Can wearable technology be used to approximate cardiopulmonary exercise testing metrics?

Area of Science:

• Perioperative medicine
• Biomedical engineering
• Exercise physiology

Background:

• Consumer wrist-worn activity monitors offer accessible physical activity data.
• Limited research exists on their use in perioperative risk prediction.
• This study investigates their utility in approximating formal cardiopulmonary exercise testing (CPET) metrics.

Purpose of the Study:

• To determine if wrist-worn activity monitors can accurately estimate CPET-derived metrics (anaerobic threshold, peak oxygen uptake, peak work) in high-risk surgical patients.
• To explore the role of wearable technology in pre-operative risk assessment.

Main Methods:

• Patients undergoing major elective intra-abdominal surgery and CPET were enrolled.
• Wrist-worn activity monitors (Garmin Vivosmart HR+) collected physical activity data for 7 days pre-surgery.
• International Physical Activity Questionnaire (IPAQ) data was also collected.
• Correlations and ROC curve analyses were used to compare wearable data with CPET parameters.

Main Results:

• Wearable-measured floors climbed, steps, and distance showed moderate correlations with CPET parameters (peak VO2, anaerobic threshold, peak work).
• Receiver operating characteristic (ROC) analysis indicated that wearable data could accurately approximate ventilatory equivalent for carbon dioxide (VE/VCO2) and anaerobic threshold (AUC 0.89 and 0.91, respectively).
• Models using wearable data achieved high accuracy for peak VO2 (0.93) and peak work (1.00).

Conclusions:

• Wearable device data consistently approximated CPET results, with or without IPAQ scores.
• Wearable technology holds potential for assessing physical functioning.
• These devices may play a significant role in pre-operative risk stratification.