Wearable activity trackers have become popular for tracking individual's daily physical activity, but little information is available to substantiate the validity of these devices in step counts. Thirty-five healthy individuals completed three conditions of activity tracker measurement: walking/jogging on a treadmill, walking over-ground on an indoor track, and a 24-hour free-living condition. Participants wore 10 activity trackers at the same time for both treadmill and over-ground protocol. Of these 10 activity trackers three were randomly given for 24-hour free-living condition. Correlations of steps measured to steps observed were r = 0.84 and r = 0.67 on a treadmill and over-ground protocol, respectively. The mean MAPE (mean absolute percentage error) score for all devices and speeds on a treadmill was 8.2% against manually counted steps. The MAPE value was higher for over-ground walking (9.9%) and even higher for the 24-hour free-living period (18.48%) on step counts. Equivalence testing for step count measurement resulted in a significant level within ±5% for the Fitbit Zip, Withings Pulse, and Jawbone UP24 and within ±10% for the Basis B1 band, Garmin VivoFit, and SenseWear Armband Mini. The results show that the Fitbit Zip and Withings Pulse provided the most accurate measures of step count under all three different conditions (i.e. treadmill, over-ground, and 24-hour condition), and considerable variability in accuracy across monitors and also by speeds and conditions.

Wearable trackers that detect sleep offer users a way to track their sleep quality and patterns without the use of expensive equipment. Few studies have tested the validity of these trackers on sleep measure. PURPOSE: To examine the validity of the Actigraph GT9X (AG), SenseWear Mini Armband (SW), Basis Peak (BP), Fitbit Charge HR (FB), Jawbone UP3 (JU), and Garmin Vivosmart (GV) for estimating sleep variables as compared with a sleep diary. METHODS: 78 healthy individuals participated in the study. Group 1 (n= 38) and wore the AG, SW, BP, and FB or Group 2 (n = 40) and wore the AG, JU, and GV. Monitors were worn on the non-dominant arm for 3 nights and a sleep log was completed. Sleep variables were total sleep time (TST), time in bed (TIB), sleep efficiency (SE), and wake after sleep onset (WASO). Pearson correlation, mean absolute percentage errors (MAPE), equivalence testing, Bland-Altman plots, and ANOVA were used to assess validity compared with the diary. RESULTS: Overall, monitors that showed the greatest correlation with the sleep diary for TST were the JU and FB (effect size= 0.09 and 0.23, respectively). The greatest correlation with the sleep diary for TIB was seen with the SW, GV, and JU (effect size= 0.09, 0.16, and 0.07, respectively). SE and WASO showed very poor correlation with the log. Measures for equivalence testing confirmed the success of the JU, SW, FB, and GV for measureing TIB and TST. CONCLUSION: The FB, SW, JU, and GV could be valid measure of TST and TIB. The monitors are not valid regarding wake times during sleep. Further research is needed to validate these monitors with polysomnography.

Fitness trackers are devices or applications for monitoring and tracking fitness-related met-rics such as distance walked or run, calorie consumption, quality of sleep and heart rate. Since accurate heart rate monitoring is essential in fitness training, the objective of this study was to assess the accuracy and precision of the Fitbit Charge 2 for measuring heart rate with respect to a gold standard electrocardiograph. Fifteen healthy participants were asked to ride a stationary bike for 10 minutes and their heart rate was simultaneously recorded from each device. Results showed that the Fitbit Charge 2 underestimates the heart rate. Although the mean bias in measuring heart rate was a modest-5.9 bpm (95% CI:-6.1 to-5.6 bpm), the limits of agreement, which indicate the precision of individual measurements , between the Fitbit Charge 2 and criterion measure were wide (+16.8 to-28.5 bpm) indicating that an individual heart rate measure could plausibly be underestimated by almost 30 bpm.

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