Validity Evaluation of the Fitbit Charge2 and the Garmin vivosmart HR+ in Free-Living Environments in an Older Adult Cohort

Abstract

Background: Few studies have investigated the validity of mainstream wrist-based activity trackers in healthy older adults in real life, as opposed to laboratory settings.

Objective: This study explored the performance of two wrist-worn trackers (Fitbit Charge 2 and Garmin vivosmart HR+) in estimating steps, energy expenditure, moderate-to-vigorous physical activity (MVPA) levels, and sleep parameters (total sleep time [TST] and wake after sleep onset [WASO]) against gold-standard technologies in a cohort of healthy older adults in a free-living environment.

Methods: Overall, 20 participants (>65 years) took part in the study. The devices were worn by the participants for 24 hours, and the results were compared against validated technology (ActiGraph and New-Lifestyles NL-2000i). Mean error, mean percentage error (MPE), mean absolute percentage error (MAPE), intraclass correlation (ICC), and Bland-Altman plots were computed for all the parameters considered.

Results: For step counting, all trackers were highly correlated with one another (ICCs>0.89). Although the Fitbit tended to overcount steps (MPE=12.36%), the Garmin and ActiGraph undercounted (MPE 9.36% and 11.53%, respectively). The Garmin had poor ICC values when energy expenditure was compared against the criterion. The Fitbit had moderate-to-good ICCs in comparison to the other activity trackers, and showed the best results (MAPE=12.25%), although it underestimated calories burned. For MVPA levels estimation, the wristband trackers were highly correlated (ICC=0.96); however, they were moderately correlated against the criterion and they overestimated MVPA activity minutes. For the sleep parameters, the ICCs were poor for all cases, except when comparing the Fitbit with the criterion, which showed moderate agreement. The TST was slightly overestimated with the Fitbit, although it provided good results with an average MAPE equal to 10.13%. Conversely, WASO estimation was poorer and was overestimated by the Fitbit but underestimated by the Garmin. Again, the Fitbit was the most accurate, with an average MAPE of 49.7%.

Conclusions: The tested well-known devices could be adopted to estimate steps, energy expenditure, and sleep duration with an acceptable level of accuracy in the population of interest, although clinicians should be cautious in considering other parameters for clinical and research purposes.

Keywords: Fitbit; Garmin; aging; energy expenditure; fitness trackers; older adults; physical activity; sleep; wearable activity trackers; wristbands.

Conflict of interest statement

Conflicts of Interest: None declared.

©Salvatore Tedesco, Marco Sica, Andrea Ancillao, Suzanne Timmons, John Barton, Brendan O'Flynn. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 19.06.2019.

Figures

Figure 1

Placement of devices on a participant.

Figure 2

Mean absolute percentage error (MAPE) with standard deviation for each parameter and tracker. EE: energy expenditure; MVPA: moderate-to-vigorous physical activity; TST: total sleep time; WASO: wake after sleep onset.

Figure 3

Bland-Altman plots for steps.

Figure 4

Bland-Altman plots for energy expenditure.

Figure 5

Bland-Altman plots for moderate-to-vigorous physical activity.

Figure 6

Bland-Altman plots for sleep parameters. Top row: total sleep time; bottom row: wake after sleep onset.