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Related Experiment Video

Updated: Aug 9, 2025

Assessing the Accuracy of Fitness Smartwatch Data for Cardiovascular and Physical Activity Monitoring: A Validation Study in Digital Health
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Are Activity Wrist-Worn Devices Accurate for Determining Heart Rate during Intense Exercise?

Pilar Martín-Escudero1, Ana María Cabanas2, María Luisa Dotor-Castilla3

  • 1Professional Medical School of Physical Education and Sport, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain.

Bioengineering (Basel, Switzerland)
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Summary

Popular wrist-worn devices show varying accuracy in heart rate (HR) monitoring during exercise. While reliable at low intensities, some devices underestimate HR during high-intensity workouts, necessitating cautious interpretation of data.

Keywords:
accuracydigital healthexercise prescriptionheart ratemedical devicesmonitoringphotopletismographyphysical exertionwearables

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Area of Science:

  • Sports Medicine
  • Biomedical Engineering
  • Wearable Technology

Background:

  • The rapid growth of the wrist-worn device market necessitates accuracy assessments.
  • Limited studies evaluate wearable sensor accuracy across diverse populations and activities.
  • Understanding wearable sensor performance is crucial for sports medicine applications.

Purpose of the Study:

  • To evaluate the accuracy of popular wrist-worn devices for heart rate (HR) monitoring.
  • To compare HR measurements from Fitbit Charge, Apple Watch, Tomtom Runner Cardio, and Samsung G2 against electrocardiogram (ECG) gold standard.
  • To assess device performance across different exercise intensities.

Main Methods:

  • Comparative study involving eight athletes undergoing maximal stress testing.
  • Simultaneous recording of HR data from four wrist-worn devices and continuous ECG.
  • Analysis of 1,286 paired HR data points.

Main Results:

  • All four devices demonstrated reasonable accuracy at low activity levels.
  • Fitbit Charge and Samsung G2 tended to underestimate HR during high-intensity exercise.
  • Apple Watch and Tomtom Runner Cardio showed greater reliability across exercise intensities.

Conclusions:

  • HR estimations from wrist-worn devices should be interpreted cautiously, especially at high intensities (above 150 bpm).
  • Further research and potential interventions are needed to ensure accurate HR readings during intense physical activity.
  • Researchers must evaluate wrist-worn technology to understand its impact on health, particularly during strenuous exercise.