Accuracy of consumer-level and research-grade activity trackers in ambulatory settings in older adults

PLoS One. 2019 May 21;14(5):e0216891. doi: 10.1371/journal.pone.0216891. eCollection 2019.

Abstract

Wrist-worn activity trackers have experienced a tremendous growth lately and studies on the accuracy of mainstream trackers used by older adults are needed. This study explores the performance of six trackers (Fitbit Charge2, Garmin VivoSmart HR+, Philips Health Watch, Withings Pulse Ox, ActiGraph GT9X-BT, Omron HJ-72OITC) for estimating: steps, travelled distance, and heart-rate measurements for a cohort of older adults. Eighteen older adults completed a structured protocol involving walking tasks, simulated household activities, and sedentary activities. Less standardized activities were also included, such as: dusting, using a walking aid, or playing cards, in order to simulate real-life scenarios. Wrist-mounted and chest/waist-mounted devices were used. Gold-standards included treadmill, ECG-based chest strap, direct observation or video recording according to the activity and parameter. Every tracker showed a decreasing accuracy with slower walking speed, which resulted in a significant step under-counting. A large mean absolute percentage error (MAPE) was found for every monitor at slower walking speeds with the lowest reported MAPE at 2 km/h being 7.78%, increasing to 20.88% at 1.5 km/h, and 44.53% at 1 km/h. During household activities, the MAPE climbing up/down-stairs ranged from 8.38-19.3% and 10.06-19.01% (dominant and non-dominant arm), respectively. Waist-worn devices showed a more uniform performance. However, unstructured activities (e.g. dusting, playing cards), and using a walking aid represent a challenge for all wrist-worn trackers as evidenced by large MAPE (> 57.66% for dusting, > 67.32% when using a walking aid). Poor performance in travelled distance estimation was also evident during walking at low speeds and climbing up/down-stairs (MAPE > 71.44% and > 48.3%, respectively). Regarding heart-rate measurement, there was no significant difference (p-values > 0.05) in accuracy between trackers placed on the dominant or non-dominant arm. Concordant with existing literature, while the mean error was limited (between -3.57 bpm and 4.21 bpm), a single heart-rate measurement could be underestimated up to 30 beats-per-minute. This study showed a number of limitations of consumer-level wrist-based activity trackers for older adults. Therefore caution is required when used, in healthcare or in research settings, to measure activity in older adults.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Exercise Test*
  • Female
  • Heart Rate*
  • Humans
  • Male
  • Video Recording*
  • Walking*
  • Wearable Electronic Devices*

Grants and funding

This publication has emanated from research supported by EU H2020 funded project ProACT under grant agreement No. 689996. Aspects of this work have been supported in part by a research grant from Science Foundation Ireland (SFI) and is co-funded under the European Regional Development Fund under Grant Number 13/RC/2077. Aspects of this work have been supported in part by INTERREG NPA funded project SenDOC.