Heart rate measurement has become one of the most widely used methods of monitoring the intensity of physical activity. The purpose of this study was to assess whether in-ear photoplethysmographic (PPG) pulse rate (PR) measurement devices represent a valid alternative to heart rate derived from electrocardiography (ECG), which is considered a gold standard. Twenty subjects (6 women, 14 men) completed one trial of graded cycling under laboratory conditions. In the trial, PR was recorded by two commercially available in-ear devices, the Dash Pro and the Cosinuss°One. They were compared to HR measured by a Bodyguard2 ECG. Validity of the in-ear PR measurement devices was tested by ANOVA, mean absolute percentage errors (MAPE), intra-class correlation coefficient (ICC), and Bland–Altman plots. Both devices achieved a MAPE ≤5%. Despite excellent to good levels of agreement, Bland–Altman plots showed that both in-ear devices tend to slightly underestimate the ECG’s HR values. It may be concluded that in-ear PPG PR measurement is a promising technique that shows accurate but imprecise results under controlled conditions. However, PPG PR measurement in the ear is sensitive to motion artefacts. Thus, accuracy and precision of the measured PR depend highly on measurement site, stress situation, and exercise.

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 (VO_2max). 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 VO_2max 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.