Accuracy of Wrist-Worn Photoplethysmography Devices at Measuring Heart Rate in the Laboratory and During Free-Living Activities

This study compared heart rate (HR) measurements taken from two wrist-worn devices; the Empatica E4 and the Apple Watch Series 5, to that taken from a Polar H10 chest strap. Ten healthy adult volunteers took part in a laboratory validation study and performed a treadmill exercise protocol. A single-subject validity study was also conducted to evaluate the accuracy of continuous HR measurements obtained during free-living activities. The participant wore both wrist devices, as well as the Polar H10 for 12-hours, as she continued her habitual daily activities. The key findings of the laboratory study were that the Apple Watch was accurate at assessing HR compared to the Polar H10 with Mean Absolute Percentage Error (MAPE) values < 5% during treadmill exercise. The accuracy of the E4 however was generally poor with MAPE values > 15%. Findings from the single-subject validity study indicate that the Apple Watch produces accurate measurements of HR, whereas the E4 device overestimated HR, except for during the more strenuous activities undertaken where HR was underestimated.Clinical Relevance— The Apple Watch has acceptable accuracy in measuring HR during treadmill exercise and during free-living activities in healthy adult volunteers.