Abstract
A placement effect on activity measures from movement sensors has been reported during treadmill and free-living activity. Positioning of electrodes may impact on movement artifact susceptibility as well as surface ECG waveform amplitudes and thus potentially on the precision by which heart rate (HR) is ascertained from such ECG traces. The purpose of this study was to examine the extent to which placement of the combined HR and movement sensor, Actiheart, influences measurement of HR and movement, and estimates of energy expenditure. A total of 24 participants (20–39 years, 45–109 kg, 1.54–2.05 m, 19–29 kg m−2) were recruited. Whilst wearing two monitors, one placed at the level of the third intercostal space (upper position) and one just below the apex of the sternum (lower position), study participants performed level walking, incline walking, and level running on treadmill, and completed at least one day of free-living monitoring. Placement differences in HR data quality, movement counts, and energy expenditure (estimated from combined HR and movement) were analyzed with regression techniques. Quality of HR data was generally higher when monitors were placed in the lower position. This effect was more pronounced in men during both treadmill activity (relative risk, RR [95% CI] of noisy HR data in upper vs. lower position, RR=1.3[0.3; 5.6] in women, RR=174[14; 2,156] in men) and during free-living (RR=1.2[0.4; 3.3] in women, RR=25[9.6; 67] in men). There were minor placement differences (≤8%) in movement counts only in women during incline walking and running. During free-living, no placement effect on counts was observed. In all test scenarios, estimates of energy expenditure from the two positions were not significantly different. Positioning the Actiheart at the level below the sternum may yield cleaner HR data. Regardless of which position is used, this has little or no effect on movement counts and energy expenditure estimates, which is encouraging for studies where research participants may have to position the monitors themselves.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ask P, Oberg PA, Odman S, Tenland T, Skogh M (1979) ECG electrodes. A study of electrical and mechanical long-term properties. Acta Anaesthesiol Scand 23:189–206
Avons P, Garthwaite P, Davies HL, Murgatroyd PR, James WP (1988) Approaches to estimating physical activity in the community: calorimetric validation of actometers and heart rate monitoring. Eur J Clin Nutr 42:185–196
Brage S, Brage N, Franks PW, Ekelund U, Wong MY, Andersen LB, Froberg K, Wareham N (2004) Branched equation modeling of simultaneous accelerometry and heart rate monitoring improves estimate of directly measured physical activity energy expenditure. J Appl Physiol 96:343–351
Brage S, Brage N, Franks PW, Ekelund U, Wareham NJ (2005) Reliability and validity of the combined heart rate and movement sensor Actiheart. Eur J Clin Nutr 59:561–570
Burke MJ, Gleeson DT (2000) A micropower dry-electrode ECG preamplifier. IEEE Trans Biomed Eng 47:155–162
Burke MC, Song Z, Jenkins J, Alberts M, Priore JD, Arzbaecher R (2003) Analysis of electrocardiograms for subcutaneous monitors. J Electrocardiol 36:227–232
Cavagna GA, Thys H, Zamboni A (1976) The sources of external work in level walking and running. J Physiol (Lond) 262:639–657
Chang YH, Kram R (1999) Metabolic cost of generating horizontal forces during human running. J Appl Physiol 86:1657–1662
Fernandez M, Pallas-Areny R (2000) Ag–AgCl electrode noise in high-resolution ECG measurements. Biomed Instrum Technol 34:125–130
Geddes LA, Hoff HE, Hickman DM, Hinds M, Baker L (1962) Recording respiration and the electrocardiogram with common electrodes. Aeromed Acta 33:791–793
Goran MI, Poehlman ET (1992) Endurance training does not enhance total energy expenditure in healthy elderly persons. Am J Physiol Endocrinol Metab 263:E950–E957
Hagemann B, Luhede G, Luczak H (1985) Improved “active” electrodes for recording bioelectric signals in work physiology. Eur J Appl Physiol Occup Physiol 54:95–98
Haskell WL, Yee MC, Evans A, Irby PJ (1993) Simultaneous measurement of heart rate and body motion to quantitate physical activity. Med Sci Sports Exerc 25:109–115
Horan LG, Hand RC, Flowers NC, Johnson JC, Sridharan MR (1980) The influence of electrode placement in the reconstruction and analysis of body surface potential maps from limited thoracic arrays. J Electrocardiol 13:311–321
Klingler DR, Schoenberg AA, Worth NP, Egleston CF, Burkart JA (1979) A comparison of gel-to-gel and skin measurements of electrode impedance. Med Instrum 13:266–268
Li G, Lian J, Salla P, Cheng J, Ramachandra I, Shah P, Avitall B, He B (2003) Body surface Laplacian electrocardiogram of ventricular depolarization in normal human subjects. J Cardiovasc Electrophysiol 14:16–27
Moon JK, Butte NF (1996) Combined heart rate and activity improve estimates of oxygen consumption and carbon dioxide production rates. J Appl Physiol 81:1754–1761
Nash MP, Pullan AJ (2005) Challenges facing validation of noninvasive electrical imaging of the heart. Ann Noninvasive Electrocardiol 10:73–82
Olson WH, Schmincke DR, Henley BL (1979) Time and frequency dependence of disposable ECG electrode-skin impedance. Med Instrum 13:269–272
Pan J, Tompkins WJ (1985) A real-time QRS detection algorithm. IEEE Trans Biomed Eng 32:230–236
Patterson RP (1978) The electrical characteristics of some commercial ECG electrodes. J Electrocardiol 11:23–26
Rautaharju PM, Zhou SH, Calhoun HP (1994) Ethnic differences in ECG amplitudes in North American white, black, and Hispanic men and women. Effect of obesity and age. J Electrocardiol 27(Suppl):20–31
Rautaharju PM, Park L, Rautaharju FS, Crow R (1998) A standardized procedure for locating and documenting ECG chest electrode positions: consideration of the effect of breast tissue on ECG amplitudes in women. J Electrocardiol 31:17–29
Rennie K, Rowsell T, Jebb SA, Holburn D, Wareham NJ (2000) A combined heart rate and movement sensor: proof of concept and preliminary testing study. Eur J Clin Nutr 54:409–414
Schijvenaars BJ, Kors JA, van HG, Kornreich F, van Bemmel JH (1995) Interpolation of body surface potential maps. J Electrocardiol 28(Suppl):104–109
Schijvenaars BJ, Kors JA, van HG, Kornreich F, van Bemmel JH (1997) Effect of electrode positioning on ECG interpretation by computer. J Electrocardiol 30:247–256
Searle A, Kirkup L (2000) A direct comparison of wet, dry and insulating bioelectric recording electrodes. Physiol Meas 21:271–283
Strath SJ, Bassett DR Jr, Swartz AM, Thompson DL (2001) Simultaneous heart rate-motion sensor technique to estimate energy expenditure. Med Sci Sports Exerc 33:2118–2123
Strath SJ, Bassett DR Jr, Thompson DL, Swartz AM (2002) Validity of the simultaneous heart rate-motion sensor technique for measuring energy expenditure. Med Sci Sports Exerc 34:888–894
Tanaka H, Monahan KD, Seals DR (2001) Age-predicted maximal heart rate revisited. J Am Coll Cardiol 37:153–156
Wareham NJ, Rennie KL (1998) The assessment of physical activity in individuals and populations: why try to be more precise about how physical activity is assessed? Int J Obes Relat Metab Disord 22(Suppl 2):S30–S38
Welk GJ, Blair SN, Wood K, Jones S, Thompson RW (2000) A comparative evaluation of three accelerometry-based physical activity monitors. Med Sci Sports Exerc 32:S489–S497
Xu P, Carotenuto G, Nicolais L, Zheng Z, Kuang X (1999) Preparation and characterization of new electrocardiogram electrodes. J Mater Sci Mater Med 10:65–68
Yngve A, Nilsson A, Sjostrom M, Ekelund U (2003) Effect of monitor placement and of activity setting on the MTI accelerometer output. Med Sci Sports Exerc 35:320–326
Acknowledgements
Funding for this study was provided in part by The Wellcome Trust, UK. The use of trade names in this manuscript is for information purposes only and does not imply endorsement.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Brage, S., Brage, N., Ekelund, U. et al. Effect of combined movement and heart rate monitor placement on physical activity estimates during treadmill locomotion and free-living. Eur J Appl Physiol 96, 517–524 (2006). https://doi.org/10.1007/s00421-005-0112-6
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00421-005-0112-6