Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 28, 2021
Date Accepted: Dec 6, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Accuracy and Acceptability of Wrist-Wearable Activity Tracking Devices: A Systematic Review of the Literature.
ABSTRACT
Background:
Numerous wrist-wearable devices to measure physical activity are currently available, but little is known about how they compare in terms of acceptability and accuracy.
Objective:
We performed a systematic review of the literature to assess the acceptability (defined as the level to which a device is tolerated and used by the user) and accuracy of wrist-wearable activity trackers.
Methods:
We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) and SPORTDiscus for studies measuring physical activity in the general population, using wrist-wearable activity trackers. We screened articles for inclusion and, for included studies, reported data on the studies’ setting and population, outcome measured, and risk of bias.
Results:
65 articles were included in our review. Acceptability was more frequently measured through data availability and wearing time. Data availability was ≥ 75% for FitBit Charge HR, FitBit Flex 2, and Garmin Vivofit. The wearing time was 89% for both GENE Activ and Nike Fuelband. Accuracy was assessed for 14 different outcomes, that can be classified in the following categories: count of specific activities (including step counts), time spent being active, intensity of physical activity (including energy expenditure), heart rate, distance, and speed. Substantial clinical heterogeneity did not allow to perform a meta-analysis of the results. The outcomes assessed more frequently were step counts, heart rate, and energy expenditure. For step counts, Fitbit Charge (or Charge HR) had a MAPE < 25% across 20 studies. For heart rate, Apple watch had a MAPE < 10% in 2 studies. For energy expenditure, the MAPE > 30% for all the brands, showing poor accuracy across devices.
Conclusions:
Fitbit Charge and Charge HR were consistently shown to have a good accuracy for step counts and Apple watch for measuring heart rate. None of the tested devices proved to be accurate in measuring energy expenditure. Efforts should be made to reduce the heterogeneity between studies
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