Cardiac patients perception of continuous heart rate monitoring by commercially available heart rate monitors for physical activity follow-up

Abstract Background The introduction of wearable heart rate monitors (HRMs) could enable continuous, transmural and objective physical activity (PA) tracking. Wrist-worn devices and heart rate (HR) straps seem particularly interesting for this application. However, patients’ attitudes towards wearing these devices for prolonged periods and acknowledging their use as PA monitors are unknown. Aims To determine how adult participants perceive the long-term wearing and usage of commercially available HRMs for PA follow-up. Methods A prospective study was conducted in which participants wore both a Fitbit Inspire 2 activity tracker and a Polar H10 chest strap throughout the study, with an average duration of 12 weeks. Participants from three groups were included: cardiac rehabilitation (CR) patients, healthy volunteers and recreational athletes. The Fitbit was worn continuously, whereas the Polar was worn once for 24 hours at the start of the study and afterwards only during PA. On completion of the study, participants filled in two self-developed questionnaires assessing the everyday use of the devices, rating their attitude towards different usage scenarios on 10-point scales (8 questions for continuous Fitbit and 4 for non-continuous Polar). Results A total of 122 participants (72.1% male; 48.3±13.7 years old), completed the questionnaires after device usage for 12.8±1.8 weeks. Overall satisfaction was high for both devices (Fitbit: 7.2±1.9; Polar: 8.4±1.5). Participants reported significantly higher satisfaction with the Polar device than the Fitbit (p.05). No significant differences in satisfaction were found between the groups (p=.084 and .409 respectively). Participants reported minimal hindrance from the Fitbit during daily activities like household chores and working (1.5±1.8), even less during exercise (0.9±1.4), and minimal hindrance during sleep (1.8±2.2). Fitbit was perceived as easy to charge (9.2±1.3) and synchronise (8.6±1.9). The majority (62.3%) were willing to wear the Fitbit either permanently or for a period longer than 6 months, while 25.4% would prefer not to wear a Fitbit long-term (mainly due to insufficient screen readability). Regarding the Polar H10 chest strap, participants experienced minimal inconvenience during exercise (1.4±1.7) and found recording through the Polar Beat application easy (8.3±2.1). CR participants noted a significantly increased motivation to perform PA from the use of the Polar chest strap beyond their usual levels as compared to the healthy participants/athletes (p =.017). A similar trend was noted for Fitbit, although it was not statistically significant (p=.069). Conclusions Adult participants demonstrated overall positive attitudes and experiences with continuous HR monitoring using both devices. Satisfaction scores were high for both devices, reflecting minimal issues to wear these devices in daily usage scenarios and when performing PA.