Validation of heart rate measurements from the polar verity sense during the submaximal Ekblom-Bak test in adult individuals with obesity
DOI:
https://doi.org/10.2340/jrm.v58.44975Keywords:
Obesity, heart rate, photoplethysmogram, Polar Verity Sense, Polar H10, Ekblom-Bak cycle test, Validation, FeasibilityAbstract
Objective: To assess the validity of Polar Verity Sense, an arm-worn heart rate (HR) monitor, for measuring HR in individuals with obesity during the submaximal ergometer cycle Ekblom-Bak test.
Subjects/Patients: Adults in an inpatient rehabilitation programme for individuals with obesity.
Methods: Participants completed the Ekblom-Bak test wearing the Polar H10 chest strap and 2 Verity Sense devices on the forearm and upper arm. Statistical analyses included intraclass correlation coefficient (ICC), Lin’s concordance correlation coefficient (CCC), Bland–Altman analyses with 95% limits of agreement (LoA), and mean absolute percentage error (MAPE). Feasibility was assessed with a post-test questionnaire.
Results: 49 participants were included in the analyses of estimated maximal oxygen consumption (VO2max), while 48 were included in analyses of HR data. ICC and CCC values ranged from 0.998–0.999 between the H10 chest strap and Verity Sense measures. Small differences were observed in Bland–Altman plots. MAPE ranged from 0.46% to 0.51%. Feasibility responses from the questionnaire showed that participants preferred the Verity Sense to the H10.
Conclusion: Polar Verity Sense accurately measures HR and estimates VO2max in adults with obesity during the Ekblom-Bak test. Individuals with obesity may freely opt for either device without sacrificing accuracy during steady-state activities at low and moderate intensities. This choice may eliminate a barrier in assessing their cardiorespiratory fitness.
Downloads
References
Mayoral LP, Andrade GM, Mayoral EP, Huerta TH, Canseco SP, Rodal Canales FJ, et al. Obesity subtypes, related biomarkers & heterogeneity. Indian J Med Res 2020; 151: 11–21. DOI: https://doi.org/10.4103/ijmr.IJMR_1768_17
Kaminsky LA, Arena R, Ellingsen Ø, Harber MP, Myers J, Ozemek C, et al. Cardiorespiratory fitness and cardiovascular disease: the past, present, and future. Prog Cardiovasc Dis 2019; 62: 86–93. DOI: https://doi.org/10.1016/j.pcad.2019.01.002
Ross R, Blair SN, Arena R, Church TS, Després JP, Franklin BA, et al. Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association. Circulation 2016; 134: e653–e699. DOI: https://doi.org/10.1161/CIR.0000000000000461
Björkman F, Ekblom-Bak E, Ekblom Ö, Ekblom B. Validity of the revised Ekblom Bak cycle ergometer test in adults. Eur J Appl Physiol 2016; 116: 1627–1638. DOI: https://doi.org/10.1007/s00421-016-3412-0
Arena R, Myers J, Williams MA, Gulati M, Kligfield P, Balady GJ, et al. Assessment of functional capacity in clinical and research settings: a scientific statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention of the Council on Clinical Cardiology and the Council on Cardiovascular Nursing. Circulation 2007; 116: 329–343. DOI: https://doi.org/10.1161/CIRCULATIONAHA.106.184461
Gilgen-Ammann R, Schweizer T, Wyss T. RR interval signal quality of a heart rate monitor and an ECG Holter at rest and during exercise. Eur J Appl Physiol 2019; 119: 1525–1532. DOI: https://doi.org/10.1007/s00421-019-04142-5
Schubert MM, Clark A, De La Rosa AB. The Polar (®) OH1 optical heart rate sensor is valid during moderate-vigorous exercise. Sports Med Int Open 2018; 2: E67–e70. DOI: https://doi.org/10.1055/a-0631-0920
Hettiarachchi IT, Hanoun S, Nahavandi D, Nahavandi S. Validation of Polar OH1 optical heart rate sensor for moderate and high intensity physical activities. PLoS One 2019; 14: e0217288. DOI: https://doi.org/10.1371/journal.pone.0217288
Temko A. Accurate heart rate monitoring during physical exercises using PPG. IEEE Trans Biomed Eng 2017; 64: 2016–2024. DOI: https://doi.org/10.1109/TBME.2017.2676243
Singh N, Moneghetti KJ, Christle JW, Hadley D, Plews D, Froelicher V. Heart rate variability: an old metric with new meaning in the era of using mHealth technologies for health and exercise training guidance. Part One: Physiology and methods. Arrhythm Electrophysiol Rev 2018; 7: 193–198. DOI: https://doi.org/10.15420/aer.2018.27.2
Muggeridge DJ, Hickson K, Davies AV, Giggins OM, Megson IL, Gorely T, et al. Measurement of heart rate using the Polar OH1 and Fitbit Charge 3 wearable devices in healthy adults during light, moderate, vigorous, and sprint-based exercise: validation study. JMIR Mhealth Uhealth 2021; 9: e25313. DOI: https://doi.org/10.2196/25313
Navalta JW, Davis DW, Malek EM, Carrier B, Bodell NG, Manning JW, et al. Heart rate processing algorithms and exercise duration on reliability and validity decisions in biceps-worn Polar Verity Sense and OH1 wearables. Sci Rep 2023; 13: 11736. DOI: https://doi.org/10.1038/s41598-023-38329-w
López-Belmonte Ó, Febles-Castro A, Gay A, Cuenca-Fernández F, Arellano R, Ruiz-Navarro JJ. Validity of the polar verity sense during swimming at different locations and intensities. Scand J Med Sci Sports 2023. DOI: https://doi.org/10.1111/sms.14494
Schweizer T, Gilgen-Ammann R. Wrist-worn and arm-worn wearables for monitoring heart rate during sedentary and light-to-vigorous physical activities: device validation study. JMIR Cardio 2025; 9: e67110. DOI: https://doi.org/10.2196/67110
Schneider C, Hanakam F, Wiewelhove T, Döweling A, Kellmann M, Meyer T, et al. Heart rate monitoring in team sports: a conceptual framework for contextualizing heart rate measures for training and recovery prescription. Front Physiol 2018; 9: 639. DOI: https://doi.org/10.3389/fphys.2018.00639
Unicare. Sykelig overvekt voksen: Unicare Helsefort; 2024. Available from: https: //unicare.no/helsefort/rehabiliteringstilbud/sykelig-overvekt-voksen/
Swedish School of Sport and Health Science. The Ekblom-Bak test: GIH; 2024 [updated 12. February 2024. Available from: https: //www.gih.se/english/research/laboratories/the-astrand-laboratory/the-ekblom-bak-test
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Int J Nurs Stud 2010; 47: 931–936. DOI: https://doi.org/10.1016/j.ijnurstu.2009.10.001
Bland JM, Altman DG. Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat 2007; 17: 571–582. DOI: https://doi.org/10.1080/10543400701329422
Reddy RK, Pooni R, Zaharieva DP, Senf B, El Youssef J, Dassau E, et al. Accuracy of wrist-worn activity monitors during common daily physical activities and types of structured exercise: evaluation study. JMIR Mhealth Uhealth 2018; 6: e10338. DOI: https://doi.org/10.2196/10338
Shcherbina A, Mattsson CM, Waggott D, Salisbury H, Christle JW, Hastie T, et al. Accuracy in wrist-worn, sensor-based measurements of heart rate and energy expenditure in a diverse cohort. J Pers Med 2017; 7. DOI: https://doi.org/10.3390/jpm7020003
Navalta JW, Montes J, Bodell NG, Salatto RW, Manning JW, DeBeliso M. Concurrent heart rate validity of wearable technology devices during trail running. PLoS One 2020; 15: e0238569. DOI: https://doi.org/10.1371/journal.pone.0238569
Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 15: 155–163. DOI: https://doi.org/10.1016/j.jcm.2016.02.012
Olstad BH, Zinner C. Validation of the Polar OH1 and M600 optical heart rate sensors during front crawl swim training. PLoS One 2020; 15: e0231522. DOI: https://doi.org/10.1371/journal.pone.0231522
Mühlen JM, Stang J, Lykke Skovgaard E, Judice PB, Molina-Garcia P, Johnston W, et al. Recommendations for determining the validity of consumer wearable heart rate devices: expert statement and checklist of the INTERLIVE Network. Br J Sports Med 2021; 55: 767–779. DOI: https://doi.org/10.1136/bjsports-2020-103148
Downloads
Additional Files
Published
How to Cite
License
Copyright (c) 2026 Grete Rudi Onstad, Fredrik Klæboe Lohne , Marius Steiro Fimland
This work is licensed under a Creative Commons Attribution 4.0 International License.
All digitalized JRM contents is available freely online. The Foundation for Rehabilitation Medicine owns the copyright for all material published until volume 40 (2008), as from volume 41 (2009) authors retain copyright to their work and as from volume 49 (2017) the journal has been published Open Access, under CC-BY-NC licences (unless otherwise specified). The CC-BY-NC licenses allow third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
From 2024, articles are published under the CC-BY licence. This license permits sharing, adapting, and using the material for any purpose, including commercial use, with the condition of providing full attribution to the original publication.
