VALIDATION OF SMARTPHONE FREE HEART RATE MONITORING APPLICATION DURING TREADMILL EXERCISE

Jaafar, Zulkarnain; Murugan, Aravind Kumar

doi:10.1590/1517-869220192502200793

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Revista Brasileira de Medicina do Esporte

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Original Article, Cardiology • Rev Bras Med Esporte 25 (2) • Mar-Apr 2019 • https://doi.org/10.1590/1517-869220192502200793 copy

VALIDATION OF SMARTPHONE FREE HEART RATE MONITORING APPLICATION DURING TREADMILL EXERCISE

VALIDAÇÃO DE APLICATIVO GRATUITO DE SMARTPHONE PARA MONITORAMENTO DA FREQUÊNCIA CARDÍACA DURANTE EXERCÍCIO EM ESTEIRA

VALIDACIÓN DE APLICACIÓN GRATUITA DE SMARTPHONE PARA MONITORIZACIÓN DE LA FRECUENCIA CARDÍACA DURANTE EJERCICIO EN CINTA

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

The number of people participating in leisure sports activities and amateur competitions has been rising sharply. Free smartphone heart rate monitoring applications are readily available for use; however, information on their accuracy during exercise is still limited. Therefore, the purpose of our study was to validate a smartphone free heart rate monitoring application during treadmill exercise in healthy individuals.

Methods:

This was a prospective experimental study testing the free heart rate app 'INSTANT HEART RATE: AZUMIO.' Twenty-seven healthy participants were requested to perform the treadmill task with four different workloads: walking at 2.0 mph, walking at 3.5 mph, jogging at 4.5 mph and running at 6.0 mph. Participants had to perform the exercises for 3 minutes for each workload, and heart rates were recorded using the smartphone app and ECG at rest, during the exercise and recovery periods at each 60-second interval.

Results:

Heart rates measured using the free smartphone app at rest, walking at 2.0 mph, brisk walking at 3.5 mph, slow jogging at 4.5 mph and recovery stage were accurate with correlation coefficient value ≥0.95 and standard error of estimate <1 bpm. However, the correlation values during running at 6 mph were inconsistent with a standard error of estimate >5 bpm.

Conclusion:

The free smartphone app that we tested accurately estimates heart rate at rest, during low to moderate intensity exercise and the recovery period, but becomes less consistent during high-intensity exercise, making this app suitable for use during indoor activities of low to moderate intensity. Level of evidence II; Diagnostic Studies - Investigating a diagnostic test.

Keywords:
Validation, software; Heart rate; Smartphone; Exercise

Stage of exercise	Smartphone App Mean ± SD	ECG Mean ± SD	Mean Different	Standard estimation error (SEE)	p-value
Stage resting
0 min	77.81 ±11.86	77.81 ±11.86	-	0.001^{^} ^ SEE was significant if value ≤ 5.	-
1 min	77.59 ±13.05	77.52 ±13.08	0.074	0.270^{^} ^ SEE was significant if value ≤ 5.	0.161^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
2 min	78.00 ±12.28	78.04 ±12.29	0.037	0.196^{^} ^ SEE was significant if value ≤ 5.	0.327^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
Stage 1 (2 mph)
3 min	87.41 ±10.71	87.41 ±10.71	0.037	0.001^{^} ^ SEE was significant if value ≤ 5.	0.327^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
4 min	91.19 ±11.93	91.19 ±11.93	0.074	0.001^{^} ^ SEE was significant if value ≤ 5.	0.161^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
5 min	92.59 ±12.93	92.59 ±12.93	0.037	0.001^{^} ^ SEE was significant if value ≤ 5.	0.574^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
Stage 2 (3.5 mph)
6 min	100.52 ±12.42	100.48 ±12.35	0.037	0.185^{^} ^ SEE was significant if value ≤ 5.	0.327^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
7 min	106.26 ±13.08	106.26 ±13.08	-	0.001^{^} ^ SEE was significant if value ≤ 5.	-
8 min	110.33 ±13.22	110.30 ±13.18	0.037	0.328^{^} ^ SEE was significant if value ≤ 5.	0.574^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
Stage 3 (4.5 mph)
9 min	121.15 ±11.54	121.15 ±11.54	0.074	0.272^{^} ^ SEE was significant if value ≤ 5.	0.161^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
10 min	130.63 ±12.51	130.41±12.36	0.222	0.901^{^} ^ SEE was significant if value ≤ 5.	0.207^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
11 min	137.63±11.54	137.41 ±11.73	0.222	0.923^{^} ^ SEE was significant if value ≤ 5.	0.227^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
Stage 4 (6 mph)
12 min	148.00 ±9.66	147.26 ±10.20	0.742	1.365^{^} ^ SEE was significant if value ≤ 5.	0.015
13 min	146.93 ±17.00	154.78 ±9.71	7.851	16.48	0.075^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
14 min	153.30±22.93	162.07 ±8.88	8.778	22.830	0.095^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
Stage Recovery
15 min	135.07±10.00	135.11 ±9.943	0.037	0.188^{^} ^ SEE was significant if value ≤ 5.	0.327^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
16 min	120.07 ±8.22	120.15 ±8.26	0.074	0.392^{^} ^ SEE was significant if value ≤ 5.	0.327^* * Smartphone app heart rate were equal to ECG reading if p>0.05.
17 min	106.07 ±9.01	105.89 ±9.01	0.185	0.978^{^} ^ SEE was significant if value ≤ 5.	0.327^* * Smartphone app heart rate were equal to ECG reading if p>0.05.

Stage of exercise	Correlation coefficient (r) of Heart rate smartphone app and Heart rate ECG	Pearson Correlation Sig. (2-tailed)
Stage resting
0 min	1.000^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
1 min	1.000^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
2min	1.000^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
Stage 1 (2 mph)
3 min	1.000^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
4 min	1.000^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
5 min	1.000^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
Stage 2 (3.5 mph)
6 min	1.000^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
7 min	1.000^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
8 min	1.000^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
Stage 3 (4.5 mph)
9 min	1.000^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
10 min	0.998^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
11 min	0.997^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
Stage 4 (6 mph)
12 min	0.990^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
13 min	0.310	0.116
14 min	0.217	0.277
Stage Recovery
15 min	1.000^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
16 min	0.999^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.
17 min	0.994^{^^} ^^ correlation coefficient was significant if value ≥ 0.90.	0.001^ p-value was significant if value <0.05.

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[1] Correspondence Zulkarnain Jaafar, Sports Medicine Unit, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur. Malaysia. zulkarnainj@um.edu.my