+1 Recommend
0 collections
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Accuracy of Fitbit Devices: Systematic Review and Narrative Syntheses of Quantitative Data

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.



          Although designed as a consumer product to help motivate individuals to be physically active, Fitbit activity trackers are becoming increasingly popular as measurement tools in physical activity and health promotion research and are also commonly used to inform health care decisions.


          The objective of this review was to systematically evaluate and report measurement accuracy for Fitbit activity trackers in controlled and free-living settings.


          We conducted electronic searches using PubMed, EMBASE, CINAHL, and SPORTDiscus databases with a supplementary Google Scholar search. We considered original research published in English comparing Fitbit versus a reference- or research-standard criterion in healthy adults and those living with any health condition or disability. We assessed risk of bias using a modification of the Consensus-Based Standards for the Selection of Health Status Measurement Instruments. We explored measurement accuracy for steps, energy expenditure, sleep, time in activity, and distance using group percentage differences as the common rubric for error comparisons. We conducted descriptive analyses for frequency of accuracy comparisons within a ±3% error in controlled and ±10% error in free-living settings and assessed for potential bias of over- or underestimation. We secondarily explored how variations in body placement, ambulation speed, or type of activity influenced accuracy.


          We included 67 studies. Consistent evidence indicated that Fitbit devices were likely to meet acceptable accuracy for step count approximately half the time, with a tendency to underestimate steps in controlled testing and overestimate steps in free-living settings. Findings also suggested a greater tendency to provide accurate measures for steps during normal or self-paced walking with torso placement, during jogging with wrist placement, and during slow or very slow walking with ankle placement in adults with no mobility limitations. Consistent evidence indicated that Fitbit devices were unlikely to provide accurate measures for energy expenditure in any testing condition. Evidence from a few studies also suggested that, compared with research-grade accelerometers, Fitbit devices may provide similar measures for time in bed and time sleeping, while likely markedly overestimating time spent in higher-intensity activities and underestimating distance during faster-paced ambulation. However, further accuracy studies are warranted. Our point estimations for mean or median percentage error gave equal weighting to all accuracy comparisons, possibly misrepresenting the true point estimate for measurement bias for some of the testing conditions we examined.


          Other than for measures of steps in adults with no limitations in mobility, discretion should be used when considering the use of Fitbit devices as an outcome measurement tool in research or to inform health care decisions, as there are seemingly a limited number of situations where the device is likely to provide accurate measurement.

          Related collections

          Most cited references 78

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          The validity of consumer-level, activity monitors in healthy adults worn in free-living conditions: a cross-sectional study

          Background Technological advances have seen a burgeoning industry for accelerometer-based wearable activity monitors targeted at the consumer market. The purpose of this study was to determine the convergent validity of a selection of consumer-level accelerometer-based activity monitors. Methods 21 healthy adults wore seven consumer-level activity monitors (Fitbit One, Fitbit Zip, Jawbone UP, Misfit Shine, Nike Fuelband, Striiv Smart Pedometer and Withings Pulse) and two research-grade accelerometers/multi-sensor devices (BodyMedia SenseWear, and ActiGraph GT3X+) for 48-hours. Participants went about their daily life in free-living conditions during data collection. The validity of the consumer-level activity monitors relative to the research devices for step count, moderate to vigorous physical activity (MVPA), sleep and total daily energy expenditure (TDEE) was quantified using Bland-Altman analysis, median absolute difference and Pearson’s correlation. Results All consumer-level activity monitors correlated strongly (r > 0.8) with research-grade devices for step count and sleep time, but only moderately-to-strongly for TDEE (r = 0.74-0.81) and MVPA (r = 0.52-0.91). Median absolute differences were generally modest for sleep and steps (<10% of research device mean values for the majority of devices) moderate for TDEE (<30% of research device mean values), and large for MVPA (26-298%). Across the constructs examined, the Fitbit One, Fitbit Zip and Withings Pulse performed most strongly. Conclusions In free-living conditions, the consumer-level activity monitors showed strong validity for the measurement of steps and sleep duration, and moderate valid for measurement of TDEE and MVPA. Validity for each construct ranged widely between devices, with the Fitbit One, Fitbit Zip and Withings Pulse being the strongest performers.
            • Record: found
            • Abstract: found
            • Article: not found

            Pedometer measures of free-living physical activity: comparison of 13 models.

            The purpose of this study was to compare the step values of multiple brands of pedometers over a 24-h period. The following 13 electronic pedometers were assessed in the study: Accusplit Alliance 1510 (AC), Freestyle Pacer Pro (FR), Colorado on the Move (CO), Kenz Lifecorder (KZ), New-Lifestyles NL-2000 (NL), Omron HJ-105 (OM), Oregon Scientific PE316CA (OR), Sportline 330 (SL330) and 345 (SL345), Walk4Life LS 2525 (WL), Yamax Skeletone EM-180 (SK), Yamax Digi-Walker SW-200 (YX200), and the Yamax Digi-Walker SW-701 (YX701). Ten males (39.5 +/- 16.6 yr, mean +/- SD) and 10 females (43.3 +/- 16.6 yr) ranging in BMI from 19.8 to 35.4 kg.m-2 wore two pedometers for a 24-h period. The criterion pedometer (YX200) was worn on the left side of the body, and a comparison pedometer was worn on the right. Steps counted by each device were recorded at the end of the day for each of the thirteen pedometers. Subjects took an average of 9244 steps.d-1. The KZ, YX200, NL, YX701, and SL330 yielded mean values that were not significantly different from the criterion. The FR, AC, SK, CO, and SL345 significantly underestimated steps (P < 0.05) and the WL, OM, and OR significantly overestimated steps (P < 0.05) when compared with the criterion. In addition, some pedometers underestimated by 25% whereas others overestimated by 45%. The KZ, YX200, NL, and YX701 appear to be suitable for most research purposes. Given the potential for pedometers in physical activity research, it is necessary that there be consistency across studies in the measurement of "steps per day."
              • Record: found
              • Abstract: found
              • Article: not found

              Validity of consumer-based physical activity monitors.

              Many consumer-based monitors are marketed to provide personal information on the levels of physical activity and daily energy expenditure (EE), but little or no information is available to substantiate their validity. This study aimed to examine the validity of EE estimates from a variety of consumer-based, physical activity monitors under free-living conditions. Sixty (26.4 ± 5.7 yr) healthy males (n = 30) and females (n = 30) wore eight different types of activity monitors simultaneously while completing a 69-min protocol. The monitors included the BodyMedia FIT armband worn on the left arm, the DirectLife monitor around the neck, the Fitbit One, the Fitbit Zip, and the ActiGraph worn on the belt, as well as the Jawbone Up and Basis B1 Band monitor on the wrist. The validity of the EE estimates from each monitor was evaluated relative to criterion values concurrently obtained from a portable metabolic system (i.e., Oxycon Mobile). Differences from criterion measures were expressed as a mean absolute percent error and were evaluated using 95% equivalence testing. For overall group comparisons, the mean absolute percent error values (computed as the average absolute value of the group-level errors) were 9.3%, 10.1%, 10.4%, 12.2%, 12.6%, 12.8%, 13.0%, and 23.5% for the BodyMedia FIT, Fitbit Zip, Fitbit One, Jawbone Up, ActiGraph, DirectLife, NikeFuel Band, and Basis B1 Band, respectively. The results from the equivalence testing showed that the estimates from the BodyMedia FIT, Fitbit Zip, and NikeFuel Band (90% confidence interval = 341.1-359.4) were each within the 10% equivalence zone around the indirect calorimetry estimate. The indicators of the agreement clearly favored the BodyMedia FIT armband, but promising preliminary findings were also observed with the Fitbit Zip.

                Author and article information

                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                August 2018
                09 August 2018
                : 6
                : 8
                1 Department of Physical Therapy University of British Columbia Vancouver, BC Canada
                2 Arthritis Research Canada Richmond, BC Canada
                3 School of Population and Public Health University of British Columbia Vancouver, BC Canada
                4 BC Children’s Hospital Research Institute Vancouver, BC Canada
                Author notes
                Corresponding Author: Lynne M Feehan lynnefeehan@
                ©Lynne M Feehan, Jasmina Geldman, Eric C Sayre, Chance Park, Allison M Ezzat, Ju Young Yoo, Clayon B Hamilton, Linda C Li. Originally published in JMIR Mhealth and Uhealth (, 09.08.2018.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on well as this copyright and license information must be included.



                Comment on this article