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. 2020 Sep 8;8(9):e18694.
doi: 10.2196/18694.

Reliability and Validity of Commercially Available Wearable Devices for Measuring Steps, Energy Expenditure, and Heart Rate: Systematic Review

Daniel Fuller #  1   2   3 , Emily Colwell #  1 , Jonathan Low #  1 , Kassia Orychock  1 , Melissa Ann Tobin  4 , Bo Simango  1 , Richard Buote  4 , Desiree Van Heerden  5 , Hui Luan  6 , Kimberley Cullen  1   3 , Logan Slade  4 , Nathan G A Taylor  7
Affiliations

Reliability and Validity of Commercially Available Wearable Devices for Measuring Steps, Energy Expenditure, and Heart Rate: Systematic Review

Daniel Fuller et al. JMIR Mhealth Uhealth. .

Abstract

Background: Consumer-wearable activity trackers are small electronic devices that record fitness and health-related measures.

Objective: The purpose of this systematic review was to examine the validity and reliability of commercial wearables in measuring step count, heart rate, and energy expenditure.

Methods: We identified devices to be included in the review. Database searches were conducted in PubMed, Embase, and SPORTDiscus, and only articles published in the English language up to May 2019 were considered. Studies were excluded if they did not identify the device used and if they did not examine the validity or reliability of the device. Studies involving the general population and all special populations were included. We operationalized validity as criterion validity (as compared with other measures) and construct validity (degree to which the device is measuring what it claims). Reliability measures focused on intradevice and interdevice reliability.

Results: We included 158 publications examining nine different commercial wearable device brands. Fitbit was by far the most studied brand. In laboratory-based settings, Fitbit, Apple Watch, and Samsung appeared to measure steps accurately. Heart rate measurement was more variable, with Apple Watch and Garmin being the most accurate and Fitbit tending toward underestimation. For energy expenditure, no brand was accurate. We also examined validity between devices within a specific brand.

Conclusions: Commercial wearable devices are accurate for measuring steps and heart rate in laboratory-based settings, but this varies by the manufacturer and device type. Devices are constantly being upgraded and redesigned to new models, suggesting the need for more current reviews and research.

Keywords: Apple Watch; Fitbit; Garmin; Polar; commercial wearable devices; energy expenditure; heart rate; step count; systematic review.

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Conflict of interest statement

Conflicts of Interest: Author JL was employed by Garmin Inc. during the publication process but after completion of the paper. All other authors have no conflicts to declare.

Figures

Figure 1
Figure 1
PRISMA flow chart for systematic review of the reliability and validity of commercial wearable devices.
Figure 2
Figure 2
Number of studies published per year by measurement type. EE: energy expenditure; HR: heart rate; SC: step count.
Figure 3
Figure 3
Line graph of studies published per year by device brand.
Figure 4
Figure 4
Mean percentage error (MPE) plots by study sample size for step count, heart rate, and energy expenditure. The solid black line represents zero. The solid grey line represents average MPE for all data points. The dashed grey lines represent the 95% CIs.
Figure 5
Figure 5
Box plots representing mean percentage error (MPE) for steps, heart rate, and energy expenditure by device brand for devices with 10 or more comparisons.
Figure 6
Figure 6
Box plots representing mean percentage error (MPE) for steps, heart rate, and energy expenditure by device brand and model for devices with 10 or more comparisons.
See this image and copyright information in PMC

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