Usefulness of Modern Activity Trackers for Monitoring Exercise Behavior in Chronic Cardiac Patients: Validation Study
Open accessAbstract
Background: Improving physical activity (PA) is a core component of secondary prevention and cardiac (tele)rehabilitation. Commercially available activity trackers are frequently used to monitor and promote PA in cardiac patients. However, studies on the validity of these devices in cardiac patients are scarce. As cardiac patients are being advised and treated based on PA parameters measured by these devices, it is highly important to evaluate the accuracy of these parameters in this specific population. Objective: The aim of this study was to determine the accuracy and responsiveness of 2 wrist-worn activity trackers, Fitbit Charge 2 (FC2) and Mio Slice (MS), for the assessment of energy expenditure (EE) in cardiac patients. Methods: EE assessed by the activity trackers was compared with indirect calorimetry (Oxycon Mobile [OM]) during a laboratory activity protocol. Two groups were assessed: patients with stable coronary artery disease (CAD) with preserved left ventricular ejection fraction (LVEF) and patients with heart failure with reduced ejection fraction (HFrEF). Results: A total of 38 patients were included: 19 with CAD and 19 with HFrEF (LVEF 31.8%, SD 7.6%). The CAD group showed no significant difference in total EE between FC2 and OM (47.5 kcal, SD 112 kcal; P=.09), in contrast to a significant difference between MS and OM (88 kcal, SD 108 kcal; P=.003). The HFrEF group showed significant differences in EE between FC2 and OM (38 kcal, SD 57 kcal; P=.01), as well as between MS and OM (106 kcal, SD 167 kcal; P=.02). Agreement of the activity trackers was low in both groups (CAD: intraclass correlation coefficient [ICC] FC2=0.10, ICC MS=0.12; HFrEF: ICC FC2=0.42, ICC MS=0.11). The responsiveness of FC2 was poor, whereas MS was able to detect changes in cycling loads only. Conclusions: Both activity trackers demonstrated low accuracy in estimating EE in cardiac patients and poor performance to detect within-patient changes in the low-to-moderate exercise intensity domain. Although the use of activity trackers in cardiac patients is promising and could enhance daily exercise behavior, these findings highlight the need for population-specific devices and algorithms.
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Many validation studies have questioned the accuracy of raw sensor data and software algorithms.
“Many validation studies have questioned the accuracy of raw sensor data and software algorithms92–94.”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [94]
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Smart wearable devices in cardiovascular care: Where we are and how to move forward
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- Authors
- Herkert, C., Kraal, J. J., van Loon, E. M. A., van Hooff, M., & Kemps, H. M. C.
- Corresponding author
- Herkert, Cyrille
- ORCID
- Venue
- JMIR mHealth and uHealth
- Publisher
- JMIR Publications Inc.
- Published
- 2019-12-19
- Volume
- 7
- Issue
- 12
- Pages
- e15045
- ISSN
- 2291-5222 (ISSN-L)
- PMC
- PMC6940867
- OpenAlex
- W2995874039
- Cited by
- 19
- References
- 39
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 2
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR mhealth and uhealth (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
- Keywords
- wearable activity trackers, energy expenditure, cardiac patients, heart failure with reduced ejection fraction, coronary artery disease, device validation, indirect calorimetry, cardiac rehabilitation, secondary prevention
- MeSH terms
- Fitness Trackers, Wearable Electronic Devices, Aged, Calorimetry, Indirect, Coronary Artery Disease, Energy Metabolism, Female, Heart Diseases, Heart Failure, Humans, Male, Middle Aged, Monitoring, Physiologic, Stroke Volume, Exercise, Case-Control Studies, Ventricular Function, Left, Validation Studies as Topic
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