Validation of Aerobic Capacity (VO2max) and Pulse Oximetry in Wearable Technology

Abstract

Introduction: As wearable technology becomes increasingly popular and sophisticated, independent validation is needed to determine its accuracy and potential applications. Therefore, the purpose of this study was to evaluate the accuracy (validity) of VO2max estimates and blood oxygen saturation measured via pulse oximetry using the Garmin fēnix 6 with a general population participant pool. Methods: We recruited apparently healthy individuals (both active and sedentary) for VO2max (n = 19) and pulse oximetry testing (n = 22). VO2max was assessed through a graded exercise test and an outdoor run, comparing results from the Garmin fēnix 6 to a criterion measurement obtained from a metabolic system. Pulse oximetry involved comparing fēnix 6 readings under normoxic and hypoxic conditions against a medical-grade pulse oximeter. Data analysis included descriptive statistics, error analysis, correlation analysis, equivalence testing, and bias assessment, with the validation criteria set at a concordance correlation coefficient (CCC) > 0.7 and a mean absolute percentage error (MAPE) < 10%. Results: The Garmin fēnix 6 provided accurate VO2max estimates, closely aligning with the 15 s and 30 s averaged laboratory data (MAPE for 30 s avg = 7.05%; Lin’s concordance correlation coefficient for 30 s avg = 0.73). However, it failed to accurately measure blood oxygen saturation (BOS) under any condition or combined analysis (MAPE for combined conditions BOS = 4.29%; Lin’s concordance correlation coefficient for combined conditions BOS = 0.10). Conclusion: While the Garmin fēnix 6 shows promise for estimating the VO2max, reflecting its utility for both individuals and researchers, it falls short in accurately measuring BOS, limiting its application for monitoring acclimatization and managing pulmonary diseases. This research underscores the importance of validating wearable technology to leverage its full potential in enhancing personal health and advancing public health research.