Validity and Reliability of a New Wearable Chest Strap to Estimate Respiratory Frequency in Elite Soccer Athletes.

Assessing respiratory frequency () is practical in monitoring training progress in competitive athletes, especially during exercise. This study aimed to validate a new wearable chest strap (wCS) to estimate against ergospirometry as a criterion device in soccer players. A total of 26 elite professional soccer players (mean [standard deviation]: 23.6 [4.8] years; 180.6 [5.7] cm; 77.2 [5.4] kg) from three Italian Serie A League teams participated in this cross-sectional study. The sample included attackers, midfielders, and defenders. was assessed during a maximal cardiopulmonary exercise test (CPET) on a treadmill using (i) a breath-by-breath gas exchange analyzer (Vyntus CPX, Vyaire Medical) and (ii) a novel wCS with sensors designed to assess breath frequency following chest expansions. Pearson's correlation coefficient (), adjusted coefficient of determination (aR), Bland-Altman plot analysis, and Lin's concordance correlation coefficient (ρ) were used for comparative analysis (correlation and concordance) among the methods. The repeated measures correlation coefficient (r) was used to assess the strength of the linear association between the methods. The intraclass correlation coefficient (ICC) and the Finn coefficient (r) were used for inter-rater reliability. All statistical analyses were performed within the R statistical computing environment, with 95% confidence intervals (95% CIs) reported and statistical significance set at < 0.05. A total of 16529 comparisons were performed after collecting the CPET data. The robust time series analysis with Hodges-Lehmann estimation showed no significant differences between both methods ( > 0.05). Correlation among devices was statistically significant and very large ( [95% CI]: 0.970 [0.970, 0.971], < 0.01; aR [95% CI]: 0.942 [0.942, 0.943], < 0.01) with strong evidence supporting consistency of the new wCS (BF > 100). In addition, a high concordance was found (ρ [95% CI]: 0.970 [0.969, 0.971], bias correction factor: 0.999). Vyntus CPX, as a standard criterion, showed moderate agreement with wCS after Bland-Altman analysis (bias [95% lower to the upper limit of agreement]; % agree: 0.170 [-4.582 to 4.923] breaths·min; 69.9%). A strong association between measurements (r [95% CI]: 0.960 [0.959, 0.961]), a high absolute agreement between methods (ICC [95% CI]: 0.970 [0.970, 0.971]), and high inter-rater reliability (r: 0.947) were found. With an RMSE = 2.42 breaths·min, the new wCS seems to be an valid and reliable in-field method to evaluate compared to a breath-by-breath gas exchange analyzer. Notwithstanding, caution is advised if methods are used interchangeably while further external validation occurs.