title: A combined heart rate and movement sensor: proof of concept and preliminary testing study.
abstract: OBJECTIVE
  Heart rate monitoring has previously been used as a technique for measuring energy expenditure (EE) in field studies. However, the combination of heart rate monitoring with movement sensoring could have theoretical advantages compared to either method used alone. Therefore, this study was undertaken to develop and validate a new combined heart rate monitor and movement sensor instrument (HR+M) for measuring EE.
  
  
  METHODS
  The HR+M instrument is a single-piece instrument worn around the chest which records minute-by-minute heart rate and movement. Eight subjects underwent an individual calibration in which EE and heart rate were measured at rest and during a sub-maximal bicycle ergometer test. They then wore the HR+M for 24 hours in a whole-body calorimeter and underwent a standard protocol including periods of physical activity and inactivity. Minute-by-minute heart rate was converted to EE using individual calibration curves with the motion data discriminating between periods of inactivity and activity at low heart rate levels. EE was also calculated using the HRFlex method which relies on heart rate alone. Both estimates of EE were compared to EE measured in the whole-body calorimeter.
  
  
  RESULTS
  The mean percentage error of the HR+M method calculating TEE compared with the gold standard of the calorimeter measurement was 0.00% (95% CI of the mean error -0.25, 1. 25). The HRFlex method using the heart rate information alone resulted in a mean percentage error of 16.5% (95% CI of the mean error -0.57, 1.76).
  
  
  CONCLUSIONS
  This preliminary test of HR+M demonstrates its ability to estimate EE and the pattern of EE and activity throughout the day. Further validation studies in free-living individuals are necessary.
  
  
  BACKGROUND
  NJW is an MRC Clinician Scientist Fellow. KLR holds an MRC PhD scholarship.
authors.affiliation: Department of Community Medicine, Institute of Public Health, University of Cambridge, UK.
authors.forename: K
authors.initials: K
authors.lastname: Rennie
authors.forename: T
authors.initials: T
authors.lastname: Rowsell
authors.forename: S A
authors.initials: SA
authors.lastname: Jebb
authors.forename: D
authors.initials: D
authors.lastname: Holburn
authors.forename: N J
authors.initials: NJ
authors.lastname: Wareham
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002151:Calorimetry; D004734:Energy Metabolism; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D008991:Monitoring, Physiologic; D009068:Movement