Key result
Ring-type wearable sensors show high HR validity and acceptable HRV performance with condition-dependent lateral differences.
Why the study?
Evidence regarding the measurement validity and potential lateral differences of ring-type wearable sensors for continuous HR and HRV monitoring remains limited.
Are ring-type wearable sensors valid for monitoring heart rate and heart rate variability compared to Holter ECG, and are there lateral differences between hands?
Are ring-type wearable sensors valid for monitoring heart rate and heart rate variability compared to Holter ECG, and are there lateral differences between hands?
Ring-type wearable sensors provide valid heart rate and acceptable heart rate variability monitoring during rest and low activity, though minor condition-dependent lateral differences exist.
Ring sensors may support resting HR monitoring; leaves open HRV standardization across hands and conditions.
Ring-type wearable sensors are increasingly used for continuous monitoring of heart rate (HR) and heart rate variability (HRV); however, evidence regarding their measurement validity and potential lateral differences remains limited. This study aimed to evaluate (1) the validity of HR and HRV obtained from ring-type photoplethysmography (PPG) sensors under multiple activity conditions (Experiment 1), and (2) the presence of lateral differences in autonomic indices when worn on the left versus right hand (Experiment 2). In Experiment 1, HR and HRV indices from the ring sensor were compared with those from a Holter electrocardiogram (ECG) and a wrist device during rest, low activity, and moderate activity. Mixed-model analysis revealed significant differences in very low frequency (VLF) power between the left- and right-hand rings (p = 0.001). Additionally, significant interactions between device side and measurement condition were observed for HR and low-frequency (LF) components, indicating that lateral differences were condition-dependent. In Experiment 2, participants wore two ring sensors simultaneously to assess left–right discrepancies under rest and exercise conditions. The SDPP index showed a significant difference (p = 0.017), with mean values differing between Rest and Exercise, demonstrating condition-related variability but limited systematic lateral bias. Overall, ring-type wearable sensors demonstrated high validity for HR and acceptable performance for selected HRV metrics during rest and low-activity states. While some condition-dependent lateral differences emerged for specific HRV parameters, the practical impact on overall measurement performance remained modest. These findings support the utility of ring-type wearable devices for autonomic monitoring while highlighting the importance of considering activity level and side–condition interactions.
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Yuda et al. (2025) studied this question. Ring-type wearable sensors showed high validity for heart rate and acceptable performance for HRV, with condition-dependent lateral differences observed.
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