Validation of photoplethysmography as a method to detect heart rate during rest and exercise
Abstract
Despite their enhanced marketplace visibility, validity of wearable photoplethysmographic heart rate monitoring is scarce. Forty-seven healthy participants performed seven, 6-min exercise bouts and completed a valid skin type scale. Participants wore an Omron HR500U (OHR) and a Mio Alpha (MA), two commercial wearable photoplethysmographic heart rate monitors. Data were compared to a Polar RS800CX (PRS). Means and error were calculated between devices using minutes 2-5. Compared to PRS, MA data was significantly different in walking, biking (2.41 ± 3.99 bpm and 3.26 ± 11.38 bpm, p < 0.05) and weight lifting (23.30 ± 31.94 bpm, p < 0.01). OHR differed from PRS in walking (4.95 ± 7.53 bpm, p < 0.05) and weight lifting (4.67 ± 8.95 bpm, p < 0.05). MA during elliptical, stair climbing and biking conditions demonstrated a strong correlation between jogging speed and error (r = 0.55, p < 0.0001), and showed differences in participants with less photosensitive skin.
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PPG sensors used to measure HR are liable to poor accuracy during activities with increased physical exertion or activities involving repetitive contractions of forearm skeletal muscles.
“Prior research has suggested that PPG sensors used to measure the HR are liable to poor accuracy during activities with increased physical exertion or activities involving repetitive contractions of forearm skeletal muscles [36-38].”
From Accuracy of Wrist-Worn Activity Monitors During Common Daily Physical Activities and Types of Structured Exercise: Evaluation Study (2018) · cites this paper as [38]
The remaining two of the ten included studies observed mixed results across different wearable devices.
“The remaining two studies showed mixed results.”
From Accuracy of heart rate measurement with wrist-worn wearable devices in various skin tones: a systematic review (2023) · cites this paper as [16]
Spierer et al. found that the Mio Alpha device had a higher mean average error in Fitzpatrick 6 patients compared to Fitzpatrick 1 patients (16 beats/min compared to 3 beats/min).
“Spierer et al. found that one of the two devices tested (Mio Alpha) had a higher mean average error in Fitzpatrick 6 patients compared to Fitzpatrick 1 patients (16 beats/min compared to 3 beats/min, respectively) [16].”
From Accuracy of heart rate measurement with wrist-worn wearable devices in various skin tones: a systematic review (2023) · cites this paper as [16]
Heart rate measurement error increases with activity intensity for the Omron HR-500U and Mio Alpha when jogging, stair climbing, and using the stationary bike.
“Investigators have found that heart rate measurement error increases with activity intensity for the Omron HR-500U and Mio Alpha when jogging, stair climbing, and using the stationary bike [21].”
From Estimating Accuracy at Exercise Intensities: A Comparative Study of Self-Monitoring Heart Rate and Physical Activity Wearable Devices (2017) · cites this paper as [21]
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- Authors
- Spierer, D. K., Rosen, Z., Litman, L. L., & Fujii, K.
- Affiliations
- Long Island University (US)
- New York Medical College (US)
- Lander University (US)
- Omron (Japan) (JP)
- Corresponding author
- Spierer, David K.
- Venue
- Journal of Medical Engineering & Technology
- Publisher
- Informa UK Limited
- Published
- 2015-06-26
- Volume
- 39
- Issue
- 5
- Pages
- 264-271
- ISSN
- 0309-1902 (ISSN-L)
- 1464-522X
- OpenAlex
- W2119121237
- Cited by
- 139
- References
- 40
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 9 · 2023: 9 · 2022: 11 · 2021: 19 · 2020: 14 · 2019: 21 · 2018: 21 · 2017: 15 · 2016: 5 · 2015: 1
- FWCI
- 6.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Medical Engineering & Technology (publishedVersion)
- PubMed (publishedVersion)
- Touro Scholar (Touro College) (submittedVersion)
- Funders
- Omron Healthcare
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- photoplethysmography, wearable heart rate monitor, heart rate response to exercise, device comparison, walking, cycling, weightlifting
- MeSH terms
- Adult, Algorithms, Diagnosis, Computer-Assisted, Equipment Design, Female, Heart Rate, Humans, Male, Motor Activity, Rest, Sensitivity and Specificity, Reproducibility of Results, Exercise, Photoplethysmography, Monitoring, Ambulatory, Equipment Failure Analysis, Actigraphy
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