Colonna Giulia, Hoye Jocelyn, de Laat Bart, Stanley Gelsina, Ibrahimy Alaaddin, Tinaz Sule, Morris Evan D
Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, United States.
Department of Psychiatry, Yale University, New Haven, CT, United States.
JMIR Biomed Eng. 2023 Dec 8;8:e51515. doi: 10.2196/51515.
Parkinson disease (PD) is the second most common neurodegenerative disease, affecting approximately 1% of the world's population. Increasing evidence suggests that aerobic physical exercise can be beneficial in mitigating both motor and nonmotor symptoms of the disease. In a recent pilot study of the role of exercise on PD, we sought to confirm exercise intensity by monitoring heart rate (HR). For this purpose, we asked participants to wear a chest strap HR monitor (Polar Electro Oy) and the Fitbit Charge 4 (Fitbit Inc) wrist-worn HR monitor as a potential proxy due to its convenience. Polar H10 has been shown to provide highly accurate R-R interval measurements. Therefore, we treated it as the gold standard in this study. It has been shown that Fitbit Charge 4 has comparable accuracy to Polar H10 in healthy participants. It has yet to be determined if the Fitbit is as accurate as Polar H10 in patients with PD during rest and exercise.
This study aimed to compare Fitbit Charge 4 to Polar H10 for monitoring HR in patients with PD at rest and during an intensive exercise program.
A total of 596 exercise sessions from 11 (6 male and 5 female) participants were collected simultaneously with both devices. Patients with early-stage PD (Hoehn and Yahr ≤2) were enrolled in a 6-month exercise program designed for patients with PD. They participated in 3 one-hour exercise sessions per week. They wore both Fitbit and Polar H10 during each session. Sessions included rest, warm-up, intense exercise, and cool-down periods. We calculated the bias in the HR of the Fitbit Charge 4 at rest (5 min) and during intense exercise (20 min) by comparing the mean HR during each of the periods to the respective means measured by Polar H10 (HRFitbit - HRPolar). We also measured the sensitivity and specificity of Fitbit Charge 4 to detect average HRs that exceed the threshold for intensive exercise, defined as 70% of an individual's theoretical maximum HR. Different types of correlations between the 2 devices were investigated.
The mean bias was 1.68 beats per minute (bpm) at rest and 6.29 bpm during high-intensity exercise, with an overestimation by Fitbit Charge 4 in both conditions. The mean bias of the Fitbit across both rest and intensive exercise periods was 3.98 bpm. The device's sensitivity in identifying high-intensity exercise sessions was 97.14%. The correlation between the 2 devices was nonlinear, suggesting Fitbit's tendency to saturate at high values of HR.
The performance of Fitbit Charge 4 is comparable to Polar H10 for assessing exercise intensity in a cohort of patients with PD (mean bias 3.98 bpm). The device could be considered a reasonable surrogate for more cumbersome chest-worn devices in future studies of clinical cohorts.
帕金森病（PD）是第二常见的神经退行性疾病，影响着全球约1%的人口。越来越多的证据表明，有氧运动有助于减轻该疾病的运动和非运动症状。在最近一项关于运动对帕金森病作用的初步研究中，我们试图通过监测心率（HR）来确定运动强度。为此，我们让参与者佩戴胸带式心率监测器（Polar Electro Oy），并由于其便利性，让他们佩戴Fitbit Charge 4腕戴式心率监测器作为潜在替代设备。已证明Polar H10能提供高度准确的R-R间期测量值。因此，我们在本研究中将其视为金标准。已表明Fitbit Charge 4在健康参与者中与Polar H10具有相当的准确性。在帕金森病患者休息和运动期间，Fitbit是否与Polar H10一样准确尚待确定。
本研究旨在比较Fitbit Charge 4与Polar H10在帕金森病患者休息时和强化运动计划期间监测心率的情况。
同时使用这两种设备收集了11名（6名男性和5名女性）参与者的596次运动数据。早期帕金森病患者（Hoehn和Yahr≤2）参加了一项为帕金森病患者设计的为期6个月的运动计划。他们每周参加3次一小时的运动课程。每次课程中他们都佩戴Fitbit和Polar H10。课程包括休息、热身、高强度运动和冷却期。通过将每个时间段的平均心率与Polar H10测量的相应平均值（HRFitbit - HRPolar）进行比较，我们计算了Fitbit Charge 4在休息（5分钟）和高强度运动（20分钟）时心率的偏差。我们还测量了Fitbit Charge 4检测超过高强度运动阈值（定义为个体理论最大心率的70%）的平均心率的敏感性和特异性。研究了两种设备之间不同类型的相关性。
休息时平均偏差为每分钟1.68次心跳（bpm），高强度运动时为6.29 bpm，在两种情况下Fitbit Charge 4均高估。Fitbit在休息和高强度运动期间的平均偏差为3.98 bpm。该设备识别高强度运动课程的敏感性为97.14%。两种设备之间的相关性是非线性的，表明Fitbit在高心率值时趋于饱和。
在一组帕金森病患者中评估运动强度时，Fitbit Charge 4的性能与Polar H10相当（平均偏差3.98 bpm）。在未来临床队列研究中，该设备可被视为更笨重的胸戴式设备的合理替代物。
