Dustin's mHealth Corner: Kickstart my Heart(rate)

Dustin’s mHealth Corner: Kickstart my Heart(rate)

In this post Matthew Middlebrooks (@middleman05) and I continue the discussion Chad Cruse (@bfstcruse) and I started in my last post, mHealth Corner:  Battle of the (wrist) Bands. During the month of June, we wore one of the best selling wearable wristbands on the market. In addition to the things that are standard in most wearable bands—sleep tracking, pedometer, alarm—this device has a real-time heart rate monitor and a display that allows you to check your daily data without having to look at the partner app on your phone. The display allows the device to act more like a smartwatch, plus it also shows the time and gives incoming call notifications—quite a step up from last month!

Is a wrist the best place to monitor your heart?

Wristband wearables monitor your heart rate using lights that track your blood flow. The band illuminates your capillaries with green LEDs, and then a sensor next to the LEDs measures the frequency of the blood pumping past it. For normal use, the band Chad and I wore should be loosely worn approximately one finger width above the wrist bone, and during intense exercise, it should be moved to approximately three finger widths above the wrist bone and secured tightly to obtain a more accurate reading. Placing the band into exercise mode continuously monitors heart rate compared to the intermittent method used in normal mode.

Even when worn as instructed, wristband devices aren’t guaranteed to be accurate though.  Variables such as movement, skin tone, body hair, tattoo ink and sweat can affect the heart rate reading. For example, on a fair skinned person in a very bright setting, the LED lights can become washed out, which can cause an inaccurate reading. Some wristbands require you to be perfectly still to get an accurate reading.

The wristband fake out

 I think that the wrist also presents accuracy issues when tracking steps and movement. This device asks you to specify which arm you wear it on to account for more or less movement depending on which hand is your dominant one, but in my experience, this didn’t matter. On my first day wearing the band I hopped on my cyclocross bike for a 25-mile ride on a local greenway that’s a mix of pavement, gravel and dirt roads. I was extremely excited to see what kind of tracking data I would get from the band. It was disappointing.

I had only been wearing the band for two hours prior to the ride, and after completing it, the wristband and its companion mobile app logged 17,000 steps, 34 flights of stairs and a couple of thousand calories burned. This data, along with data from my Strava cycling app, was pushed to the MyFitnessPal app, which promptly told me that I needed to immediately consume 8000 calories to avoid certain death—ok… I’m kidding about the death part, but I knew enough about my day to know that this was bad data. To make sure this wasn’t just a fluke I kept wearing the band, but after a few more rides on different bikes through various terrains, I saw similar inaccurate data patterns. I had to stop wearing the band on rides as the data recorded was throwing my daily data out of balance.

Even pop culture has picked up on these inaccuracies.  In season one, episode two of the Netflix animated series Bojack Horseman, Bojack decides to improve his life by starting to run. He puts on his headphones, sets his wearable wristband (similar to the one I’m writing about) to exercise mode, and then takes off running. He almost immediately stops, due to exhaustion. The scene then cuts to him, still wearing his running gear, in the office of a companion. He proudly tells her that he has started jogging again, and when asked if he ran to her office, he responded, “Well I drove here, but I moved my arm a bunch so the wristband counted the miles.” This is definitely in line with my experience!

That said, I do think that the resting heart rate information was relatively accurate, based on what I already knew about my data from a previous analysis. My resting heart rate averaged in the low 50s over the month that I wore the band, and dipped into the low 40s a few times when calmly sitting at my desk. The device was also a great conversation piece. In the office or at social outings, we would hold friendly “who has the lowest heart rate” competitions, which always led to a fun conversation about wearables and fitness.

How wearing a wristband influenced behavior

Speaking of competition, let’s take a look at how Matthew and I used this month’s wearable to push us through several different sports and workouts.

  1. What activities did you participate in?
    • Matthew:  Running, biking, weightlifting, high intensity training and yoga
    • Dustin:  Running, cycling, weightlifting, basketball, kickball, and yoga 
  2. Did you change your workout habits?
    • Matthew:  I incorporated some interval training, which I haven’t done in quite some time. This made for major fluctuations in heart rate, which I focused on when reviewing the performance of the wristband.
    • Dustin:  I ran more than usual with this device so I do think that my habits changed even though I was more reverting back to old habits rather than starting new ones.
  3. Did you eat better?
    • Matthew:  I did tighten up my diet this month with higher protein intake and high carbs in the mornings. I also increased my water consumption and only allowed myself one cheat day per week.
    • Dustin:  Although MyFitnessPal told me to eat way more due to false data push, I escaped that trap and didn’t really change my diet. High protein, moderate carbs and cheat days incorporated into the days I do longer bike rides are standard for me.
  4. Did you sleep more?
    • Matthew:  I didn’t sleep more, but I noticed much more REM sleep without tossing and turning. I’m typcially an uneasy sleeper. However, by adding yoga and some changes to my diet, I found that I slept much better and without sporadic movement.
    • Dustin:  I found this wristband to be much more comfortable than last month’s so I don’t think that I slept more, but I do think that I slept more soundly. Like Matthew, I’m not the best sleeper, and a wristband alone can’t solve that—at least not yet.
  5. How was the overall experience? Would you wear this band post trial?
    • Matthew:  I enjoyed wearing the device and think it allows for some great functionality for the standard user. I am a watch lover and found that the device was relatively the same size on my non-watch wrist, which wasn’t ideal from a comfort standpoint. I did find that the water resistance was pretty solid. I’m a sweater and that has been an issue with other headphones and devices that I’ve tried. This one required simple cleaning every few days and worked perfectly. The ability to view my heart rate really allowed me to fine tune my aerobic activity to maximize the focus of my workouts and made a difference in efficiency during workouts and running. The companion app’s dashboard was simple and easy to understand, and it allowed me to engage with more of my own health data, which was a major focus of mine with the device. I plan to continue to wear the device while still testing others to find one that has additional functionality, data and comfort.
    • Dustin:  I liked this device much more than last month’s. It looked better, was more comfortable and had more features. I do think that there are some pretty big accuracy issues with it, but not wearing it while cycling did seem to decrease those. The problem is that I’m searching for the wearable that does everything while I’m doing everything or the one that has perfect integration with other apps that I use. I decided not to continue wearing this wristband and I passed it down to another Benefitstore associate. While I think it could be a great device for many people, it didn’t meet my personal needs.

It looks like we have a split decision this month. Matthew enjoyed this wearable and saw some improvement, while I wasn’t a huge fan.  I think a big part of my dissatisfaction was that I was relying heavily on data that was gathered from the wearable to be synced with other apps for the big picture aspect of my day/week. Integration is a huge feature that will continue to be referenced in my posts because, until there is a wearable that is 100 percent effective at monitoring all types of activity and data points, people will need to use several apps or devices to achieve their goals. My current belief is that we’re a long way out from a wearable that does it all, and the most successful wearable will be the one that cleanly and accurately integrates with apps designed to be the expert at one thing.

Look forward to my next post where the wristband trend continues, but with a different approach. Four Benefitstore associates who have no experience with wearables will join me to test one of the cheapest wristbands available— straight from China—and we’ll report on our experience.

Bonus: The average person’s resting heart rate is 60-100 beats per minute. A lower rate generally implies more efficient heart function and better cardiovascular fitness, but extremes on either end could be the sign of an underlying problem and should be checked by a doctor.

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