Validity of wrist-worn activity trackers for estimating VO_2max and energy expenditure

Activity trackers are a simple and mostly low-priced method to capture physiological parameters. Despite the high number of wrist-worn devices, there is a lack of scientific validation. The purpose of this study was to assess whether the activity trackers represent a valid alternative to gold-standard methods in terms of estimating energy expenditure (EE) and maximum oxygen uptake (VO2max). Twenty-four healthy subjects participated in this study. In total, five commercially available wrist-worn devices were tested with regard to their validity of EE and/or VO_2max. Estimated values were compared with indirect calorimetry. Validity of the activity trackers was determined by paired sample t-tests, mean absolute percentage errors (MAPE), Intraclass Correlation Coefficient, and Bland-Altman plots. Within the tested devices, differences in scattering in VO2max and EE could be observed. This results in a MAPE > 10% for all evaluations, except for the VO_2max-estimation of the Garmin Forerunner 920XT (7.3%). The latter significantly underestimates the VO_2max (t(23) = -2.37, p = 0.027), whereas the Garmin Vivosmart HR significantly overestimates the EE (t(23) = 2.44, p = 0.023). The tested devices did not show valid results concerning the estimation of VO_2max and EE. Hence, the current wrist-worn activity trackers are most likely not accurate enough to be used for neither purposes in sports, nor in health care applications.