Hung Stanley Hughwa, Serwa Kelsey, Rosenthal Gillian, Eng Janice J
Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada.
Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
PLoS One. 2025 Feb 10;20(2):e0318724. doi: 10.1371/journal.pone.0318724. eCollection 2025.
To evaluate the accuracy of a wrist-based heart rate (HR) monitor at different exercise intensities across different skin tones.
Using a cross-sectional design, we compared HR measures from the wrist-based photoplethysmography Fitbit Charge 5 to the Polar H10 chest strap at rest and during the YMCA Protocol using a recumbent cycle ergometer. Participant were grouped into three skin tone categories: light (Fitzpatrick Scale Skin Types 1+2), medium (Types 3+4), and darker skin tone (Types 5+6). HR measures using the Polar chest strap during the exercise test were categorized as <40%, 40-60%, or >60% HR reserve (HRR). Absolute error in beats per minute (bpm) between the two devices was calculated for each measure. A linear mixed effects model was used to assess interaction effects between skin tone and exercise intensity, with participants as the random effect. Bland-Altman plots were used for visual analyses.
Twenty-five participants [mean (SD): 25.8 (1.9) years old; 64% female] were included with 495 observations of simultaneous Fitbit and Polar HR recordings collected during exercise. During exercise, we observed a statistically significant interaction effect between skin tone and exercise intensity. Compared with light skin tone at <40% HRR, mean error was greater for medium skin tone at >60% HRR [mean error (95%CI): 11.8 (5.6-17.9) bpm, p<0.001] and darker skin tone at 40-60% HRR [7.6 (1.7-13.5) bpm, p = 0.011] and >60% HRR [11.7 (5.3-18.0) bpm, p<0.001].
HR measurement error using a wrist-based device was greater with increasing exercise intensity for people with darker skin tones.
评估腕式心率监测仪在不同运动强度和不同肤色人群中的准确性。
采用横断面设计，我们将基于手腕光电容积脉搏波描记法的Fitbit Charge 5的心率测量值与使用卧式自行车测力计进行YMCA方案测试时Polar H10胸带的心率测量值进行比较。参与者被分为三类肤色：浅色（菲茨帕特里克皮肤分型1+2型）、中等（3+4型）和深色（5+6型）。运动测试期间使用Polar胸带测得的心率被分类为心率储备（HRR）的<40%、40-60%或>60%。计算两种设备之间每分钟心跳数（bpm）的绝对误差。使用线性混合效应模型评估肤色和运动强度之间的交互作用，参与者作为随机效应。采用布兰德-奥特曼图进行视觉分析。
纳入了25名参与者[平均（标准差）：25.8（1.9）岁；64%为女性]，在运动期间共收集了495次Fitbit和Polar同步心率记录观察值。在运动期间，我们观察到肤色和运动强度之间存在统计学上显著的交互作用。与心率储备<40%时的浅色皮肤相比，心率储备>60%时中等肤色的平均误差更大[平均误差（95%置信区间）：11.8（5.6-17.9）bpm，p<0.001]，心率储备在40-60%时深色皮肤的平均误差更大[7.6（1.7-13.5）bpm，p = 0.011]，心率储备>60%时深色皮肤的平均误差更大[11.7（5.3-18.0）bpm，p<0.001]。
对于肤色较深的人，随着运动强度增加，使用腕式设备测量心率的误差更大。
