Validity of wrist-worn consumer products to measure heart rate and energy expenditure

INTRODUCTION: The ability to monitor physical activity throughout the day and during various activities continues to improve with the development of wrist-worn monitors. However, the accuracy of wrist-worn monitors to measure both heart rate and energy expenditure during physical activity is still unclear. The purpose of this study was to determine the accuracy of several popular wrist-worn monitors at measuring heart rate and energy expenditure. METHODS: Participants wore the TomTom Cardio, Microsoft Band and Fitbit Surge on randomly assigned locations on each wrist. The maximum number of monitors per wrist was two. The criteria used for heart rate and energy expenditure were a three-lead electrocardiogram and indirect calorimetry using a metabolic cart. Participants exercised on a treadmill at 3.2, 4.8, 6.4, 8 and 9.7 km/h for 3 minutes at each speed, with no rest between speeds. Heart rate and energy expenditure were manually recorded every minute throughout the protocol. RESULTS: Mean absolute percentage error for heart rate varied from 2.17 to 8.06% for the Fitbit Surge, from 1.01 to 7.49% for the TomTom Cardio and from 1.31 to 7.37% for the Microsoft Band. The mean absolute percentage error for energy expenditure varied from 25.4 to 61.8% for the Fitbit Surge, from 0.4 to 26.6% for the TomTom Cardio and from 1.8 to 9.4% for the Microsoft Band. CONCLUSION: Data from these devices may be useful in obtaining an estimate of heart rate for everyday activities and general exercise, but energy expenditure from these devices may be significantly over- or underestimated.