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As wearables expand their presence in the market and their features are progressively developing, making these gadgets increasingly precise; the medical community is gradually embracing these innovations. Thus, it is essential to assess the accuracy of these devices, comparing it, for example, with more traditional methods long used in medicine, which serve as the gold standard for evaluating certain parameters. A recent interesting study (link 1) aimed to compare the ability of 6 wearables available in the market to assess heart rate (HR) with that of a typical electrocardiogram (EKG). For this purpose, individuals with a normal heart rhythm (sinus rhythm - SR) and those with a fairly common heart arrhythmia (atrial fibrillation - AF) were evaluated. These groups of people were assessed individually, comparing the performance of the devices while evaluating people at rest and during exercise.
Although no significant differences were recorded in the assessment at rest of people with SR, the difference increased when these individuals were assessed during exercise. In the case of people with AF, this difference was significant at rest, and even more so during exercise.
Although it should not be disregarded, for the purposes of this text, and considering the core of our activity, I will set aside the conclusions regarding people with AF. The difference found between the values measured by the devices and the values of the EKG in people with SR was not very significant, but it gained significance when these individuals were evaluated during physical exercise. Considering that this is probably the main goal of those who use them, it is important to take this difference into account. As professionals who frequently use these and other similar tools to assist our clients, it is up to us to stay informed about the market and, above all, to know which devices are most reliable. At the beginning of an assessment, even considering that measurements at rest are close to real values, the collection of a precise and exhaustive medical history should never be neglected. And when the need for interventions at the level of physical activity is identified, if it is prudent to conduct a more accurate cardiac evaluation at an earlier stage, the EKG should always be the method of choice (or even other prescribed methods of cardiac evaluation for our clients, if deemed necessary).
From there, and always keeping in mind the singularities of each individual, it is essential to keep in mind that, although not as precise as an EKG, the values provided serve as an essential indicator to guide the physical activity of those who seek our advice, whether in terms of improvements in activities of daily living or in sports counseling. Until there are methods that are 100% identical to the EKG, these devices are the only way to access such an important parameter in real time, allowing us to adjust our activity to the level we want at that moment.
For occasional practitioners as well as Olympic athletes, these devices are here to stay and are increasingly useful and important as allies in our quest for better performance. Have a great week! João Pedro Neto, MD
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