Cited by 346Non-Invasive Vital Sign MonitoringCardiovascular and exercise physiologyPhysical Activity and Health

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Variable Accuracy of Wearable Heart Rate Monitors during Aerobic Exercise

GILLINOV, STEPHEN, ETIWY, MUHAMMAD, WANG, ROBERT, BLACKBURN, GORDON, PHELAN, DERMOT, GILLINOV, A. MARC, HOUGHTALING, PENNY, JAVADIKASGARI, HODA, DESAI, MILIND Y.·2017·Medicine & Science in Sports & Exercise

DOI 10.1249/mss.0000000000001284

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Abstract

PURPOSE: Athletes and members of the public increasingly rely on wearable HR monitors to guide physical activity and training. The accuracy of newer, optically based monitors is unconfirmed. We sought to assess the accuracy of five optically based HR monitors during various types of aerobic exercise. METHODS: Fifty healthy adult volunteers (mean ± SD age = 38 ± 12 yr, 54% female) completed exercise protocols on a treadmill, a stationary bicycle, and an elliptical trainer (±arm movement). Each participant underwent HR monitoring with an electrocardiogaphic chest strap monitor (Polar H7), forearm monitor (Scosche Rhythm+), and two randomly assigned wrist-worn HR monitors (Apple Watch, Fitbit Blaze, Garmin Forerunner 235, and TomTom Spark Cardio), one on each wrist. For each exercise type, HR was recorded at rest, light, moderate, and vigorous intensity. Agreement between HR measurements was assessed using Lin's concordance correlation coefficient (rc). RESULTS: Across all exercise conditions, the chest strap monitor (Polar H7) had the best agreement with ECG (rc = 0.996) followed by the Apple Watch (rc = 0.92), the TomTom Spark (rc = 0.83), and the Garmin Forerunner (rc = 0.81). Scosche Rhythm+ and Fitbit Blaze were less accurate (rc = 0.75 and rc = 0.67, respectively). On treadmill, all devices performed well (rc = 0.88-0.93) except the Fitbit Blaze (rc = 0.76). While bicycling, only the Garmin, Apple Watch, and Scosche Rhythm+ had acceptable agreement (rc > 0.80). On the elliptical trainer without arm levers, only the Apple Watch was accurate (rc = 0.94). None of the devices was accurate during elliptical trainer use with arm levers (all rc < 0.80). CONCLUSION: The accuracy of wearable, optically based HR monitors varies with exercise type and is greatest on the treadmill and lowest on elliptical trainer. Electrode-containing chest monitors should be used when accurate HR measurement is imperative.

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Authors: GILLINOV, S., ETIWY, M., WANG, R., BLACKBURN, G., PHELAN, D., GILLINOV, A. M., HOUGHTALING, P., JAVADIKASGARI, H., & DESAI, M. Y.
Affiliations: Cleveland Clinic (US)
ORCID: GILLINOV, STEPHEN
ETIWY, MUHAMMAD
PHELAN, DERMOT
GILLINOV, A. MARC
JAVADIKASGARI, HODA
DESAI, MILIND Y.
Venue: Medicine & Science in Sports & Exercise
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2017-08
Volume: 49
Issue: 8
Pages: 1697-1703
ISSN: 0195-9131 (ISSN-L)
DOI: 10.1249/mss.0000000000001284
OpenAlex: W2597782088
Cited by: 345
References: 15
Citations by year: 2026: 23 · 2025: 30 · 2024: 28 · 2023: 52 · 2022: 42 · 2021: 52 · 2020: 49 · 2019: 35 · 2018: 28 · 2017: 4
FWCI: 14.27
Type: journal article
Language: en
Open access: closed
Locations: Medicine & Science in Sports & Exercise (publishedVersion)
PubMed (publishedVersion)
Topics: Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Keywords: wearable heart rate monitor, heart rate accuracy, aerobic exercise, wrist-worn devices, treadmill exercise, stationary cycling, elliptical trainer, exercise intensity, Apple Watch, Fitbit
MeSH terms: Adult, Equipment Design, Female, Heart, Humans, Male, Prospective Studies, Exercise, Electrocardiography, Ambulatory, Optical Phenomena

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Variable Accuracy of Wearable Heart Rate Monitors during Aerobic Exercise

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