Health Tracker Optimization

By George Dudziec, PT, DPT

Health Tracker Optimization: What does that Mean?

Health tracker use has grown fast over the past several years. Examples range from Fitbit wristbands and smartwatches, to chest straps, & rings. Research is ongoing in regards to the accuracy and reliability. Of course, the technology will continue to improve this, but where does the accuracy currently stand? In 2017, a study out of Stanford University Medical School found that wristband fitness trackers measured heart rate with less than 5% error, and for calories burned they averaged an error of 27%. They noted that a person’s skin color and body mass additionally distorted the accuracy.

Illustration of a woman on a treadmill monitoring her health with a health tracker. JOI Rehab

Woman on Treadmill with Health Tracker

You can buy a health tracker ranging from $20 to $799. But if you have a smartphone, you might already have a simple health tracker and not yet realize it. For example, Apple Health, an app that’s on every iPhone, will count your steps, measure your average step length, but will not measure your heart rate or other metrics that need a sensor against your skin.

Step Counter or Pedometer

Pedometers have been around for decades, and in primitive form since the 1700s. The origin of the word “pedometer” was traced back to the Japanese device made in 1965, supposedly being a literal translation to “10,000 steps meter”. Since then, the mark of 10,000 steps has been widely accepted. Recent research has questioned if that magical number has any real merit.

Illustration of a woman on her phone counting steps. JOI Rehab

Woman on Phone Monitoring Steps

Research from 2019 had showed participants who averaged 4,400 steps per day had a 41% lower mortality rate than sedentary women who averaged 2,700 steps per day. Mortality rates continued to decline with more steps taken before plateauing at 7,500 steps per day. In addition, researchers didn’t find a clear link between stepping intensity/pace and lower mortality rates.

Heart Health and Heart Rate 

Heart rate and blood pressure monitoring is, of course, far from the insight gained from an EKG & a physician visit for heart health. For simple heart rate, wristbands have been shown to be satisfactory compared to chest strap (non-clinical) heart rate monitors. Some wearables claim to measure blood pressure, but in my opinion are likely far from accurate compared to a cuff (wrist or upper arm sphygmomanometer) that pumps up automatically during measurement. Upper arm blood pressure monitors are more accurate than the monitors that pump up at the wrist. Again, a physician’s office visit is always the most reliable in regards to heart health, and general health for that matter

Setting Movement Goals

As a physical therapist, we learn through several years of schooling how important movement is. The benefits range from maintaining heart health to improving posture and mitigating other chronic diseases. Most health tracker interfaces show you your daily step count, time in standing, calories burned, and exercise time. Additionally, they can graphically show your weekly & monthly averages or trends of those. The kind of wearable devices that are designed for outdoor distance activity can track more accurately your running, biking, skating, or walking distance and pace, via GPS within the wearable device. The capabilities of each wearable device can vary, so of course compare on manufacturers’ websites the variances between models and brands. For the elderly, and those concerned with falls, some watches can detect falls and give the user the option to call from the wearable device.

Illustration of man running with a health tracker. JOI Rehab

Man running with health Tracker

The top brands come standard with settings or modifiable guidelines that are recommended for the general population. For example, standing goal of 12 times (each for a minute) through the day and deliberate exercise 30 minutes per day. These goals can be modified and reminders can be pushed to your wearable device whenever you are off-trend or off-pace to meet the daily goal. If you have a personality type that needs goals to maintain a healthy routine, some brands and devices give you virtual “badges” for achieving daily or weekly goals, along with sharing your daily activity with friends or contacts.

AHA Fitness Guidelines 

Disclaimer: Every body is different and requires different needs. Consult your physician for guidelines specific to you. For general population’s guidelines for heart health, I like to refer to the AHA (American Heart Association) [] guidelines of:

  • Get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week.
  • Add moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) on at least 2 days per week.
  • Spend less time sitting. Even light-intensity activity can offset some of the risks of being sedentary.
  • Gain even more benefits by being active at least 300 minutes (5 hours) per week.
  • Increase amount and intensity gradually over time.
  • Children and kids have separate recommendations; consult the AHA website

Tracking your Sleep

Certain health tracker devices can detect general movement, heart rate, and oxygen levels while you sleep, in order to make estimates of your sleep quality. Personally, I do not wear my smartwatch at night and do not like to make goals for sleeping because this has had reverse effects for me in the past. Additionally, I personally found a solution of reading before bed to help me fall asleep faster. For patients that ask me about sleep quality, I usually like to find out about their caffeine intake/timing, light exposure, and routine before bed.

Sleep is important for many functions of the body, including hormone release, hormone balance, and ability to recover and control pain or stress. Consult your physician if you typically have trouble sleeping or are concerned about your sleep quality.

Health Tracker as a Tool for Fitness

Health trackers and wearable devices are really just tools. Tools to help you see where your current habits of movement are and how you can potentially improve them through reminders, goal setting, and feedback. Health trackers can come in multiple forms to help measure your step count, position or activity changes and duration, along with heart rate. My advice is to start with an affordable device within the top familiar brands, and upgrade if you later feel the need. If general health is your goal, then the technology of a health tracker or wearable is an excellent option that we take for granted in the modern age. So, start somewhere.

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Written By: George Dudziec, PT, DPT

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Association of Step Volume and Intensity With All-Cause Mortality in Older Women

Fitness trackers accurately measure heart rate but not calories burned

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