Abstract
IntroductionPhysiological monitoring of soldiers can indicate combat readiness and performance. Despite demonstrated use of wearable devices for HR monitoring, commercial options lack desired military features. A newly developed OMNI monitor includes desired features such as long-range secure data transmission. This study investigated the accuracy of the OMNI to measure HR via accuracy of R-R interval duration relative to research-grade ECG and commercial products.Methods54 healthy individuals (male/female=37/17, age=22.2±3.6 years, height=173.0±9.1 cm, weight=70.1±11.2 kg) completed a submaximal exercise test while wearing a reference ECG (Biopac) and a randomly assigned chest-based monitor (OMNI, Polar H10, Equivital EQ-02, Zephyr Bioharness 3). All participants also wore two wrist-based photoplethysmography (PPG) devices, Garmin fēnix 6 and Empatica E4. Bland-Altman analyses of agreement, concordance correlation coefficient (CCC) and root-mean-squared error (RMSE) were used to determine accuracy of the OMNI and commercial devices relative to Biopac. Additionally, a linear mixed-effects model evaluated the effects of device and exercise intensity on agreement.ResultsChest-based devices showed superior agreement with Biopac for measuring R-R interval compared with wrist-based ones in terms of mean bias, CCC and RMSE, with OMNI demonstrating the best scores on all metrics. Linear mixed-effects model showed no significant main or interaction effects for the chest-based devices. However, significant effects were found for Garmin and Empatica devices (p<0.001) as well as the interaction effects between both Garmin and Empatica and exercise intensity (p<0.001).ConclusionsChest-based ECG devices are preferred to wrist-based PPG devices due to superior HR accuracy over a range of exercise intensities, with the OMNI device demonstrating equal, if not superior, performance to other commercial ECG monitors. Additionally, wrist-based PPG devices are significantly affected by exercise intensity as they underestimate HR at low intensities and overestimate HR at high intensities.
Funder
U.S. Naval Research Laboratory
Reference30 articles.
1. Friedl KE , Buller MJ , Tharion WJ , et al . Real time physiological status monitoring (RT-PSM): accomplishments, requirements, and research roadmap. ARMY RESEARCH INST OF ENVIRONMENTAL MEDICINE NATICK MA BIOPHYSICS AND BIOMEDICAL MODELING DIV; 2016.
2. Typology of “Fatigue” by Heart Rate Variability Analysis in Elite Nordic-skiers
3. Seshadri DR , Li RT , Voos JE , et al . Wearable sensors for monitoring the internal and external workload of the athlete. NPJ Digit Med 2019;2:71. doi:10.1038/s41746-019-0149-2
4. Accuracy of wrist-worn heart rate monitors;Wang;JAMA Cardiol,2017
5. Military applications of soldier physiological monitoring;Friedl;J Sci Med Sport,2018