Feasibility of Commercial Heart Rate Monitors During Group Rehabilitation for Adults With Acquired Brain Injury: Implications for Inclusive Wearable Design

Objective To describe the feasibility of using commercially available chest strap heart rate monitors to collect data for heart rate variability analysis in adults with chronic acquired brain injury (ABI) during group-based exercise interventions. Design Feasibility study embedded within a pilot randomized controlled trial. Setting University classrooms with interventions designed for community-dwelling adults. Participants Ten adults (N=10) with chronic ABI (mean age ± SD, 64±15 years). All participants had self-reported moderate or greater balance impairments and were unable to participate in mainstream (ie, nonadapted) exercise classes. Interventions Participants engaged in group adaptive yoga or low-intensity exercise twice weekly for 8 weeks. Main Outcome Measures Feasibility benchmarks for data acquisition and data quality of heart rate recordings. Results Heart rate data were obtained from 8 of 10 participants; however, only 34% of sessions were successfully recorded. Despite protocol modifications, feasibility benchmarks were not met. Of the recorded sessions, only 9 files met the predefined data quality criteria. Barriers included device setup complexity, synchronization issues, and participant-level physical and cognitive challenges. Conclusions Commercially available chest strap monitors were not feasible for collecting high-quality heart rate data during group exercise sessions for adults with chronic ABI. These findings highlight critical gaps in the accessibility and usability of wearable monitoring technologies and underscore the need for inclusive device design and validation in clinical populations.