Accuracy of Wrist-Worn Activity Monitors During Common Daily Physical Activities and Types of Structured Exercise: Evaluation Study.

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 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 PUnder 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 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