The effectiveness of electrocardiogram (ECG) monitors can be significantly impaired by motion artifacts which can cause misdiagnoses, lead to inappropriate treatment decisions, and trigger false alarms. Skin stretch associated with patient motion is a significant source of motion artifacts in current ECG monitoring. In this study, motion artifacts are adaptively filtered by using skin strain as the reference variable. Skin strain is measured non-invasively using a light emitting diode (LED) and an optical sensor incorporated in an ECG electrode. The results demonstrate that this device and method can significantly reduce skin strain induced ECG artifacts.