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Updated: May 14, 2025

Assessing the Accuracy of Fitness Smartwatch Data for Cardiovascular and Physical Activity Monitoring: A Validation Study in Digital Health
Published on: February 21, 2025
Investigation and Validation of New Heart Rate Measurement Sites for Wearable Technologies
Jumana Matouq1, Ibrahim AlSaaideh1, Oula Hatahet1
1Department of Biomedical Engineering, School of Applied Medical Sciences, German Jordanian University, Amman 11180, Jordan.
Abstract:
A recent focus has been on developing wearable health solutions that allow users to seamlessly track their health metrics during their daily activities, providing convenient and continuous access to vital physiological data. This work investigates a heart rate (HR) monitoring system and compares the HR measurement from two potential sites for foot wearable technologies. The proposed system used a commercially available photoplethysmography sensor (PPG), microcontroller, Bluetooth module, and mobile phone application. HR measurements were obtained from two anatomical sites, i.e., the dorsalis pedis artery (DPA) and the posterior tibial artery (PTA), and compared to readings from the Apple Smartwatch during standing and walking tasks. The system was validated on twenty healthy volunteers, employing ANOVA and Bland-Altman analysis to assess the accuracy and consistency of the HR measurements. During the standing test, the Bland-Altman analysis showed a mean difference of 0.08 bpm for the DPA compared to a smaller mean difference of 0.069 bpm for the PTA. On the other hand, the walking test showed a mean difference of 0.255 bpm and -0.06 bpm for the DPA and PTA, respectively. These results showed a high level of agreement between the HR measurements collected at the foot with the smartwatch measurements, with superiority for the HR measurements collected at the PTA.
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