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Reliability and validity of the combined heart rate and movement sensor Actiheart

European Journal of Clinical Nutrition volume 59, pages 561–570 (2005)Cite this article

Abstract

Accurate quantification of physical activity energy expenditure is a key part of the effort to understand disorders of energy metabolism. The Actiheart, a combined heart rate (HR) and movement sensor, is designed to assess physical activity in populations.

Objective:

To examine aspects of Actiheart reliability and validity in mechanical settings and during walking and running.

Methods:

In eight Actiheart units, technical reliability (coefficients of variation, CV) and validity for movement were assessed with sinusoid accelerations (0.1–20 m/s2) and for HR by simulated R-wave impulses (25–250 bpm). Agreement between Actiheart and ECG was determined during rest and treadmill locomotion (3.2–12.1 km/h). Walking and running intensity (in J/min/kg) was assessed with indirect calorimetry in 11 men and nine women (26–50 y, 20–29 kg/m2) and modelled from movement, HR, and movement+HR by multiple linear regression, adjusting for sex.

Results:

Median intrainstrument CV was 0.5 and 0.03% for movement and HR, respectively. Corresponding interinstrument CV values were 5.7 and 0.03% with some evidence of heteroscedasticity for movement. The linear relationship between movement and acceleration was strong (R2=0.99, P<0.001). Simulated R-waves were detected within 1 bpm from 30 to 250 bpm. The 95% limits of agreement between Actiheart and ECG were −4.2 to 4.3 bpm. Correlations with intensity were generally high (R2>0.84, P<0.001) but significantly highest when combining HR and movement (SEE<1 MET).

Conclusions:

The Actiheart is technically reliable and valid. Walking and running intensity may be estimated accurately but further studies are needed to assess validity in other activities and during free-living.

Sponsorship:

The study received financial support from the Wellcome Trust and SB was supported by a scholarship from Unilever, UK.

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References

  • Ainslie P, Reilly T & Westerterp K (2003): Estimating human energy expenditure: a review of techniques with particular reference to doubly labelled water. Sports Med. 33, 683–698.

    Article  Google Scholar 

  • Albanes D, Conway JM, Taylor PR, Moe PW & Judd J (1990): Validation and comparison of eight physical activity questionnaires. Epidemiology 1, 65–71.

    Article  CAS  Google Scholar 

  • Alfonzo-Gonzalez G, Doucet E, Almeras N, Bouchard C & Tremblay A (2004): Estimation of daily energy needs with the FAO/WHO/UNU 1985 procedures in adults: comparison to whole-body indirect calorimetry measurements. Eur. J. Clin. Nutr. 58, 1125–1131.

    Article  CAS  Google Scholar 

  • Andrews RB (1971): Net heart rate as a substitute for respiratory calorimetry. Am. J. Clin. Nutr. 24, 1139–1147.

    Article  CAS  Google Scholar 

  • Atkinson G & Nevill AM (1998): Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports Med. 26, 217–238.

    Article  CAS  Google Scholar 

  • Avons P, Garthwaite P, Davies HL, Murgatroyd PR & James WP (1988): Approaches to estimating physical activity in the community: calorimetric validation of actometers and heart rate monitoring. Eur. J. Clin. Nutr. 42, 185–196.

    CAS  PubMed  Google Scholar 

  • Bassett Jr DR, Ainsworth BE, Swartz AM, Strath SJ, O'Brien WL & King GA (2000): Validity of four motion sensors in measuring moderate intensity physical activity. Med. Sci. Sports Exerc. 32, S471–S480.

    Article  Google Scholar 

  • Bland JM & Altman DG (1986): Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1, 307–310.

    Article  CAS  Google Scholar 

  • Boudet G & Chamoux A (2000): Heart rate monitors and abnormal heart rhythm detection. Arch. Physiol. Biochem. 108, 371–379.

    Article  CAS  Google Scholar 

  • Brage S, Brage N, Franks PW, Ekelund U, Wong MY, Andersen LB Froberg K & Wareham N (2004): Branched equation modeling of simultaneous accelerometry and heart rate monitoring improves estimate of directly measured physical activity energy expenditure. J. Appl. Physiol. 96, 343–351.

    Article  Google Scholar 

  • Brage S, Brage N, Wedderkopp N & Froberg K (2003a): Reliability and validity of the Computer Science and Applications accelerometer in a mechanical setting. Meas. Phys. Edu. Exerc. Sci. 7, 101–119.

    Article  Google Scholar 

  • Brage S, Wedderkopp N, Andersen LB & Froberg K (2003b): Influence of step frequency on movement intensity predictions with the CSA accelerometer: a field validation study in children. Ped. Exerc. Sci. 15, 277–287.

    Article  Google Scholar 

  • Brage S, Wedderkopp N, Franks PW, Andersen LB & Froberg K (2003c): Reexamination of validity and reliability of the CSA monitor in walking and running. Med Sci. Sports Exerc. 35, 1447–1454.

    Article  Google Scholar 

  • Cavagna GA, Franzetti P, Heglund NC & Willems P (1988): The determinants of the step frequency in running, trotting and hopping in man and other vertebrates. J. Physiol. (Lond) 399, 81–92.

    Article  CAS  Google Scholar 

  • Cavagna GA & Kaneko M (1977): Mechanical work and efficiency in level walking and running. J. Physiol. (Lond) 268, 647–681.

    Article  Google Scholar 

  • Cavagna GA, Thys H & Zamboni A (1976): The sources of external work in level walking and running. J. Physiol. (Lond) 262, 639–657.

    Article  CAS  Google Scholar 

  • Ceesay SM, Prentice AM, Day KC, Murgatroyd PR, Goldberg GR, Scott W & Spurr GB (1989): The use of heart rate monitoring in the estimation of energy expenditure: a validation study using indirect whole-body calorimetry. Br. J. Nutr. 61, 175–186.

    Article  CAS  Google Scholar 

  • Cole CR, Blackstone EH, Pashkow FJ, Snader CE & Lauer MS (1999): Heart-rate recovery immediately after exercise as a predictor of mortality. N. Engl. J. Med. 341, 1351–1357.

    Article  CAS  Google Scholar 

  • Ekelund U, Aman J & Westerterp K (2003): Is the ArteACC Index a valid indicator of free-living physical activity in adolescents? Obes. Res. 11, 793–801.

    Article  Google Scholar 

  • Freedson PS, Melanson E & Sirard J (1998): Calibration of the Computer Science and Applications, Inc. accelerometer. Med. Sci. Sports Exerc. 30, 777–781.

    Article  CAS  Google Scholar 

  • Godsen R, Carroll T & Stone S (1991): How well does Polar Vantage XL heart rate monitor estimate actual heart rate? Med. Sci. Sports Exerc. 23, S14.

    Google Scholar 

  • Haskell WL, Yee MC, Evans A & Irby PJ (1993): Simultaneous measurement of heart rate and body motion to quantitate physical activity. Med. Sci. Sports Exerc. 25, 109–115.

    Article  CAS  Google Scholar 

  • Hausswirth C, Bigard AX & Le Chevalier JM (1997): The Cosmed K4 telemetry system as an accurate device for oxygen uptake measurements during exercise. Int. J. Sports Med. 18, 449–453.

    Article  CAS  Google Scholar 

  • Haymes EM & Byrnes WC (1993): Walking and running energy expenditure estimated by Caltrac and indirect calorimetry. Med. Sci. Sports Exerc. 25, 1365–1369.

    Article  CAS  Google Scholar 

  • Hendelman D, Miller K, Baggett C, Debold E & Freedson P (2000): Validity of accelerometry for the assessment of moderate intensity physical activity in the field. Med. Sci. Sports Exerc. 32, S442–S449.

    Article  CAS  Google Scholar 

  • Hiilloskorpi HK, Pasanen ME, Fogelholm MG, Laukkanen RM & Manttari AT (2003): Use of heart rate to predict energy expenditure from low to high activity levels. Int. J. Sports Med. 24, 332–336.

    Article  CAS  Google Scholar 

  • Jakicic JM, Winters C, Lagally K, Ho J, Robertson RJ & Wing RR (1999): The accuracy of the TriTrac-R3D accelerometer to estimate energy expenditure. Med. Sci. Sports Exerc. 31, 747–754.

    Article  CAS  Google Scholar 

  • Karvonen J, Chwalbinska-Monet J & Säynäjäkangas S (1984): Comparison of heart rates measured by ECG and microcomputer. Phys. Sports Med. 12, 65–69.

    Article  Google Scholar 

  • King GA, Torres N, Potter C, Brooks TJ & Coleman KJ (2004): Comparison of activity monitors to estimate energy cost of treadmill exercise. Med. Sci. Sports Exerc. 36, 1244–1251.

    Article  Google Scholar 

  • Kriska A (2000): Physical activity and the prevention of type 2 diabetes mellitus: how much for how long? Sports Med. 29, 147–151.

    Article  CAS  Google Scholar 

  • LaMonte MJ & Ainsworth BE (2001): Quantifying energy expenditure and physical activity in the context of dose response. Med. Sci. Sports Exerc. 33, S370–S378.

    Article  CAS  Google Scholar 

  • Leger L & Thivierge M (1988): Heart rate monitors: validity, stability, and functionality. Phys. Sports Med. 16, 143–151.

    Article  CAS  Google Scholar 

  • Li R, Deurenberg P & Hautvast JG (1993): A critical evaluation of heart rate monitoring to assess energy expenditure in individuals. Am. J. Clin. Nutr. 58, 602–607.

    Article  CAS  Google Scholar 

  • Livingstone MB, Prentice AM, Coward WA, Ceesay SM, Strain JJ, McKenna PG, Nevin GB, Barker ME & Hickey RJ (1990): Simultaneous measurement of free-living energy expenditure by the doubly labeled water method and heart-rate monitoring. Am. J. Clin. Nutr. 52, 59–65.

    Article  CAS  Google Scholar 

  • Luke A, Maki KC, Barkey N, Cooper R & McGee D (1997): Simultaneous monitoring of heart rate and motion to assess energy expenditure. Med. Sci. Sports Exerc. 29, 144–148.

    Article  CAS  Google Scholar 

  • Masse LC, Heesch KC, Fulton JE & Watson KB (2002): Raters' objectivity in using the compendium of physical activities to code physical activity diaries. Meas. Phys. Edu. Exerc. Sci. 6, 207–224.

    Article  Google Scholar 

  • Mazur W, Rivera JM, Khoury AF, Basu AG, Perez-Verdia A, Marks GF, Chang SM, Olmos L, Quinones MA & Zoghbi WA (2003): Prognostic value of exercise echocardiography: validation of a new risk index combining echocardiographic, treadmill, and exercise electrocardiographic parameters. J. Am. Soc. Echocardiogr. 16, 318–325.

    Article  Google Scholar 

  • McLaughlin JE, King GA, Howley ET, Bassett Jr DR & Ainsworth BE (2001): Validation of the COSMED K4 b2 portable metabolic system. Int. J. Sports Med. 22, 280–284.

    Article  CAS  Google Scholar 

  • Montoye HJ, Washburn R, Servais S, Ertl A, Webster JG & Nagle FJ (1983): Estimation of energy expenditure by a portable accelerometer. Med. Sci. Sports Exerc. 15, 403–407.

    Article  CAS  Google Scholar 

  • Moon JK & Butte NF (1996): Combined heart rate and activity improve estimates of oxygen consumption and carbon dioxide production rates. J. Appl. Physiol. 81, 1754–1761.

    Article  CAS  Google Scholar 

  • Mora S, Redberg RF, Cui Y, Whiteman MK, Flaws JA, Sharrett AR & Blumenthal RS (2003): Ability of exercise testing to predict cardiovascular and all-cause death in asymptomatic women: a 20-year follow-up of the lipid research clinics prevalence study. JAMA 290, 1600–1607.

    Article  CAS  Google Scholar 

  • Nichols JF, Morgan CG, Sarkin JA, Sallis JF & Calfas KJ (1999): Validity, reliability, and calibration of the Tritrac accelerometer as a measure of physical activity. Med. Sci. Sports Exerc. 31, 908–912.

    Article  CAS  Google Scholar 

  • Paffenbarger Jr RS, Brand RJ, Sholtz RI & Jung DL (1978): Energy expenditure, cigarette smoking, and blood pressure level as related to death from specific diseases. Am. J. Epidemiol. 108, 12–18.

    Article  Google Scholar 

  • Rennie K, Rowsell T, Jebb SA, Holburn D & Wareham NJ (2000): A combined heart rate and movement sensor: proof of concept and preliminary testing study. Eur. J. Clin. Nutr. 54, 409–414.

    Article  CAS  Google Scholar 

  • Rennie KL, Hennings SJ, Mitchell J & Wareham NJ (2001): Estimating energy expenditure by heart-rate monitoring without individual calibration. Med. Sci. Sports Exerc. 33, 939–945.

    Article  CAS  Google Scholar 

  • Rennie KL & Wareham NJ (1998): The validation of physical activity instruments for measuring energy expenditure: problems and pitfalls. Public Health Nutr. 1, 265–271.

    Article  CAS  Google Scholar 

  • Rowell LB (2004): Ideas about control of skeletal and cardiac muscle blood flow (1876–2003): cycles of revision and new vision. J. Appl. Physiol. 97, 384–392.

    Article  Google Scholar 

  • Saltin B, Lindgarde F, Houston M, Horlin R, Nygaard E & Gad P (1979): Physical training and glucose tolerance in middle-aged men with chemical diabetes. Diabetes 28 (Suppl 1), 30–32.

    Article  Google Scholar 

  • Seaward BL, Sleamaker RH, McAuliffe T & Clapp III JF (1990): The precision and accuracy of a portable heart rate monitor. Biomed. Instrum. Technol. 24, 37–41.

    CAS  PubMed  Google Scholar 

  • Sekioka K, Takaba H & Nakano T (1998): Parallel recording of physical activity on commercial Holter recorders. Front. Med. Biol. Eng. 8, 253–268.

    Google Scholar 

  • Singel DJ & Stamler JS (2004): Blood traffic control. Nature 430, 297.

    Article  CAS  Google Scholar 

  • Speakman JR (1998): The history and theory of the doubly labeled water technique. Am. J. Clin. Nutr. 68, 932S–938S.

    Article  CAS  Google Scholar 

  • Strath SJ, Bassett Jr DR & Swartz AM (2003): Comparison of MTI accelerometer cut-points for predicting time spent in physical activity. Int. J. Sports Med. 24, 298–303.

    Article  CAS  Google Scholar 

  • Strath SJ, Bassett Jr DR, Thompson DL & Swartz AM (2002): Validity of the simultaneous heart rate-motion sensor technique for measuring energy expenditure. Med. Sci. Sports Exerc. 34, 888–894.

    Article  Google Scholar 

  • Strath SJ, Bassett Jr DR, Swartz AM & Thompson DL (2001): Simultaneous heart rate-motion sensor technique to estimate energy expenditure. Med. Sci. Sports Exerc. 33, 2118–2123.

    Article  CAS  Google Scholar 

  • Strath SJ, Swartz AM, Bassett DR, O'Brien WL, King GA & Ainsworth BE (2000): Evaluation of heart rate as a method for assessing moderate intensity physical activity. Med. Sci. Sports Exerc. 32, S465–S470.

    Article  CAS  Google Scholar 

  • Tanaka H, Monahan KD & Seals DR (2001): Age-predicted maximal heart rate revisited. J. Am. Coll. Cardiol. 37, 153–156.

    Article  CAS  Google Scholar 

  • Tate DF, Jackvony EH & Wing RR (2003): Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. JAMA 289, 1833–1836.

    Article  Google Scholar 

  • Terbizan DJ, Dolezal BA & Albano C (2002): Validity of seven commercially available heart rate monitors. Meas. Phys. Edu. Exerc. Sci. 6, 243–247.

    Article  Google Scholar 

  • Treuth MS, Adolph AL & Butte NF (1998): Energy expenditure in children predicted from heart rate and activity calibrated against respiration calorimetry. Am. J. Physiol. 275, E12–E18.

    CAS  PubMed  Google Scholar 

  • Treuth MS, Schmitz K, Catellier DJ, McMurray RG, Murray DM, Almeida MJ, Going S, Norman JE & Pate R (2004): Defining accelerometer thresholds for activity intensities in adolescent girls. Med. Sci. Sports Exerc. 36, 1259–1266.

    Article  Google Scholar 

  • Uth N, Sorensen H, Overgaard K & Pedersen PK (2004): Estimation of VO2max from the ratio between HRmax and HRrest—the Heart Rate Ratio Method. Eur. J Appl. Physiol. 91, 111–115.

    Article  Google Scholar 

  • Wareham NJ, Jakes RW, Rennie KL, Mitchell J, Hennings S & Day NE (2002): Validity and repeatability of the EPIC-Norfolk Physical Activity Questionnaire. Int. J. Epidemiol. 31, 168–174.

    Article  Google Scholar 

  • Wareham NJ & Rennie KL (1998): The assessment of physical activity in individuals and populations: why try to be more precise about how physical activity is assessed? Int. J. Obes. Relat. Metab. Disord. 22 (Suppl 2), S30–S38.

    PubMed  Google Scholar 

  • Weir JB (1949): New methods for calculating metabolic rate with special reference to protein metabolism. J. Physiol. 109, 1–9.

    Article  Google Scholar 

  • Whipp BJ, Higgenbotham MB & Cobb FC (1996): Estimating exercise stroke volume from asymptotic oxygen pulse in humans. J. Appl. Physiol. 81, 2674–2679.

    Article  CAS  Google Scholar 

  • Wickstrom G & Bendix T (2000): The ‘Hawthorne effect’—what did the original Hawthorne studies actually show? Scand. J. Work Environ. Health 26, 363–367.

    Article  CAS  Google Scholar 

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Acknowledgements

We like to thank the study participants for their time and effort. Mrs S Hennings, Mrs J Mitchell, Mrs S Emms, and Mrs E Lucia-Rolfe are acknowledged for assistance with data collection. The use of commercial names in this manuscript is for information purposes only and does not imply endorsement.

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Authors and Affiliations

  1. MRC Epidemiology Unit, Institute of Public Health, University of Cambridge, UK

    S Brage, P W Franks, U Ekelund & N J Wareham

  2. Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark

    N Brage

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  1. S Brage
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Correspondence to S Brage.

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Guarantors: S Brage and NJ Wareham.

Contributors: SB and NJW designed the study and SB was responsible for data collection. SB and NB conducted the data analysis, the results of which were discussed and interpreted by all authors. SB drafted the manuscript, which was reviewed by all authors.

Conflict of interest: None to declare.

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Brage, S., Brage, N., Franks, P. et al. Reliability and validity of the combined heart rate and movement sensor Actiheart. Eur J Clin Nutr 59, 561–570 (2005). https://doi.org/10.1038/sj.ejcn.1602118

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