Key result
High tightening of the wristband significantly improved the accuracy of the wrist photoplethysmography heart-rate monitor compared to normal tightening, reducing the coefficient of variation from 16.1% to 8.1% during treadmill exercise.
Why the study?
The accuracy of heart rate measured with a wrist photoplethysmography monitor can be influenced by wristband tightening, arm movement, or signal kinetics, but these hypotheses needed testing against ECG signals.
Does the tightness of a wrist photoplethysmography monitor affect its heart rate measurement accuracy compared to ECG during exercise?
Cross-Sectional (n=30)
Randomized sequence
No
Does the tightness of a wrist photoplethysmography monitor affect its heart rate measurement accuracy compared to ECG during exercise?
High tightening of wrist photoplethysmography monitors is required to achieve high heart rate measurement accuracy during exercise.
Tighter wristband fit may enhance photoplethysmography accuracy during exercise; leaves open need for prospective validation before changing device protocols.
PURPOSE: The accuracy of heart rate measured with a wrist photoplethysmography monitor can be influenced by the tightening of the wristband, movement of arms, or kinetics of the signal (eg, steady-state exercise vs on- and off-transients). To test these hypotheses, photoplethysmographic and electrocardiographic (ECG) signals were compared. METHODS: Thirty participants (50% female) randomly performed two 13' sequences (3' rest, 5' submaximal-intensity exercise, and 5' passive recovery) on a motorized treadmill and a bicycle ergometer. Heart rate was measured concomitantly with a 10-lead ECG, a chest-strap monitor, and 2 wrist photoplethysmography monitors (Polar Unite) with different tightening (free vs imposed at the maximum tolerable). RESULTS: The level of association (r) and coefficient of variation (CV; ie, the error of measurement) of the Polar Unite versus the 10-lead ECG is affected by the tightness of the wristband (normal vs high; r = .83 and .96, CV = 16.1 and 8.1% for the treadmill, respectively; r = .71 and .97, CV = 20.3% and 6.2% for the bicycle, respectively) by the phase of the signal (transition vs steady state; r = .90 and .97, CV = 9.0% and 7.6% for the treadmill, respectively; r = .93 and .99, CV = 7.5% and 3.1% for the bicycle, respectively) and movement of arms (treadmill vs bicycle; r = .90 and .93, CV = 9.0% and 7.5% during the transition phase, respectively; r = .97 and .99, CV = 7.6% and 3.1% during the steady-state phase, respectively). CONCLUSION: The accuracy of heart rate measured with a wrist photoplethysmography monitor is affected by the tightness of the wristband and the phase of the signal. A high tightening is required when high accuracy is expected.
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Bretonneau et al. (2023) conducted a cross-sectional in Healthy adults (n=30). High tightening of wrist photoplethysmography monitor (Polar Unite) vs. Normal tightening of wrist photoplethysmography monitor was evaluated on Coefficient of variation (CV) of heart rate measurement versus 10-lead ECG on a treadmill (p=<.01). High tightening of the wristband significantly improved the accuracy of the wrist photoplethysmography heart-rate monitor compared to normal tightening, reducing the coefficient of variation from 16.1% to 8.1% during treadmill exercise.
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