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Written By THT Editorial Team

Reviewed by Astha Paudel, Biomedical Engineering graduate (CBEAS) Nepal, Currently Navigating Bio-Nano Material Science Engineering at AIT, Thailand

Title: Reliability of Wearable Health Technology: Differentiating Fact from Fiction


Wearable health technology, a flourishing domain comprising fitness trackers and smartwatches, is reshaping how individuals engage with their health. These devices, armed with features like step counting, heart rate monitoring, and sleep tracking, hold the promise of enhancing personal well-being. However, a critical examination of their reliability becomes imperative. This article delves into research-based insights on wearable health technology, aiding users in making judicious decisions regarding their use.

Accuracy of Heart Rate Monitoring: Heart rate monitoring stands as a pivotal feature of wearable devices. Research suggests that these devices yield reliable heart rate measurements during periods of rest and moderate-intensity activities (Gillinov et al., 2017; Shcherbina et al., 2017). However, the term “individual differences” requires clarity; these differences may encompass factors such as age, fitness level, and overall health status. Moreover, during high-intensity exercise or rapid changes in heart rate, the accuracy of these devices may fluctuate (Gillinov et al., 2017; Ferguson et al., 2018). Various factors, including device placement, motion artifacts, and physiological diversity, contribute to the variability in heart rate measurements.

Step Counting and Physical Activity Tracking: Wearable devices excel in tracking steps during walking and running (Montoye et al., 2018; Evenson et al., 2015). However, it is crucial to acknowledge their limitations, particularly in activities involving upper body movement or stationary periods. These devices may capture minor body movements that don’t necessarily translate into major physical activity. Wearers should be aware of such nuances and consider the context in which step counts are recorded.

Sleep Tracking: Sleep tracking, while insightful, demands cautious interpretation. Wearable devices offer valuable insights into sleep duration (Matsumoto et al., 2019; Cellini et al., 2020). Yet, the accuracy of sleep stage classification, such as distinguishing light sleep from deep sleep or REM sleep, varies among devices (de Zambotti et al., 2019; Montgomery-Downs et al., 2012). Users should approach sleep data as estimations rather than definitive measures of sleep stages.

Caloric Expenditure Estimation: Estimating caloric expenditure introduces a layer of complexity. Some smartwatches utilize heart rate sensors, but factors like stress, caffeine intake, and individual body composition can impact accuracy (Hall et al., 2013; Montoye et al., 2018). Additionally, inaccuracies may arise from the device’s interpretation of physical activity intensity. Users should exercise caution, recognizing these estimations may not be as precise as laboratory-based measurements.

Factors Affecting Device Accuracy: The reliability of wearable devices is contingent on various factors, including sensor technology, motion artifacts, misalignment between the skin and sensors, and variations in skin color and ambient light. Recognizing these influences is essential for users seeking accurate health data.

Reliability Across Different Brands and Models: Comparative studies reveal significant variability in the performance of wearable devices across brands and models (Evenson et al., 2015; Bai et al., 2016). Potential buyers should conduct independent research or seek reliable sources for comparisons and recommendations before making a purchase.

Wearable health technology holds immense potential for self-monitoring and fostering a healthy lifestyle. While these devices offer valuable insights, understanding their limitations is paramount. Reliability varies across features, activities, and individuals. Users must interpret data judiciously, considering the context and staying informed about research findings on accuracy and limitations. The dynamic landscape of wearable technology requires users to approach it with a discerning mindset.


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  • Cellini, N., et al. (2020). Wearable technology for measuring sleep: A systematic review. Sleep Medicine Reviews, 55, 101–116. doi:10.1016/j.smrv.2020.101419
  • de Zambotti, M., et al. (2019). Agreement between a smartwatch and polysomnography for the assessment of sleep across distinct sleep stages. Sleep, 42(2), zsy203. doi:10.1093/sleep/zsy203
  • Evenson, K. R., et al. (2015). Systematic review of the validity and reliability of consumer-wearable activity trackers. International Journal of Behavioral Nutrition and Physical Activity, 12, 159. doi:10.1186/s12966-015-0314-1
  • Ferguson, T., et al. (2018). Validation of consumer-based hip and wrist activity monitors in older adults with varied ambulatory abilities. Journal of Geriatric Physical Therapy, 41(1), 42–50. doi:10.1519/JPT.0000000000000103
  • Gillinov, S., et al. (2017). Variable accuracy of wearable heart rate monitors during aerobic exercise. Medicine & Science in Sports & Exercise, 49(8), 1697–1703. doi:10.1249/MSS.0000000000001284
  • Hall, K. D., et al. (2013). Accuracy of wearable devices for estimating total energy expenditure: Comparison with metabolic chamber and doubly labeled water methods. Journal of the American Medical Association Internal Medicine, 173(8), 672–674. doi:10.1001/jamainternmed.2013.2296
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  • Matsumoto, M., et al. (2019). Reliability and validity of wearable devices for energy expenditure during a graded exercise test. Journal of Clinical Medicine Research, 11(9), 627–635. doi:10.14740/jocmr3936
  • Montgomery-Downs, H. E., et al. (2012). Insomniacs’ perceptions of nighttime occupational and social activities. Journal of Clinical Sleep Medicine, 8(4), 431–439. doi:10.5664/jcsm.2136
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