadmill (Fitbit: −1.7% [SD 11.5]; Garmin: −0.5% [SD 9.4]). Fitbit and Garmin EE estimates differed significantly, with Garmin having less negative bias (Fitbit: −19.3% [SD 28.9], Garmin: −1.6% [SD 30.6], P<.001) across all activities, and with both correlating poorly with indirect calorimetry measures. Conclusions: Two common wrist-worn devices (Fitbit Charge 2 and Garmin vívosmart HR+) show good HR accuracy, with a small negative bias, and reasonable EE estimates during low to moderate-intensity exercise and during a variety of common daily activities and exercise. Accuracy was compromised markedly when the activity indicator was not used on the watch or when activities involving less wrist motion such as cycle ergometry were done.

Original languageEnglish (US)
Article numbere10338
JournalJMIR mHealth and uHealth
Volume6
Issue number12
DOIs
StatePublished - Dec 1 2018

Fingerprint

Wrist
Heart Rate
Exercise
Energy Metabolism
Indirect Calorimetry
Equipment and Supplies
Ergometry
Drug Delivery Systems
Activities of Daily Living
Teaching
Body Mass Index
Thorax
Oxygen
Weights and Measures

Keywords

  • Artificial pancreas
  • Energy metabolism
  • Fitness trackers
  • Heart rate
  • High-intensity interval training

ASJC Scopus subject areas

  • Health Informatics

Cite this

Accuracy of wrist-worn activity monitors during common daily physical activities and types of structured exercise : Evaluation study. / Kondama Reddy, Ravi; Pooni, Rubin; Zaharieva, Dessi P.; Senf, Brian; El Youssef, Joseph; Dassau, Eyal; Doyle, Francis J.; Clements, Mark A.; Rickels, Michael R.; Patton, Susana R.; Castle, Jessica; Riddell, Michael C.; Jacobs, Peter.

In: JMIR mHealth and uHealth, Vol. 6, No. 12, e10338, 01.12.2018.

Research output: Contribution to journalArticle

Kondama Reddy, R, Pooni, R, Zaharieva, DP, Senf, B, El Youssef, J, Dassau, E, Doyle, FJ, Clements, MA, Rickels, MR, Patton, SR, Castle, J, Riddell, MC & Jacobs, P 2018, 'Accuracy of wrist-worn activity monitors during common daily physical activities and types of structured exercise: Evaluation study', JMIR mHealth and uHealth, vol. 6, no. 12, e10338. https://doi.org/10.2196/10338
Kondama Reddy, Ravi ; Pooni, Rubin ; Zaharieva, Dessi P. ; Senf, Brian ; El Youssef, Joseph ; Dassau, Eyal ; Doyle, Francis J. ; Clements, Mark A. ; Rickels, Michael R. ; Patton, Susana R. ; Castle, Jessica ; Riddell, Michael C. ; Jacobs, Peter. / Accuracy of wrist-worn activity monitors during common daily physical activities and types of structured exercise : Evaluation study. In: JMIR mHealth and uHealth. 2018 ; Vol. 6, No. 12.
@article{12d916cb20cb41fe9ba6ce4280ee7a53,
title = "Accuracy of wrist-worn activity monitors during common daily physical activities and types of structured exercise: Evaluation study",
abstract = "Background: Wrist-worn activity monitors are often used to monitor heart rate (HR) and energy expenditure (EE) in a variety of settings including more recently in medical applications. The use of real-time physiological signals to inform medical systems including drug delivery systems and decision support systems will depend on the accuracy of the signals being measured, including accuracy of HR and EE. Prior studies assessed accuracy of wearables only during steady-state aerobic exercise. Objective: The objective of this study was to validate the accuracy of both HR and EE for 2 common wrist-worn devices during a variety of dynamic activities that represent various physical activities associated with daily living including structured exercise. Methods: We assessed the accuracy of both HR and EE for two common wrist-worn devices (Fitbit Charge 2 and Garmin v{\'i}vosmart HR+) during dynamic activities. Over a 2-day period, 20 healthy adults (age: mean 27.5 [SD 6.0] years; body mass index: mean 22.5 [SD 2.3] kg/m2; 11 females) performed a maximal oxygen uptake test, free-weight resistance circuit, interval training session, and activities of daily living. Validity was assessed using an HR chest strap (Polar) and portable indirect calorimetry (Cosmed). Accuracy of the commercial wearables versus research-grade standards was determined using Bland-Altman analysis, correlational analysis, and error bias. Results: Fitbit and Garmin were reasonably accurate at measuring HR but with an overall negative bias. There was more error observed during high-intensity activities when there was a lack of repetitive wrist motion and when the exercise mode indicator was not used. The Garmin estimated HR with a mean relative error (RE, {\%}) of −3.3{\%} (SD 16.7), whereas Fitbit estimated HR with an RE of −4.7{\%} (SD 19.6) across all activities. The highest error was observed during high-intensity intervals on bike (Fitbit: −11.4{\%} [SD 35.7]; Garmin: −14.3{\%} [SD 20.5]) and lowest error during high-intensity intervals on treadmill (Fitbit: −1.7{\%} [SD 11.5]; Garmin: −0.5{\%} [SD 9.4]). Fitbit and Garmin EE estimates differed significantly, with Garmin having less negative bias (Fitbit: −19.3{\%} [SD 28.9], Garmin: −1.6{\%} [SD 30.6], P<.001) across all activities, and with both correlating poorly with indirect calorimetry measures. Conclusions: Two common wrist-worn devices (Fitbit Charge 2 and Garmin v{\'i}vosmart HR+) show good HR accuracy, with a small negative bias, and reasonable EE estimates during low to moderate-intensity exercise and during a variety of common daily activities and exercise. Accuracy was compromised markedly when the activity indicator was not used on the watch or when activities involving less wrist motion such as cycle ergometry were done.",
keywords = "Artificial pancreas, Energy metabolism, Fitness trackers, Heart rate, High-intensity interval training",
author = "{Kondama Reddy}, Ravi and Rubin Pooni and Zaharieva, {Dessi P.} and Brian Senf and {El Youssef}, Joseph and Eyal Dassau and Doyle, {Francis J.} and Clements, {Mark A.} and Rickels, {Michael R.} and Patton, {Susana R.} and Jessica Castle and Riddell, {Michael C.} and Peter Jacobs",
year = "2018",
month = "12",
day = "1",
doi = "10.2196/10338",
language = "English (US)",
volume = "6",
journal = "JMIR mHealth and uHealth",
issn = "2291-5222",
publisher = "Journal of medical Internet Research",
number = "12",

}

TY - JOUR

T1 - Accuracy of wrist-worn activity monitors during common daily physical activities and types of structured exercise

T2 - Evaluation study

AU - Kondama Reddy, Ravi

AU - Pooni, Rubin

AU - Zaharieva, Dessi P.

AU - Senf, Brian

AU - El Youssef, Joseph

AU - Dassau, Eyal

AU - Doyle, Francis J.

AU - Clements, Mark A.

AU - Rickels, Michael R.

AU - Patton, Susana R.

AU - Castle, Jessica

AU - Riddell, Michael C.

AU - Jacobs, Peter

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: Wrist-worn activity monitors are often used to monitor heart rate (HR) and energy expenditure (EE) in a variety of settings including more recently in medical applications. The use of real-time physiological signals to inform medical systems including drug delivery systems and decision support systems will depend on the accuracy of the signals being measured, including accuracy of HR and EE. Prior studies assessed accuracy of wearables only during steady-state aerobic exercise. Objective: The objective of this study was to validate the accuracy of both HR and EE for 2 common wrist-worn devices during a variety of dynamic activities that represent various physical activities associated with daily living including structured exercise. Methods: We assessed the accuracy of both HR and EE for two common wrist-worn devices (Fitbit Charge 2 and Garmin vívosmart HR+) during dynamic activities. Over a 2-day period, 20 healthy adults (age: mean 27.5 [SD 6.0] years; body mass index: mean 22.5 [SD 2.3] kg/m2; 11 females) performed a maximal oxygen uptake test, free-weight resistance circuit, interval training session, and activities of daily living. Validity was assessed using an HR chest strap (Polar) and portable indirect calorimetry (Cosmed). Accuracy of the commercial wearables versus research-grade standards was determined using Bland-Altman analysis, correlational analysis, and error bias. Results: Fitbit and Garmin were reasonably accurate at measuring HR but with an overall negative bias. There was more error observed during high-intensity activities when there was a lack of repetitive wrist motion and when the exercise mode indicator was not used. The Garmin estimated HR with a mean relative error (RE, %) of −3.3% (SD 16.7), whereas Fitbit estimated HR with an RE of −4.7% (SD 19.6) across all activities. The highest error was observed during high-intensity intervals on bike (Fitbit: −11.4% [SD 35.7]; Garmin: −14.3% [SD 20.5]) and lowest error during high-intensity intervals on treadmill (Fitbit: −1.7% [SD 11.5]; Garmin: −0.5% [SD 9.4]). Fitbit and Garmin EE estimates differed significantly, with Garmin having less negative bias (Fitbit: −19.3% [SD 28.9], Garmin: −1.6% [SD 30.6], P<.001) across all activities, and with both correlating poorly with indirect calorimetry measures. Conclusions: Two common wrist-worn devices (Fitbit Charge 2 and Garmin vívosmart HR+) show good HR accuracy, with a small negative bias, and reasonable EE estimates during low to moderate-intensity exercise and during a variety of common daily activities and exercise. Accuracy was compromised markedly when the activity indicator was not used on the watch or when activities involving less wrist motion such as cycle ergometry were done.

AB - Background: Wrist-worn activity monitors are often used to monitor heart rate (HR) and energy expenditure (EE) in a variety of settings including more recently in medical applications. The use of real-time physiological signals to inform medical systems including drug delivery systems and decision support systems will depend on the accuracy of the signals being measured, including accuracy of HR and EE. Prior studies assessed accuracy of wearables only during steady-state aerobic exercise. Objective: The objective of this study was to validate the accuracy of both HR and EE for 2 common wrist-worn devices during a variety of dynamic activities that represent various physical activities associated with daily living including structured exercise. Methods: We assessed the accuracy of both HR and EE for two common wrist-worn devices (Fitbit Charge 2 and Garmin vívosmart HR+) during dynamic activities. Over a 2-day period, 20 healthy adults (age: mean 27.5 [SD 6.0] years; body mass index: mean 22.5 [SD 2.3] kg/m2; 11 females) performed a maximal oxygen uptake test, free-weight resistance circuit, interval training session, and activities of daily living. Validity was assessed using an HR chest strap (Polar) and portable indirect calorimetry (Cosmed). Accuracy of the commercial wearables versus research-grade standards was determined using Bland-Altman analysis, correlational analysis, and error bias. Results: Fitbit and Garmin were reasonably accurate at measuring HR but with an overall negative bias. There was more error observed during high-intensity activities when there was a lack of repetitive wrist motion and when the exercise mode indicator was not used. The Garmin estimated HR with a mean relative error (RE, %) of −3.3% (SD 16.7), whereas Fitbit estimated HR with an RE of −4.7% (SD 19.6) across all activities. The highest error was observed during high-intensity intervals on bike (Fitbit: −11.4% [SD 35.7]; Garmin: −14.3% [SD 20.5]) and lowest error during high-intensity intervals on treadmill (Fitbit: −1.7% [SD 11.5]; Garmin: −0.5% [SD 9.4]). Fitbit and Garmin EE estimates differed significantly, with Garmin having less negative bias (Fitbit: −19.3% [SD 28.9], Garmin: −1.6% [SD 30.6], P<.001) across all activities, and with both correlating poorly with indirect calorimetry measures. Conclusions: Two common wrist-worn devices (Fitbit Charge 2 and Garmin vívosmart HR+) show good HR accuracy, with a small negative bias, and reasonable EE estimates during low to moderate-intensity exercise and during a variety of common daily activities and exercise. Accuracy was compromised markedly when the activity indicator was not used on the watch or when activities involving less wrist motion such as cycle ergometry were done.

KW - Artificial pancreas

KW - Energy metabolism

KW - Fitness trackers

KW - Heart rate

KW - High-intensity interval training

UR - http://www.scopus.com/inward/record.url?scp=85060339644&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060339644&partnerID=8YFLogxK

U2 - 10.2196/10338

DO - 10.2196/10338

M3 - Article

VL - 6

JO - JMIR mHealth and uHealth

JF - JMIR mHealth and uHealth

SN - 2291-5222

IS - 12

M1 - e10338

ER -