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Measuring Heart Rate Variability Using Commercially Available Devices in Healthy Children: A Validity and Reliability
Kathryn E Speer1,2, Stuart Semple1,2, Nenad Naumovski3
1Faculty of Health, Discipline of Sport and Exercise Science/University of Canberra, Canberra (ACT) 2617, Australia.
Insights
A finger photoplethysmography (PPG) system was not valid for measuring pediatric heart rate variability (HRV). The Polar H10 sensor demonstrated reliable HRV measurements in young children for real-world educational settings.
Area of Science:
- Pediatric cardiology
- Autonomic nervous system function
- Biomedical engineering
Background:
- Heart rate variability (HRV) is crucial for assessing autonomic nervous system activity and cardiovascular health.
- Validating wearable technology for pediatric HRV measurement is essential for real-world applications.
- Existing research often focuses on adult populations, leaving a gap in pediatric validation.
Purpose of the Study:
- To evaluate the validity and reliability of a commercial finger photoplethysmography (PPG) system for measuring heart rate variability (HRV) in healthy young children.
- To compare the performance of the PPG system against a validated heart rate (HR) sensor (Polar H10) against the electrocardiogram (ECG) gold standard.
- To determine the suitability of the PPG system for pediatric HRV assessment in a real-world educational environment.
Main Methods:
- Sixteen healthy children (aged ~4 years) participated in the study.
- Simultaneous resting R-R interval recordings were obtained using a finger PPG system and a Polar H10 HR sensor.
- Data were collected over three days in a school setting, with validity assessed via paired t-tests and Bland-Altman analyses, and reliability calculated using ICCs and TEM%.
Main Results:
- The finger PPG system demonstrated no valid HRV parameters when compared to the gold standard.
- The Polar H10 sensor exhibited moderate to good relative reliability (ICCs = 0.84 for specific parameters).
- The Polar H10 showed superior absolute reliability, with low temporal error measurements (TEM% < 12%).
Conclusions:
- The commercial finger PPG system is not recommended for accurate pediatric HRV measurement in real-world settings.
- The Polar H10 HR sensor is a reliable and valid tool for measuring HRV in young children within educational environments.
- Further research may be needed to develop accurate PPG-based HRV monitoring solutions for pediatric populations.
Abstract:
Heart rate variability (HRV) is an accepted method for determining autonomic nervous system activity and cardiovascular risk in various populations. This study assessed the validity and reliability of a commercially available finger photoplethysmography (PPG) system for measuring pediatric HRV in a real-world setting. Sixteen healthy children (4.06 ± 0.58 years) were recruited. The PPG system was compared to the Polar H10 heart rate (HR) sensor validated against ECG (gold standard) for HRV measurement. Seated short-term resting R-R intervals were recorded simultaneously using both systems. Recordings were performed on 3 days at the participants' school. Paired t-tests, effect sizes and Bland-Altman analyses determined the validity of the PPG system. The relative and absolute reliability of both systems were calculated. No HRV parameters were valid for the PPG system. Polar H10 yielded moderate (0.50-0.75) to good (0.75-0.90) relative reliability with R-R intervals and the standard deviation of instantaneous and continuous R-R variability ratio showing the best results (ICCs = 0.84). Polar H10 displayed better absolute reliability with the root mean square of successive differences, R-R intervals and HR showing the lowest values (TEM% < 12%). The use of the Polar H10 and not the PPG system is encouraged for HRV measurement of young children in an educational real-world setting.
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