Objective To assess the accuracy of recently commercialized wearable devices in heart rate (HR) measurement during cardiopulmonary exercise test (CPX) under gradual increase in exercise intensity, while wearable devices with HR monitors are reported to be less accurate in different exercise intensities.
Methods CPX was performed for patients with coronary artery disease (CAD). Twelve lead electrocardiograph (ECG) was the gold standard and Apple watch 7 (AW7), Galaxy watch 4 (GW4) and Bio Patch Mobicare 200 (MC200) were applied for comparison. Paired absolute difference (PAD), mean absolute percentage error (MAPE) and intraclass correlation coefficient (ICC) were evaluated for each device.
Results Forty-four participants with CAD were included. All the devices showed MAPE under 2% and ICC above 0.9 in rest, exercise and recovery phases (MC200=0.999, GW4=0.997, AW7=0.998). When comparing exercise and recovery phase, PAD of MC200 and AW7 in recovery phase were significantly bigger than PAD of exercise phase (p<0.05). Although not significant, PAD of GW4 tended to be bigger in recovery phase, too. Also, when stratified by HR 20, ICC of all the devices were highest under HR of 100, and ICC decreased as HR increased. However, except for ICC of GW4 at HR above 160 (=0.867), all ICCs exceeded 0.9 indicating excellent accuracy.
Conclusion The HR measurement of the devices validated in this study shows a high concordance with the ECG device, so CAD patients may benefit from the devices during high-intensity exercise under conditions where HR is measured reliably.
Citations
Citations to this article as recorded by
Prognostic Factors for Responders of Home-Based Pulmonary Rehabilitation—Secondary Analysis of a Randomized Controlled Trial Chul Kim, Hee-Eun Choi, Chin Kook Rhee, Jae Ha Lee, Ju Hyun Oh, Jun Hyeong Song Healthcare.2025; 13(3): 308. CrossRef
Wearable Devices for Exercise Prescription and Physical Activity Monitoring in Patients with Various Cardiovascular Conditions Tasuku Terada, Matheus Hausen, Kimberley L. Way, Carley D. O’Neill, Isabela Roque Marçal, Paul Dorian, Jennifer L. Reed CJC Open.2025; 7(5): 695. CrossRef
Apple watch accuracy in monitoring health metrics: a systematic review and meta-analysis Ju-Pil Choe, Minsoo Kang Physiological Measurement.2025; 46(4): 04TR01. CrossRef
Assessment of Samsung Galaxy Watch4 PPG-Based Heart Rate During Light-to-Vigorous Physical Activities Caíque Santos Lima, Felipe Capiteli Bertocco, José Igor Vasconcelos de Oliveira, Thiago Mattos Frota de Souza, Emely Pujólli da Silva, Fernando J. Von Zuben IEEE Sensors Letters.2024; 8(7): 1. CrossRef
The Accessibility and Effect of Cardiac Rehabilitation in COVID-19 Pandemic Era Chul Kim, Jun Hyeong Song, Seung Hyoun Kim Annals of Rehabilitation Medicine.2024; 48(4): 249. CrossRef
The eTRIMP method for bodybuilding training load assessment: A review with a case study Fernandes Haniel Annals of Musculoskeletal Medicine.2023; 7(2): 016. CrossRef
Recommendations for Measurement of Bodybuilding Internal Training Load by eTRIMP Method Fernandes Haniel Journal of Sports Medicine and Therapy.2023; 8(4): 051. CrossRef
Objective To assess the accuracies and validities of popular smart bands for heart rate (HR) measurement in cardiovascular disease (CVD) patients during a graded exercise test (GXT).
Methods Seventy-eight patients were randomly assigned to wear two different smart bands out of three possible choices: Samsung Galaxy Fit 2, Xiaomi Mi Band 5, or Partron PWB-250 on each wrist. A 12-lead exercise electrocardiogram (ECG) and patch-type single-lead ECG were used to assess the comparative HR accuracy of the smart bands. The HR was recorded during the GXT using the modified Bruce protocol.
Results The concordance correlation coefficients (rc) were calculated to provide a measure of agreement between each device and the ECG. In all conditions, the Mi Band 5 and Galaxy Fit 2’ correlations were rc>0.90, while the PWB-250 correlation was rc=0.58 at rest. When evaluating the accuracy according to the magnitude of HR, all smart bands performed well (rc>0.90) when the HR was below 100 but accuracy tended to decrease with higher HR values.
Conclusion This study showed that the three smart bands had a high level of accuracy for HR measurements during low-intensity exercise. However, during moderate-intensity and high-intensity exercise, all the three smart bands performed less accurately. Further studies are needed to find a more optimal smart band for HR measurement that can be used for precise HR monitoring during formal cardiac rehabilitation exercise training, including at high and maximal intensity (Clinical Trial Registration No. cris.nih.go.kr/KCT0007036).
Citations
Citations to this article as recorded by
Validation of the Use of a Smart Band in Recording Spatiotemporal Gait Parameters in the 6-Minute Walk Test Rosa María Ortiz-Gutiérrez, José Javier López-Marcos, José Luis Maté-Muñoz, Paloma Moreta-de-Esteban, Patricia Martín-Casas Sensors.2025; 25(8): 2621. CrossRef
The Accessibility and Effect of Cardiac Rehabilitation in COVID-19 Pandemic Era Chul Kim, Jun Hyeong Song, Seung Hyoun Kim Annals of Rehabilitation Medicine.2024; 48(4): 249. CrossRef
An Evaluation of the Effect of App-Based Exercise Prescription Using Reinforcement Learning on Satisfaction and Exercise Intensity: Randomized Crossover Trial Cailbhe Doherty, Rory Lambe, Ben O’Grady, Diarmuid O’Reilly-Morgan, Barry Smyth, Aonghus Lawlor, Neil Hurley, Elias Tragos JMIR mHealth and uHealth.2024; 12: e49443. CrossRef
Women’s Involvement in Steady Exercise (WISE): Study Protocol for a Randomized Controlled Trial Irene Ferrando-Terradez, Lirios Dueñas, Ivana Parčina, Nemanja Ćopić, Svetlana Petronijević, Gianfranco Beltrami, Fabio Pezzoni, Constanza San Martín-Valenzuela, Maarten Gijssel, Stefano Moliterni, Panagiotis Papageorgiou, Yelko Rodríguez-Carrasco Healthcare.2023; 11(9): 1279. CrossRef