Resting heart rate definition and its effect on apparent levels of physical activity in young children

Heart rate monitoring is widely used to measure physical activity in children, but it may be dependent on the definition of resting heart rate used and the protocol used to measure or derive resting heart rate (RHR). The aim of this study was to determine the effect of RHR definition on activity levels assessed by PAHR-25 (% time at >25% of RHR), PAHR-50 (% time at >50% of RHR), and activity heart rate (AHR; mean HR minus RHR).

Minute-to-minute heart rates were measured over 3 d in 20 healthy preschool children aged 3-4 yr. Resting heart rate was measured for 5 min after a 10-min rest and was also derived from the following different but commonly used protocols: 1) mean of lowest heart rate plus all heart rates within three beats; 2) mean of lowest 5; 3) lowest 10; 4) lowest 50. This gave five different definitions of RHR. Differences in RHR and in the derived indices of activity among definitions were tested for agreement using a Bland-Altman analysis, and by rank order correlation.

Differences in RHR among all definitions were statistically significant. These resulted in significant differences in apparent physical activity levels: PAHR-25 varied 10-50% depending on the protocol used to define RHR; PAHR-50 varied by 16-65% as a function of the protocol used to define RHR. However, the different definitions of RHR had no significant influence on physical activity level when children were rank ordered.

Choice of method for defining RHR has a profound effect on the apparent level of activity of children. This does not alter the relative assessment of activity by rank order. A consensus definition of RHR is desirable if comparisons of activity levels between samples or populations are to be made and if the adequacy of physical activity levels is to be assessed using heart rate.