Validity of Wrist-Worn photoplethysmography devices to measure heart rate: A systematic review and meta-analysis

ABSTRACT

Heart rate (HR), when combined with accelerometry, can dramatically improve estimates of energy expenditure and sleep. Advancements in technology, via the development and introduction of small, low-cost photoplethysmography devices embedded within wrist-worn consumer wearables, have made the collection of heart rate (HR) under free-living conditions more feasible. This systematic review and meta-analysis compared the validity of wrist-worn HR estimates to a criterion measure of HR (electrocardiography ECG or chest strap). Searches of PubMed/Medline, Web of Science, EBSCOhost, PsycINFO, and EMBASE resulted in a total of 44 articles representing 738 effect sizes across 15 different brands. Multi-level random effects meta-analyses resulted in a small mean difference (beats per min, bpm) of −0.40 bpm (95 confidence interval (CI) −1.64 to 0.83) during sleep, −0.01 bpm (−0.02 to 0.00) during rest, −0.51 bpm (−1.60 to 0.58) during treadmill activities (walking to running), while the mean difference was larger during resistance training (−7.26 bpm, −10.46 to −4.07) and cycling (−4.55 bpm, −7.24 to −1.87). Mean difference increased by 3 bpm (2.5 to 3.5) per 10 bpm increase of HR for resistance training. Wrist-worn devices that measure HR demonstrate acceptable validity compared to a criterion measure of HR for most common activities.

KEYWORDS:

• Heart rate
• photoplethysmography
• validity

Disclosure statement

No potential conflict of interest was reported by the authors.

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