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Updated: Aug 3, 2026

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Reliability and validity of the combined heart rate and movement sensor Actiheart
1MRC Epidemiology Unit, Institute of Public Health, University of Cambridge, CB1 9NL,UK. soren.brage@mrc-epid.cam.ac.uk
Unlabelled:
Accurate quantification of physical activity energy expenditure is a key part of the effort to understand disorders of energy metabolism. The Actiheart, a combined heart rate (HR) and movement sensor, is designed to assess physical activity in populations.
Objective:
To examine aspects of Actiheart reliability and validity in mechanical settings and during walking and running.
Methods:
In eight Actiheart units, technical reliability (coefficients of variation, CV) and validity for movement were assessed with sinusoid accelerations (0.1-20 m/s(2)) and for HR by simulated R-wave impulses (25-250 bpm). Agreement between Actiheart and ECG was determined during rest and treadmill locomotion (3.2-12.1 km/h). Walking and running intensity (in J/min/kg) was assessed with indirect calorimetry in 11 men and nine women (26-50 y, 20-29 kg/m(2)) and modelled from movement, HR, and movement + HR by multiple linear regression, adjusting for sex.
Results:
Median intrainstrument CV was 0.5 and 0.03% for movement and HR, respectively. Corresponding interinstrument CV values were 5.7 and 0.03% with some evidence of heteroscedasticity for movement. The linear relationship between movement and acceleration was strong (R(2) = 0.99, P < 0.001). Simulated R-waves were detected within 1 bpm from 30 to 250 bpm. The 95% limits of agreement between Actiheart and ECG were -4.2 to 4.3 bpm. Correlations with intensity were generally high (R(2) > 0.84, P < 0.001) but significantly highest when combining HR and movement (SEE < 1 MET).
Conclusions:
The Actiheart is technically reliable and valid. Walking and running intensity may be estimated accurately but further studies are needed to assess validity in other activities and during free-living.
Sponsorship:
The study received financial support from the Wellcome Trust and SB was supported by a scholarship from Unilever, UK.
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