Finger pulse monitoring is a reliable and valid tool for measuring heart rate during exercise among adolescents in lab and school settings

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O’ Keeffe, Úna britton, Kwok Ng This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7147261/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 07 Dec, 2025 Read the published version in BMC Sports Science, Medicine and Rehabilitation → Version 1 posted 29 You are reading this latest preprint version Abstract Background: A finger pulse monitor offers multiple advantages for monitoring heart rate during exercise in comparison to chest worn monitors, including: enhanced testing efficiency; less invasive, particularly for vulnerable populations (e.g. children); and, reduced cost. The purpose of this study was to establish the test-retest reliability of a finger pulse device for monitoring heart rate during a 3-minute step test (3MST 30 ) to estimate cardiorespiratory endurance in a lab and school setting, and to compare indices of reliability with a chest worn heart rate monitor. Methods: Participants (N= 29; male = 16; age: 15.83 ± .66) completed the 3MST 30 on two occasions, in a lab setting (T1) and in a school setting (T2), one week apart. Participants wore a Braun® finger pulse monitor and a Polar® H7 chest strap heart rate monitor. Heart rate in beats per minute (BPM) was recorded on both devices at 1-minute, 2-minutes, 3-minutes, and one minute following test completion. Equivalence testing was used to analyse the data for differences between the two devices by using the TOSTER R package. Results: Absolute mean differences between devices and settings were clinically insignificant, with the smallest variance at the 1-minute post recording (finger pulse p = .012; chest strap = .041). There were no statistically significant differences in heart rate measurement between settings. Conclusions: This study demonstrates that finger pulse monitoring is a reliable and valid tool for measuring heart rate during sub-maximal exercise in lab and school settings. Step test cardiorespiratory endurance exercise testing physical fitness Figures Figure 1 Background Cardiorespiratory endurance (CRE) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle for energy production needed during physical activity ( 1 ). In youth, CRE is a strong independent predictor of cardiometabolic related diseases ( 2 ), academic achievement ( 3 ) and mental health ( 4 ). Positive changes to CRE during adolescence can reduce the risk of negative health outcomes later in life ( 5 ). Increases in obesity, increases in sedentary time, decreased levels of moderate to vigorous physical activity, and socioeconomic changes have contributed to declining CRE levels among youth internationally ( 6 ). CRE can be objectively and accurately measured in laboratory settings by qualified technicians using sophisticated instruments. However, such tests are not feasible for administration at population level ( 7 ). Field-based tests provide a suitable alternative since they are time efficient, low in cost, and can be easily administered to large groups simultaneously ( 8 ). The 20-metre shuttle run test (20MST) is the most widely used field-based test for estimating CRE ( 9 ), and is included in frequently used fitness test batteries FITNESSGRAM, the ALPHA health-related fitness test battery and EUROFIT. The 20MST is a maximal test whereby participants are required to continue running back and forth over a 20m distance, with the running speed gradually increasing, until the participant has reached maximal effort and can no longer run at the required pace. Maximal oxygen uptake (VO 2 max) is then estimated using the final running speed, or number of shuttles completed ( 10 ). For certain populations, such as the obese paediatric population, early termination of the 20MST prior to reaching maximal effort is common ( 11 ). This issue has also been observed by the authors of this paper and is not just limited to those who are overweight/obese. Though the 20MST is considered the best field-based test for measuring CRE, it does pose several challenges. Equations to estimate maximal oxygen uptake from the 20MST assume that participants have reached their maximum running capacity at the end of the test. This may be the case for highly motivated individuals, however, many individuals, for several reasons (lack of motivation, unfamiliar with the feeling of maximal effort exercise, unwilling to participate fully on front of peers) do not reach this level of intensity before stopping the test ( 12 ). Thus, a major challenge when administering the 20MST is ensuring compliance with the maximal effort protocol. To overcome this issue, heart rate can be monitored using chest-worn heart rate monitors, which can help identify if a participant has stopped the test prior to reaching a pre-determined cut-off percentage of their maximum heart rate. However, the use of heart rate monitors presents ethical and logistical issues for research teams when testing children in large groups in school-based settings. These include fitting the chest strap directly onto the skin, cleaning and changing straps between uses if multiple groups are to be tested, and the cost of the heart rate monitoring system. Another challenge with administering the 20MST in a school-based setting is that the nature of the test is contradictory to best pedagogical practices in physical education (PE). For example, the 20MST will always end in drop-out, and peer-to-peer comparisons are unavoidable. Where CRE fitness testing takes place as part of the PE curriculum, led by the PE teacher and set up as part of a broad and balanced fitness education unit, testing can be useful and beneficial ( 13 ). However, though child and adolescent perceptions of fitness testing are under-researched, there exists numerous challenges in conducting valid tests in school-aged individuals, particularly for maximal effort tests such as the 20MST. As experienced by the authors of this study, and documented by Martin et al. ( 14 ), student participation in fitness testing, particularly by adolescents, is often a challenge. For example, Martin et al. ( 14 ) reported that one high school student swore at the testing team several times when told her class was going to do the PACER (20MST) test, while testing was also found to be interpreted as punishment by students in this study. Overall, this reaction of children and adolescents to testing can not only be counterintuitive to the proposed purpose of testing (i.e. to understand and then improve fitness and physical activity in youth) by having a negative impact on children’s self-concept ( 15 ), but it can lead to biased results, with those who are more inclined to be physically active, and more likely to engage in maximally exhausting exercise, actually participating in the 20MST. There have been increasing calls for the development of simple, accurate, and inexpensive methods to measure fitness in youth ( 16 ). Standard maximal exercise testing to estimate CRE using direct measurement of peak oxygen uptake (VO2peak) is time consuming and is not feasible in certain settings (e.g. largescale epidemiological studies, primary health care, etc.) ( 17 ). Consequently, there is a clear need for a brief, submaximal CRE test, that can be performed as part of a multifaceted health-related physical fitness assessment battery. Single-stage, fixed-time sub-maximal step tests, such as the commonly used Young Men’s Christian Association (YMCA) step test, Harvard Step test, and Queen’s college step test, have been used to estimate an individual’s CRE or VO2peak specifically. Bench stepping protocols can be administered in a relatively small space in less than ten minutes, require a limited number of supplies ( 18 ), and have proven to be sensitive to changes in CRE in randomized clinical trials ( 19 ). Differences in test protocols involving alternating step heights and time periods serve as a barrier for use in largescale epidemiological studies due to the lack of ability to compare results across studies. Furthermore, the majority of bench stepping protocols require heart rate to be monitored. Heart rate is most commonly monitored using chest worn devices ( 20 ). This presents several constraints for administration in large cohort studies, particularly among vulnerable populations (e.g. children). A finger pulse monitor offers multiple advantages for monitoring heart rate in comparison to chest worn monitors, including: enhanced testing efficiency; less invasive, particularly for vulnerable populations (e.g. children); and, reduced cost. In any testing situation, it is important that the results are derived from high-quality measurement techniques. Therefore, the aim of the current study was to 1) establish the test-retest reliability of a finger pulse device for monitoring heart rate during a 3-minute step test to estimate cardio-respiratory endurance in a lab and school setting, and to compare indices of reliability with a chest worn heart rate monitor; 2) determine the test-retest reliability of a 3-minute step test protocol using a standard gymnastics bench (height 30cm), apparatus that is present in most schools. Hypothesis 1 (H o 1): (Environment) There is no meaningful difference between measuring heart rate while performing the 3MST 30 in a laboratory or school-based setting. Hypothesis 2 (H o 2): (Device) There is no meaningful difference between measuring heartrate while performing the 3MST 30 using a chest worn Polar® device or finger pulse Braun® device Methods Participants Participants were recruited from a secondary school in the mid-west region of Ireland in March 2023. All students (N = 38) in year 4 (Ages 15–16) of secondary education in the school were invited to participate. Informed consent to participate was received from the school principal, the participants, and their parents. The participation rate was 76% (N = 29; male = 16; age: 15.83 ± .66). The Helsinki Declaration guidelines were applied in this study and research ethics approval and the associated protocols was granted by the research ethics committee of the Faculty of Education and Health Sciences, University of Limerick (Approval No. 2022_06_27_EHS). The criteria for selection and exclusion of participants in this study are described below. Inclusion criteria: 1) Participants who answered “Yes” to all questions on the Physical Activity Readiness Questionnaire (PAR-Q). 2) Participants who fully understood the test, and both they and their parents/guardian agreed with the written consent document. Exclusion criteria: 1) Participants with cardiovascular and pulmonary disease, hypertension, orthopaedic disabilities, or who were taking beta blocker or beta agonist asthma medication. 2) Participants who did not abstain from caffeine or alcohol for 24 hours, food for 2 hours, and strenuous exercise for the 10 hours prior to the test. Protocol The three-minute step test (3MST 30 ) was conducted using the following standardized procedure. First, participants were fitted with a fingertip pulse monitor (Braun® Oximeter 1, Germany) placed on the index finger of the left hand, and a chest-strap heart rate monitor (Polar, H7, Finland). Participants then sat in a chair until a steady-state resting heart rate (RHR) was achieved (i.e., less than 5 beats-per-minute change in heart rate for one minute). Then, participants continuously stepped onto and off a 30cm bench, 24 times per minute for three minutes. RHR, and heart rate after one, two and three minutes was recorded. Stepping rate was synchronized to a metronome set at 96 beats per minute (“up, up, down, down”) and monitored throughout testing. After 3 minutes of stepping, participants immediately sat down in a chair while heart rate recovery was monitored and recorded after 1 minute. An individual research assistant was assigned to record the pulse rate of both devices for the four time points. To better reflect the fidelity of test administration among larger samples, participants performed the test in small groups of three participants simultaneously. Participants were provided with instruction and verbal encouragement to maintain the stepping pace throughout the test. A test was to be terminated if the participant’s HR came within 10 bpm of their age predicted maximal heart rate (220 minus age) or if they were unable to maintain the prescribed stepping cadence for more than 10 seconds. Participants completed the 3MST 30 on two occasions, in a lab setting (T1) and in a school setting (T2), one week apart at the same time of day and using the same test protocol. Statistical Analysis The data were classified by the different times from the point of carrying out the step test per device (1min, 2min, 3min, 1min post). This led to four categories of data for the finger pulse oximeter, and four categories for the chest-strap monitor. Bland Altman plots were used to examine how the two measures compare to each other, in this case, between settings (school and lab) and between the finger pulse (Braun®) and chest strap (Polar®) devices. The mean difference of the heart rate at each time point were compared in both settings and between devices for each setting. The range for the Bland-Altman tests were set at 95%. The TOSTER package in Jamovi 2.4.14 was used to carry out statistical analyses to determine differences, and the magnitude of the differences between; 1. Environments (i.e. finger pulse monitor at school and in the laboratory setting), and 2. Devices (i.e. finger pulse monitor and chest strap monitor at school and in the laboratory). The TOSTER package returns the null-hypothesis significance testing (NHST) paired t-test results to determine if we reject the null-hypothesis that there are no differences between groups. The equivalence test from the TOSTER package is used to define if the effect is large enough to be deemed interesting, as the NHST does not provide enough evidence to suggest there is a difference between groups ( 21 ), hence we specified upper and lower bounds were based on +/-2.5 for each TOST paired samples T-Test (See Appendix Table 1), with the alpha set at 0.05. An upper and lower bound of 2.5 was created as a raw score based on an acceptable range of 5 beats per minute. As such, we reject the equivalence test when the NHST is statistically significant, but we deem it to be practically insignificant. Furthermore, due to the low sample size, we used a Bayesian approach to provide confidence on the resulting findings for each test by noting the probability that the hypothesis is true as more evidence is produced, given the posterior does not change ( 22 ). For these tests, the Equivalence T-Test package in JASP 0.18.1.0 was used. Table 1 Mean difference between finger pulse and chest strap hear rate monitor devices in a school and laboratory setting. Absolute Lower 1.96.SD Upper 1.96.SD Diff LCI UCI Diff LCI UCI Diff LCI UCI Finger pulse (Braun®) Sch vs Lab 1 min 1.34 -2.96 5.65 -20.86 -28.32 -13.39 23.55 16.08 31.01 2 min -2.31 -7.23 2.61 -27.67 -36.19 -19.14 23.05 14.52 31.57 3 min 0.93 -3.81 5.67 -23.49 -31.70 -15.28 25.35 17.15 33.56 1 post 2.28 0.55 4.00 -6.61 -9.60 -3.62 11.16 8.18 14.15 Chest strap (Polar®) Sch vs Lab 1 min 4.41 0.82 8.01 -14.10 -20.33 -7.88 22.93 16.71 29.15 2 min 1.03 -2.59 4.66 -17.64 -23.91 -11.36 19.71 13.43 25.98 3 min 0.69 -4.11 5.49 -24.04 -32.35 -15.73 25.42 17.10 33.73 1 post 1.62 0.07 3.17 -6.38 -9.07 -3.69 9.62 6.93 12.31 School Finger pulse v Chest strap 1 min 7.52 1.38 13.66 -24.12 -34.76 -13.49 39.16 28.52 49.79 2 min 6.14 0.65 11.63 -22.14 -31.65 -12.64 34.42 24.91 43.92 3 min 3.17 -1.60 7.94 -21.40 -29.66 -13.14 27.74 19.48 36.00 1 post -3.79 -5.62 -1.96 -13.23 -16.40 -10.06 5.64 2.47 8.81 Lab Finger pulse v Chest strap 1 min -4.45 -7.79 -1.11 -21.65 -27.43 -15.87 12.76 6.97 18.54 2 min -2.79 -6.11 0.52 -19.88 -25.62 -14.13 14.29 8.55 20.03 3 min -3.41 -6.18 -0.65 -17.66 -22.45 -12.87 10.83 6.04 15.62 1 post 3.14 1.15 5.13 -7.11 -10.55 -3.67 13.39 9.94 16.83 Results A total of 29 participants (males n = 16, females n = 13) completed all tests (school setting and lab setting with two devices). The average age was slightly higher (p = .005, d = 0.43) among males (mean = 16.1 years, SD = .34) than females (mean = 15.5 years, SD = .78). There was no statistically significant difference in BMI between male and female participants. Bland-Altman tests and plots The mean difference for the devices and settings are reported in Table 1 . The absolute mean differences ranged from 2.31 bpm (finger pulse (Braun®), school vs lab) to 7.52 bpm (1 min chest strap (Polar®) vs finger pulse (Braun®) school), suggesting small changes between settings and devices. For each test, the 1min post had the smallest variance, as read by range of the lower and upper 1.96 SD. Figure 1 includes the plots of each test for the 1min post exercise. As shown visually, there were two data points outside the lower and upper 1.96.SD lines, but within the 95% confidence intervals for the laboratory test between finger pulse and chest strap devices. Similar results were found for the test of the setting of chest strap devices between the school and laboratory setting. There was one data point outside the upper or lower limit line, but within the 95% CI for the school setting and finger pulse device. Equivalence tests For the chest strap device, the 1min (p = .018) and 1min post (p = .041) were lower in the lab than at the school, however, based on the TOST parameters (Table 1 ) the differences were not meaningful, thus H o 1 was not rejected. Similarly, with the finger pulse device, differences between the school and lab setting were statistically significant at 1min post, however, again, differences were not meaningful. In Table 2 , the paired T-Tests between environments (school vs lab) are reported with the TOST, and Bayes Factors. Table 2 Differences and equivalence in Mean scores between environments with Bayes Factor Hypothesis 1 School Lab NHST TOST Lower TOST Upper Effect Size Bayes Factor mean SD mean SD p p p g Finger Pulse (Braun®) 1 min 138 19.4 137 13.6 0.528 0.294 0.039 0.117 5.845 Moderate 2 min 141 18.8 143 14.7 0.344 0.028 0.469 0.176 5.285 Moderate 3 min 144 20.7 143 16.5 0.69 0.252 0.075 0.074 6.042 Moderate 1 min post 119 11.9 116 12.3 0.012 0.396 < .001 0.495 4.626 Moderate Chest strap (Polar®) 1 min 145 12.7 141 11.1 0.018 0.858 < .001 0.461 2.215 Anecdotal 2 min 147 14.6 146 13.3 0.563 0.207 0.028 0.107 5.89 Moderate 3 min 147 17.8 146 14.4 0.771 0.223 0.092 0.054 6.075 Moderate 1 min post 115 11.5 113 12.2 0.041 0.128 < .001 0.392 5.287 Moderate 1min recordings were significantly higher on the chest strap device in comparison to the finger pulse device in both the school (p = .018) and the lab (p = .011), the TOST was not rejected. At 1min post, the results from the chest strap device were lower than the finger pulse device in both the school (p < .001) and the lab (p = .003), and the TOST was not rejected. In the school setting, the chest strap had higher recording than the finger pulse device at 2min (p = .030), yet in the lab this was only at 3min (p = .017). In all the tests, the TOST was not rejected. In Table 3 , the paired T-Tests between devices are reported with the TOST, and Bayes Factors. Of the results that were statistically significant, the evidence was considered as anecdotal for the results in the school setting, as well as 1min in the lab. There was moderate evidence for the 3min and 1min post in the lab. Table 3 NHST, TOST and Bayes Factors in HR differences between Finger Pulse (Braun®) and Chest strap (Polar®) devices. Hypothesis 2 NHST TOST Lower TOST Upper Effect Size Bayes Factor p p g School, Finger Pulse (Braun®) v Chest strap (Polar®) 1 min 0.018 0.001 0.947 0.459 1.374 Anecdotal 2 min 0.03 0.002 0.907 0.42 2.28 Anecdotal 3 min 0.184 0.011 0.613 0.25 4.945 Moderate 1 min post < .001 0.920 < .001 0.777 2.762 Anecdotal Lab, Finger Pulse (Braun®) v Chest strap (Polar®) 1 min 0.011 < .001 0.879 0.5 2.355 Anecdotal 2 min 0.095 0.001 0.571 0.316 4.472 Moderate 3 min 0.017 < .001 0.748 0.463 4.184 Moderate 1 min post 0.003 0.742 < .001 0.592 3.675 Moderate In summary, more evidence is needed to support these initial findings. There is moderate evidence to support no differences in HR monitoring within devices when monitoring is conducted in either a school or lab setting. When comparing devices within a setting (school or lab) there is some evidence to suggest there may be small differences in HR monitoring at some, but not all, timepoints of measurement. Discussion The aim of this study was to establish the test-retest reliability of a finger pulse device for monitoring heart rate during a 3MST 30 to estimate cardiorespiratory endurance (CRE) in a lab and school setting, and to compare indices of reliability with a chest worn heart rate monitor. Absolute mean differences between devices and settings were clinically insignificant, with the smallest variance observed at the 1min post recording. There was no statistically significant difference between measuring heart rate while performing the 3MST 30 in a laboratory or school-based setting, thus we cannot reject Ho1 - There is no meaningful difference between measuring heart rate while performing the 3MST 30 in a laboratory or school-based setting. Furthermore, there was no statistically significant difference between measuring heartrate while performing the 3MST 30 using a chest worn Polar® or finger pulse Braun® device. Therefore, we cannot reject Ho2 - There is no meaningful difference between measuring heartrate while performing the 3MST 30 using a chest worn Polar® device or finger pulse Braun® device. Results from this study indicated there was no meaningful difference between measuring heart rate while performing the 3MST 30 in a controlled laboratory or school-based setting. Absolute mean differences ranged from 2–8 bpm for the finger pulse device between school and lab settings. The practicality and feasibility of field-based tests for administration in school settings are crucial ( 23 ), and estimation of cardiorespiratory endurance using the 3MST 30 and measuring heart rate using a finger pulse device may offer a practical and more palatable method for measurement. However, students, parents, and policymakers need to also have confidence in the validity and reliability of the data gathered ( 24 ). Lang et al. ( 16 ) identified assessing the accuracy and reliability of health measures in field-based settings as one of ten international priorities for physical fitness research and surveillance among children and adolescents identified by international experts in fitness. The current study addresses this priority by assessing the reliability of heart rate measurement during a step-test. In terms of variation across device types, no meaningful difference between measuring heartrate while performing the 3MST30 using a chest worn device or finger pulse device was observed, indicating that we can accept Ho2. In one of the first studies to examine the accuracy of pulse oximeters in estimating heart rate at rest and during exercise, Lyriboz et al ( 25 ) concluded that oximeter readings significantly correlated with those of ECG (r = 0.91; p < .001), however, the authors indicated the use of pulse oximeters as heart rate monitors during strenuous exercise of greater than 155bpm is questionable. Martín-Escudero et al ( 26 ) also reported that heart rate with wrist worn devices frequently underestimated heart rate when exercising at higher intensities. The 3MST30 step test is a sub-maximal test of CRE, thus, heart rate recordings of over 155 bpm are uncommon. In the current study mean recordings across the four timepoints (minute 1, minute 2, minute 3, 1 minute post) did not exceed 147bpm. This study had some limitations which should be noted. The small sample size and narrow age range of participants drawn from only one school limits the scope of our findings to be generalized to all field-based testing settings at this time. A larger sample size, involving a more diverse age range and the inclusion of an additional trial school-based trial could have improved the precision of the reliability estimates, while also allowing for a more detailed examination of results by age group. However, the novelty of the study design examining reliability at both a device and environment level and the authenticity of the environment in which testing took place are notable strengths of this study. This is the first study of its kind to examine and confirm the reliability of finger pulse monitoring while performing a submaximal test to estimate CRE and provides initial evidence to support the use of finger pulse monitoring during a submaximal CRE test. Conclusions Calls from leading academics for the establishment of valid and reliable tools to estimate CRE in field-based settings have largely been ignored. The aim of this study was to investigate the reliability and validity of finger pulse monitoring as a tool for measuring heart rate during exercise among adolescents in lab and school settings. Overall absolute and relative reliability indices indicated that there was no meaningful difference between measuring heart rate while performing the 3MST30 in a laboratory or school-based setting. Furthermore, there was no meaningful difference between measuring heartrate while performing the 3MST30 using a chest worn heart rate monitoring device or finger pulse heart rate monitoring device. Therefore, this study shows that finger pulse monitoring is a reliable and valid method for assessing heart rate during sub-maximal exercise in both laboratory and school environments. Abbreviations 3-minute step test (3MST 30 ) Cardiorespiratory endurance (CRE) 20-metre shuttle run test (20MST) physical education (PE). Young Men’s Christian Association (YMCA) Beats per minute (BPM) Physical Activity Readiness Questionnaire (PAR-Q) Declarations Ethics approval and consent to participate The Helsinki Declaration guidelines were applied in this study and research ethics approval and the associated protocols was granted by the research ethics committee of the Faculty of Education and Health Sciences, University of Limerick (Approval No. 2022_06_27_EHS). Informed consent to participate was received from the school principal, the participants, and their parents Competing interests No potential conflict of interest was reported by the authors. This manuscript has not been published elsewhere and that it has not been submitted simultaneously for publication elsewhere. Data availability statement Data are available upon reasonable request. Funding The study received support funding from the University of Limerick Faculty of Education and Health Sciences Seed funding Scheme . Clinical trial number: Not applicable. Authors Contributions BO’K: Data collection and curation; Data Analysis; Writing, original draft preparation; Writing, review and editing. UB: Methodological design; Data Analysis; Writing, review and editing KN: Data Analysis; Writing, review and editing Acknowledgements Not applicable References Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126–31. Schmidt M, Magnussen C, Rees E, Dwyer T, Venn A. Childhood fitness reduces the long-term cardiometabolic risks associated with childhood obesity. Int J Obes. 2016;40(7):1134. Bezold CP, Konty KJ, Day SE, Berger M, Harr L, Larkin M, et al. The effects of changes in physical fitness on academic performance among New York City youth. J Adolesc Health. 2014;55(6):774–81. Raghuveer G, Hartz J, Lubans DR, Takken T, Wiltz JL, Mietus-Snyder M, et al. 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O’ Keeffe","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA80lEQVRIiWNgGAWjYBACexDBAyMqbBjkGNgZGA7g02LYgKzlTBqDMQMzAS0GB9C0JDYwE3CY4ezDxx68qbnDwM9z+OCDAwk26RsOMzAe+IDPL3xp6YZzjj1jkOxtSzY4kJCWC9TCcHAGPlt6eMykedgOMxicBzI+/jgM1nKYB59fzvB/k+b5B9LC//3HgYT/6QYgLX/wauFhk+ZtA2o528PGcCDhQAJYC17v97CZSc7tO8wj2XPMWOJAQrLhzMOMDQd78Hmfh/mZxJtvh+X4eZIffjiQYCfPd7z58Icf+KyBAmT/MjYQoWEUjIJRMApGAT4AAKzfUcNddjXoAAAAAElFTkSuQmCC","orcid":"","institution":"University of Limerick","correspondingAuthor":true,"prefix":"","firstName":"Brendan","middleName":"T. O’","lastName":"Keeffe","suffix":""},{"id":505171143,"identity":"18047514-47b0-4c74-92be-1fd0ff5964d2","order_by":1,"name":"Úna britton","email":"","orcid":"","institution":"Dublin City University","correspondingAuthor":false,"prefix":"","firstName":"Úna","middleName":"","lastName":"britton","suffix":""},{"id":505171144,"identity":"d9dffde7-86b4-4e4e-9888-581bcac72b82","order_by":2,"name":"Kwok Ng","email":"","orcid":"","institution":"University of Limerick","correspondingAuthor":false,"prefix":"","firstName":"Kwok","middleName":"","lastName":"Ng","suffix":""}],"badges":[],"createdAt":"2025-07-17 09:23:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7147261/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7147261/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s13102-025-01467-x","type":"published","date":"2025-12-07T15:58:07+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":90306411,"identity":"9ad3a7bf-da7d-4971-aec8-7d1d2808783c","added_by":"auto","created_at":"2025-09-01 09:27:12","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":546115,"visible":true,"origin":"","legend":"\u003cp\u003eBland Altman Plots 1 minute post exercise of laboratory-based chest strap and finger pulse devices (top left), school-based chest strap and finger pulse devices (top right), school-based and laboratory-based chest strap device, and (bottom left), finger pulse school-based and laboratory-based device (bottom right).\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7147261/v1/60cb8afb6e6f391af9f91f4a.jpeg"},{"id":97724095,"identity":"f2b37208-6549-411b-a800-f7b4c85c0331","added_by":"auto","created_at":"2025-12-08 16:11:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1383188,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7147261/v1/a4317792-a42a-4452-8b66-bed96b032b8c.pdf"},{"id":90306410,"identity":"b9fec127-f2b2-4c48-b69d-98220dd23a41","added_by":"auto","created_at":"2025-09-01 09:27:12","extension":"sav","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":30839,"visible":true,"origin":"","legend":"","description":"","filename":"MasterfileSPSS3.sav","url":"https://assets-eu.researchsquare.com/files/rs-7147261/v1/43ce268f7b74474e9be2a494.sav"}],"financialInterests":"No competing interests reported.","formattedTitle":"Finger pulse monitoring is a reliable and valid tool for measuring heart rate during exercise among adolescents in lab and school settings","fulltext":[{"header":"Background","content":"\u003cp\u003eCardiorespiratory endurance (CRE) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle for energy production needed during physical activity (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). In youth, CRE is a strong independent predictor of cardiometabolic related diseases (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), academic achievement (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) and mental health (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Positive changes to CRE during adolescence can reduce the risk of negative health outcomes later in life (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Increases in obesity, increases in sedentary time, decreased levels of moderate to vigorous physical activity, and socioeconomic changes have contributed to declining CRE levels among youth internationally (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). CRE can be objectively and accurately measured in laboratory settings by qualified technicians using sophisticated instruments. However, such tests are not feasible for administration at population level (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Field-based tests provide a suitable alternative since they are time efficient, low in cost, and can be easily administered to large groups simultaneously (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe 20-metre shuttle run test (20MST) is the most widely used field-based test for estimating CRE (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e), and is included in frequently used fitness test batteries FITNESSGRAM, the ALPHA health-related fitness test battery and EUROFIT. The 20MST is a maximal test whereby participants are required to continue running back and forth over a 20m distance, with the running speed gradually increasing, until the participant has reached maximal effort and can no longer run at the required pace. Maximal oxygen uptake (VO\u003csub\u003e2\u003c/sub\u003emax) is then estimated using the final running speed, or number of shuttles completed (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). For certain populations, such as the obese paediatric population, early termination of the 20MST prior to reaching maximal effort is common (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). This issue has also been observed by the authors of this paper and is not just limited to those who are overweight/obese. Though the 20MST is considered the best field-based test for measuring CRE, it does pose several challenges. Equations to estimate maximal oxygen uptake from the 20MST assume that participants have reached their maximum running capacity at the end of the test. This may be the case for highly motivated individuals, however, many individuals, for several reasons (lack of motivation, unfamiliar with the feeling of maximal effort exercise, unwilling to participate fully on front of peers) do not reach this level of intensity before stopping the test (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Thus, a major challenge when administering the 20MST is ensuring compliance with the maximal effort protocol. To overcome this issue, heart rate can be monitored using chest-worn heart rate monitors, which can help identify if a participant has stopped the test prior to reaching a pre-determined cut-off percentage of their maximum heart rate. However, the use of heart rate monitors presents ethical and logistical issues for research teams when testing children in large groups in school-based settings. These include fitting the chest strap directly onto the skin, cleaning and changing straps between uses if multiple groups are to be tested, and the cost of the heart rate monitoring system.\u003c/p\u003e\u003cp\u003eAnother challenge with administering the 20MST in a school-based setting is that the nature of the test is contradictory to best pedagogical practices in physical education (PE). For example, the 20MST will always end in drop-out, and peer-to-peer comparisons are unavoidable. Where CRE fitness testing takes place as part of the PE curriculum, led by the PE teacher and set up as part of a broad and balanced fitness education unit, testing can be useful and beneficial (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). However, though child and adolescent perceptions of fitness testing are under-researched, there exists numerous challenges in conducting valid tests in school-aged individuals, particularly for maximal effort tests such as the 20MST. As experienced by the authors of this study, and documented by Martin et al. (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e), student participation in fitness testing, particularly by adolescents, is often a challenge. For example, Martin et al. (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) reported that one high school student swore at the testing team several times when told her class was going to do the PACER (20MST) test, while testing was also found to be interpreted as punishment by students in this study. Overall, this reaction of children and adolescents to testing can not only be counterintuitive to the proposed purpose of testing (i.e. to understand and then improve fitness and physical activity in youth) by having a negative impact on children’s self-concept (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), but it can lead to biased results, with those who are more inclined to be physically active, and more likely to engage in maximally exhausting exercise, actually participating in the 20MST.\u003c/p\u003e\u003cp\u003eThere have been increasing calls for the development of simple, accurate, and inexpensive methods to measure fitness in youth (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Standard maximal exercise testing to estimate CRE using direct measurement of peak oxygen uptake (VO2peak) is time consuming and is not feasible in certain settings (e.g. largescale epidemiological studies, primary health care, etc.) (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Consequently, there is a clear need for a brief, submaximal CRE test, that can be performed as part of a multifaceted health-related physical fitness assessment battery. Single-stage, fixed-time sub-maximal step tests, such as the commonly used Young Men’s Christian Association (YMCA) step test, Harvard Step test, and Queen’s college step test, have been used to estimate an individual’s CRE or VO2peak specifically. Bench stepping protocols can be administered in a relatively small space in less than ten minutes, require a limited number of supplies (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), and have proven to be sensitive to changes in CRE in randomized clinical trials (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Differences in test protocols involving alternating step heights and time periods serve as a barrier for use in largescale epidemiological studies due to the lack of ability to compare results across studies. Furthermore, the majority of bench stepping protocols require heart rate to be monitored. Heart rate is most commonly monitored using chest worn devices (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). This presents several constraints for administration in large cohort studies, particularly among vulnerable populations (e.g. children).\u003c/p\u003e\u003cp\u003eA finger pulse monitor offers multiple advantages for monitoring heart rate in comparison to chest worn monitors, including: enhanced testing efficiency; less invasive, particularly for vulnerable populations (e.g. children); and, reduced cost. In any testing situation, it is important that the results are derived from high-quality measurement techniques. Therefore, the aim of the current study was to 1) establish the test-retest reliability of a finger pulse device for monitoring heart rate during a 3-minute step test to estimate cardio-respiratory endurance in a lab and school setting, and to compare indices of reliability with a chest worn heart rate monitor; 2) determine the test-retest reliability of a 3-minute step test protocol using a standard gymnastics bench (height 30cm), apparatus that is present in most schools.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 1\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e(H\u003csub\u003eo\u003c/sub\u003e1): (Environment) There is no meaningful difference between measuring heart rate while performing the 3MST\u003csub\u003e30\u003c/sub\u003e in a laboratory or school-based setting.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 2\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e(H\u003csub\u003eo\u003c/sub\u003e2): (Device) There is no meaningful difference between measuring heartrate while performing the 3MST\u003csub\u003e30\u003c/sub\u003e using a chest worn Polar® device or finger pulse Braun® device\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e\u003ch2\u003e\u003c/h2\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eParticipants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants were recruited from a secondary school in the mid-west region of Ireland in March 2023. All students (N\u0026thinsp;=\u0026thinsp;38) in year 4 (Ages 15\u0026ndash;16) of secondary education in the school were invited to participate. Informed consent to participate was received from the school principal, the participants, and their parents. The participation rate was 76% (N\u0026thinsp;=\u0026thinsp;29; male\u0026thinsp;=\u0026thinsp;16; age: 15.83\u0026thinsp;\u0026plusmn;\u0026thinsp;.66). The Helsinki Declaration guidelines were applied in this study and research ethics approval and the associated protocols was granted by the research ethics committee of the Faculty of Education and Health Sciences, University of Limerick (Approval No. 2022_06_27_EHS). The criteria for selection and exclusion of participants in this study are described below. Inclusion criteria: 1) Participants who answered \u0026ldquo;Yes\u0026rdquo; to all questions on the Physical Activity Readiness Questionnaire (PAR-Q). 2) Participants who fully understood the test, and both they and their parents/guardian agreed with the written consent document. Exclusion criteria: 1) Participants with cardiovascular and pulmonary disease, hypertension, orthopaedic disabilities, or who were taking beta blocker or beta agonist asthma medication. 2) Participants who did not abstain from caffeine or alcohol for 24 hours, food for 2 hours, and strenuous exercise for the 10 hours prior to the test.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProtocol\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe three-minute step test (3MST\u003csub\u003e30\u003c/sub\u003e) was conducted using the following standardized procedure. First, participants were fitted with a fingertip pulse monitor (Braun\u0026reg; Oximeter 1, Germany) placed on the index finger of the left hand, and a chest-strap heart rate monitor (Polar, H7, Finland). Participants then sat in a chair until a steady-state resting heart rate (RHR) was achieved (i.e., less than 5 beats-per-minute change in heart rate for one minute). Then, participants continuously stepped onto and off a 30cm bench, 24 times per minute for three minutes. RHR, and heart rate after one, two and three minutes was recorded. Stepping rate was synchronized to a metronome set at 96 beats per minute (\u0026ldquo;up, up, down, down\u0026rdquo;) and monitored throughout testing. After 3 minutes of stepping, participants immediately sat down in a chair while heart rate recovery was monitored and recorded after 1 minute. An individual research assistant was assigned to record the pulse rate of both devices for the four time points. To better reflect the fidelity of test administration among larger samples, participants performed the test in small groups of three participants simultaneously. Participants were provided with instruction and verbal encouragement to maintain the stepping pace throughout the test. A test was to be terminated if the participant\u0026rsquo;s HR came within 10 bpm of their age predicted maximal heart rate (220 minus age) or if they were unable to maintain the prescribed stepping cadence for more than 10 seconds. Participants completed the 3MST\u003csub\u003e30\u003c/sub\u003e on two occasions, in a lab setting (T1) and in a school setting (T2), one week apart at the same time of day and using the same test protocol.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data were classified by the different times from the point of carrying out the step test per device (1min, 2min, 3min, 1min post). This led to four categories of data for the finger pulse oximeter, and four categories for the chest-strap monitor. Bland Altman plots were used to examine how the two measures compare to each other, in this case, between settings (school and lab) and between the finger pulse (Braun\u0026reg;) and chest strap (Polar\u0026reg;) devices. The mean difference of the heart rate at each time point were compared in both settings and between devices for each setting. The range for the Bland-Altman tests were set at 95%. The TOSTER package in Jamovi 2.4.14 was used to carry out statistical analyses to determine differences, and the magnitude of the differences between; 1. Environments (i.e. finger pulse monitor at school and in the laboratory setting), and 2. Devices (i.e. finger pulse monitor and chest strap monitor at school and in the laboratory). The TOSTER package returns the null-hypothesis significance testing (NHST) paired t-test results to determine if we reject the null-hypothesis that there are no differences between groups. The equivalence test from the TOSTER package is used to define if the effect is large enough to be deemed interesting, as the NHST does not provide enough evidence to suggest there is a difference between groups (\u003cspan class=\"CitationRef\"\u003e21\u003c/span\u003e), hence we specified upper and lower bounds were based on +/-2.5 for each TOST paired samples T-Test (See Appendix Table\u0026nbsp;1), with the alpha set at 0.05. An upper and lower bound of 2.5 was created as a raw score based on an acceptable range of 5 beats per minute. As such, we reject the equivalence test when the NHST is statistically significant, but we deem it to be practically insignificant. Furthermore, due to the low sample size, we used a Bayesian approach to provide confidence on the resulting findings for each test by noting the probability that the hypothesis is true as more evidence is produced, given the posterior does not change (\u003cspan class=\"CitationRef\"\u003e22\u003c/span\u003e). For these tests, the Equivalence T-Test package in JASP 0.18.1.0 was used.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eMean difference between finger pulse and chest strap hear rate monitor devices in a school and laboratory setting.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\u003ccolgroup\u003e\u003c/colgroup\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eAbsolute\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eLower 1.96.SD\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"3\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eUpper 1.96.SD\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDiff\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLCI\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUCI\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eDiff\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLCI\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUCI\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eDiff\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLCI\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eUCI\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFinger pulse (Braun\u0026reg;)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSch vs Lab\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.34\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-2.96\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-20.86\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-28.32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-13.39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e23.55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16.08\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e31.01\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-2.31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-7.23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.61\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-27.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-36.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-19.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e23.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e31.57\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-3.81\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-23.49\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-31.70\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-15.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e25.35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e33.56\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 post\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-6.61\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-9.60\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-3.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e11.16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e14.15\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChest strap (Polar\u0026reg;)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSch vs Lab\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.82\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-14.10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-20.33\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-7.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e22.93\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16.71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e29.15\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-2.59\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-17.64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-23.91\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-11.36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e19.71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e25.98\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-4.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.49\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-24.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-32.35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-15.73\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e25.42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17.10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e33.73\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 post\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.07\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-6.38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-9.07\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-3.69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e9.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.93\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e12.31\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSchool\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFinger pulse v Chest strap\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-24.12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-34.76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-13.49\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e39.16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e28.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e49.79\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11.63\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-22.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-31.65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-12.64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e34.42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24.91\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e43.92\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-1.60\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7.94\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-21.40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-29.66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-13.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e27.74\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19.48\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e36.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 post\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-3.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-5.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-1.96\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-13.23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-16.40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-10.06\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e5.64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.47\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e8.81\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLab\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFinger pulse v Chest strap\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-4.45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-7.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-1.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-21.65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-27.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-15.87\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e12.76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e18.54\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-2.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-6.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-19.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-25.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-14.13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e14.29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e20.03\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-3.41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-6.18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-0.65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-17.66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-22.45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-12.87\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e10.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e15.62\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 post\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e-7.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-10.55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-3.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e13.39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9.94\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e16.83\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 29 participants (males n\u0026thinsp;=\u0026thinsp;16, females n\u0026thinsp;=\u0026thinsp;13) completed all tests (school setting and lab setting with two devices). The average age was slightly higher (p\u0026thinsp;=\u0026thinsp;.005, d\u0026thinsp;=\u0026thinsp;0.43) among males (mean\u0026thinsp;=\u0026thinsp;16.1 years, SD\u0026thinsp;=\u0026thinsp;.34) than females (mean\u0026thinsp;=\u0026thinsp;15.5 years, SD\u0026thinsp;=\u0026thinsp;.78). There was no statistically significant difference in BMI between male and female participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBland-Altman tests and plots\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe mean difference for the devices and settings are reported in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. The absolute mean differences ranged from 2.31 bpm (finger pulse (Braun\u0026reg;), school vs lab) to 7.52 bpm (1 min chest strap (Polar\u0026reg;) vs finger pulse (Braun\u0026reg;) school), suggesting small changes between settings and devices. For each test, the 1min post had the smallest variance, as read by range of the lower and upper 1.96 SD.\u003c/p\u003e\n\u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e includes the plots of each test for the 1min post exercise. As shown visually, there were two data points outside the lower and upper 1.96.SD lines, but within the 95% confidence intervals for the laboratory test between finger pulse and chest strap devices. Similar results were found for the test of the setting of chest strap devices between the school and laboratory setting. There was one data point outside the upper or lower limit line, but within the 95% CI for the school setting and finger pulse device.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEquivalence tests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor the chest strap device, the 1min (p\u0026thinsp;=\u0026thinsp;.018) and 1min post (p\u0026thinsp;=\u0026thinsp;.041) were lower in the lab than at the school, however, based on the TOST parameters (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e) the differences were not meaningful, thus H\u003csub\u003eo\u003c/sub\u003e1 was not rejected. Similarly, with the finger pulse device, differences between the school and lab setting were statistically significant at 1min post, however, again, differences were not meaningful. In Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e, the paired T-Tests between environments (school vs lab) are reported with the TOST, and Bayes Factors.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eDifferences and equivalence in Mean scores between environments with Bayes Factor\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eHypothesis \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eSchool\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eLab\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eNHST\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTOST Lower\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTOST Upper\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eEffect Size\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eBayes Factor\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003emean\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSD\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003emean\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSD\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eg\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFinger Pulse (Braun\u0026reg;)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e138\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e137\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.528\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.294\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.039\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.117\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.845\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e141\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e143\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.344\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.028\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.469\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.176\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.285\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e144\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e143\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.252\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.075\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.074\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.042\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min post\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e119\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e116\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.012\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.396\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.495\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.626\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChest strap (Polar\u0026reg;)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e145\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e141\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.018\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.858\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.461\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.215\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAnecdotal\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e147\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e146\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.563\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.207\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.028\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.107\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.89\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e147\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e146\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.771\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.223\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.092\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.054\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.075\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min post\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e115\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e113\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.041\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.128\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.392\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.287\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1min recordings were significantly higher on the chest strap device in comparison to the finger pulse device in both the school (p\u0026thinsp;=\u0026thinsp;.018) and the lab (p\u0026thinsp;=\u0026thinsp;.011), the TOST was not rejected. At 1min post, the results from the chest strap device were lower than the finger pulse device in both the school (p\u0026thinsp;\u0026lt;\u0026thinsp;.001) and the lab (p\u0026thinsp;=\u0026thinsp;.003), and the TOST was not rejected. In the school setting, the chest strap had higher recording than the finger pulse device at 2min (p\u0026thinsp;=\u0026thinsp;.030), yet in the lab this was only at 3min (p\u0026thinsp;=\u0026thinsp;.017). In all the tests, the TOST was not rejected. In Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e, the paired T-Tests between devices are reported with the TOST, and Bayes Factors. Of the results that were statistically significant, the evidence was considered as anecdotal for the results in the school setting, as well as 1min in the lab. There was moderate evidence for the 3min and 1min post in the lab.\u0026nbsp;\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eNHST, TOST and Bayes Factors in HR differences between Finger Pulse (Braun\u0026reg;) and Chest strap (Polar\u0026reg;) devices.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eHypothesis \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eNHST\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTOST Lower\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTOST Upper\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eEffect Size\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eBayes Factor\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eg\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eSchool, Finger Pulse (Braun\u0026reg;) v Chest strap (Polar\u0026reg;)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.018\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.947\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.459\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.374\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAnecdotal\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.03\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.002\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.907\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAnecdotal\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.184\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.011\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.613\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.945\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min post\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026lt;\u0026thinsp;.001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.920\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.777\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.762\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAnecdotal\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eLab, Finger Pulse (Braun\u0026reg;) v Chest strap (Polar\u0026reg;)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.011\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.879\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.355\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAnecdotal\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.095\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.571\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.316\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.472\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 min\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.017\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.748\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.463\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.184\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 min post\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.742\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.592\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.675\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModerate\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eIn summary, more evidence is needed to support these initial findings. There is moderate evidence to support no differences in HR monitoring within devices when monitoring is conducted in either a school or lab setting. When comparing devices within a setting (school or lab) there is some evidence to suggest there may be small differences in HR monitoring at some, but not all, timepoints of measurement.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe aim of this study was to establish the test-retest reliability of a finger pulse device for monitoring heart rate during a 3MST\u003csub\u003e30\u003c/sub\u003e to estimate cardiorespiratory endurance (CRE) in a lab and school setting, and to compare indices of reliability with a chest worn heart rate monitor. Absolute mean differences between devices and settings were clinically insignificant, with the smallest variance observed at the 1min post recording. There was no statistically significant difference between measuring heart rate while performing the 3MST\u003csub\u003e30\u003c/sub\u003e in a laboratory or school-based setting, thus we cannot reject Ho1 - There is no meaningful difference between measuring heart rate while performing the 3MST\u003csub\u003e30\u003c/sub\u003e in a laboratory or school-based setting. Furthermore, there was no statistically significant difference between measuring heartrate while performing the 3MST\u003csub\u003e30\u003c/sub\u003e using a chest worn Polar\u0026reg; or finger pulse Braun\u0026reg; device. Therefore, we cannot reject Ho2 - There is no meaningful difference between measuring heartrate while performing the 3MST\u003csub\u003e30\u003c/sub\u003e using a chest worn Polar\u0026reg; device or finger pulse Braun\u0026reg; device.\u003c/p\u003e\u003cp\u003eResults from this study indicated there was no meaningful difference between measuring heart rate while performing the 3MST\u003csub\u003e30\u003c/sub\u003e in a controlled laboratory or school-based setting. Absolute mean differences ranged from 2\u0026ndash;8 bpm for the finger pulse device between school and lab settings. The practicality and feasibility of field-based tests for administration in school settings are crucial (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e), and estimation of cardiorespiratory endurance using the 3MST\u003csub\u003e30\u003c/sub\u003e and measuring heart rate using a finger pulse device may offer a practical and more palatable method for measurement. However, students, parents, and policymakers need to also have confidence in the validity and reliability of the data gathered (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Lang et al. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) identified assessing the accuracy and reliability of health measures in field-based settings as one of ten international priorities for physical fitness research and surveillance among children and adolescents identified by international experts in fitness. The current study addresses this priority by assessing the reliability of heart rate measurement during a step-test.\u003c/p\u003e\u003cp\u003eIn terms of variation across device types, no meaningful difference between measuring heartrate while performing the 3MST30 using a chest worn device or finger pulse device was observed, indicating that we can accept Ho2. In one of the first studies to examine the accuracy of pulse oximeters in estimating heart rate at rest and during exercise, Lyriboz et al (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) concluded that oximeter readings significantly correlated with those of ECG (r\u0026thinsp;=\u0026thinsp;0.91; p\u0026thinsp;\u0026lt;\u0026thinsp;.001), however, the authors indicated the use of pulse oximeters as heart rate monitors during strenuous exercise of greater than 155bpm is questionable. Mart\u0026iacute;n-Escudero et al (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) also reported that heart rate with wrist worn devices frequently underestimated heart rate when exercising at higher intensities. The 3MST30 step test is a sub-maximal test of CRE, thus, heart rate recordings of over 155 bpm are uncommon. In the current study mean recordings across the four timepoints (minute 1, minute 2, minute 3, 1 minute post) did not exceed 147bpm.\u003c/p\u003e\u003cp\u003eThis study had some limitations which should be noted. The small sample size and narrow age range of participants drawn from only one school limits the scope of our findings to be generalized to all field-based testing settings at this time. A larger sample size, involving a more diverse age range and the inclusion of an additional trial school-based trial could have improved the precision of the reliability estimates, while also allowing for a more detailed examination of results by age group. However, the novelty of the study design examining reliability at both a device and environment level and the authenticity of the environment in which testing took place are notable strengths of this study. This is the first study of its kind to examine and confirm the reliability of finger pulse monitoring while performing a submaximal test to estimate CRE and provides initial evidence to support the use of finger pulse monitoring during a submaximal CRE test.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eCalls from leading academics for the establishment of valid and reliable tools to estimate CRE in field-based settings have largely been ignored. The aim of this study was to investigate the reliability and validity of finger pulse monitoring as a tool for measuring heart rate during exercise among adolescents in lab and school settings. Overall absolute and relative reliability indices indicated that there was no meaningful difference between measuring heart rate while performing the 3MST30 in a laboratory or school-based setting. Furthermore, there was no meaningful difference between measuring heartrate while performing the 3MST30 using a chest worn heart rate monitoring device or finger pulse heart rate monitoring device. Therefore, this study shows that finger pulse monitoring is a reliable and valid method for assessing heart rate during sub-maximal exercise in both laboratory and school environments.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e3-minute step test (3MST\u003csub\u003e30\u003c/sub\u003e)\u003c/p\u003e\n\u003cp\u003eCardiorespiratory endurance (CRE)\u003c/p\u003e\n\u003cp\u003e20-metre shuttle run test (20MST)\u003c/p\u003e\n\u003cp\u003ephysical education (PE).\u003c/p\u003e\n\u003cp\u003eYoung Men’s Christian Association (YMCA)\u003c/p\u003e\n\u003cp\u003eBeats per minute (BPM)\u003c/p\u003e\n\u003cp\u003ePhysical Activity Readiness Questionnaire (PAR-Q)\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthics approval and consent to participate\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThe Helsinki Declaration guidelines were applied in this study and research ethics approval and the associated protocols was granted by the research ethics committee of the Faculty of Education and Health Sciences, University of Limerick (Approval No. 2022_06_27_EHS).\u0026nbsp;Informed consent to participate was received from the school principal, the participants, and their parents\u003c/p\u003e\n\u003ch2\u003eCompeting interests\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eNo potential conflict of interest was reported by the authors. This manuscript has not been published elsewhere and that it has not been submitted simultaneously for publication elsewhere.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData are available upon reasonable request.\u003c/p\u003e\n\u003ch2\u003eFunding\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThe study received support funding from \u003cem\u003ethe University of Limerick Faculty of Education and Health Sciences Seed funding Scheme\u003c/em\u003e. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eClinical trial number: Not applicable.\u003c/p\u003e\n\u003ch3\u003eAuthors Contributions\u003c/h3\u003e\n\u003cp\u003eBO\u0026rsquo;K: \u0026nbsp;Data collection and curation; Data Analysis; Writing, \u0026nbsp;original draft preparation; Writing, review and editing.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUB: Methodological design; Data Analysis; Writing, review and editing\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eKN: Data Analysis; Writing, review and editing\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eAcknowledgements\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCaspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSchmidt M, Magnussen C, Rees E, Dwyer T, Venn A. Childhood fitness reduces the long-term cardiometabolic risks associated with childhood obesity. Int J Obes. 2016;40(7):1134.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBezold CP, Konty KJ, Day SE, Berger M, Harr L, Larkin M, et al. The effects of changes in physical fitness on academic performance among New York City youth. J Adolesc Health. 2014;55(6):774\u0026ndash;81.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRaghuveer G, Hartz J, Lubans DR, Takken T, Wiltz JL, Mietus-Snyder M, et al. Cardiorespiratory fitness in youth: an important marker of health: a scientific statement from the American Heart Association. Circulation. 2020;142(7):e101\u0026ndash;18.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGr\u0026oslash;ntved A, Ried-Larsen M, M\u0026oslash;ller NC, Kristensen PL, Froberg K, Brage S, et al. Muscle strength in youth and cardiovascular risk in young adulthood (the European Youth Heart Study). Br J Sports Med. 2015;49(2):90\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTomkinson GR, Lang JJ, Tremblay MS. Temporal trends in the cardiorespiratory fitness of children and adolescents representing 19 high-income and upper middle-income countries between 1981 and 2014. Br J Sports Med. 2019;53(8):478\u0026ndash;86.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eO\u0026rsquo;Keeffe BT, Donnelly AE, MacDonncha C. Test-retest reliability of student administered health-related fitness tests in school settings. Pediatr Exerc Sci. 2020;32(1):48\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEspana-Romero V, Artero EG, Jimenez-Pavon D, Cuenca-Garcia M, Ortega FB, Castro-Pinero J, et al. Assessing health-related fitness tests in the school setting: reliability, feasibility and safety; the ALPHA Study. Int J Sports Med. 2010;31(7):490\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOlds T, Tomkinson G, L\u0026eacute;ger L, Cazorla G. Worldwide variation in the performance of children and adolescents: an analysis of 109 studies of the 20-m shuttle run test in 37 countries. J Sports Sci. 2006;24(10):1025\u0026ndash;38.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRuiz JR, Silva G, Oliveira N, Ribeiro JC, Oliveira JF, Mota J. Criterion-related validity of the 20-m shuttle run test in youths aged 13\u0026ndash;19 years. J Sports Sci. 2009;27(9):899\u0026ndash;906.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBreithaupt P, Adamo KB, Colley RC. The HALO submaximal treadmill protocol to measure cardiorespiratory fitness in obese children and youth: a proof of principle study. Appl Physiol Nutr Metab. 2012;37(2):308\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWelsman J, Armstrong N. The 20 m shuttle run is not a valid test of cardiorespiratory fitness in boys aged 11\u0026ndash;14 years. BMJ Open Sport Exerc Med. 2019;5(1):e000627.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLloyd M, Colley RC, Tremblay MS. Advancing the debate on \u0026lsquo;fitness testing\u0026rsquo;for children: Perhaps we\u0026rsquo;re riding the wrong animal. Pediatr Exerc Sci. 2010;22(2):176\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMartin SB, Ede A, Morrow JR, Jackson AW. Statewide Physical Fitness Testing. Res Q Exerc Sport. 2010;81(sup3):S31\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCohen DD, Voss C, Sandercock GR. Fitness Testing for Children: Let\u0026rsquo;s Mount the Zebra! J Phys Activity Health. 2015;12(5):597\u0026ndash;603.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLang JJ, Zhang K, Agostinis-Sobrinho C, Andersen LB, Basterfield L, Berglind D et al. Top 10 International Priorities for Physical Fitness Research and Surveillance Among Children and Adolescents: A Twin-Panel Delphi Study. Sports Med. 2022.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBeutner F, Ubrich R, Zachariae S, Engel C, Sandri M, Teren A, et al. Validation of a brief step-test protocol for estimation of peak oxygen uptake. Eur J Prev Cardiol. 2020;22(4):503\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eJacks DE, Topp R, Moore JB. Prediction of VO2 Peak Using a Sub-maximal Bench Step Test in Children. Clin Kinesiol (Online Edition). 2012;66(3).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTrevi\u0026ntilde;o RP, Yin Z, Hernandez A, Hale DE, Garcia OA, Mobley C. Impact of the Bienestar School-Based Diabetes Mellitus Prevention Program on Fasting Capillary Glucose Levels: A Randomized Controlled Trial. Arch Pediatr Adolesc Med. 2004;158(9):911\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCosoli G, Spinsante S, Scalise L. Wrist-worn and chest-strap wearable devices: Systematic review on accuracy and metrological characteristics. Measurement. 2020;159:107789.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLakens D, McLatchie N, Isager PM, Scheel AM, Dienes Z. Improving inferences about null effects with Bayes factors and equivalence tests. Journals Gerontology: Ser B. 2020;75(1):45\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eO\u0026rsquo;Hagan A. The Bayesian approach to statistics. Chapter; 2008.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBianco A, Jemni M, Thomas E, Patti A, Paoli A, Ramos Roque J, et al. A systematic review to determine reliability and usefulness of the field-based test batteries for the assessment of physical fitness in adolescents - The ASSO Project. Int J Occup Med Environ Health. 2015;28(3):445\u0026ndash;78.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFroberg K. Relations between physical activity, fitness, muscle strength and health: findings from the European youth heart study (EYHS). Educ Phys Train Sport. 2014;2:10\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eIyriboz Y, Powers S, Morrow J, Ayers D, Landry G. Accuracy of pulse oximeters in estimating heart rate at rest and during exercise. Br J Sports Med. 1991;25(3):162\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMart\u0026iacute;n-Escudero P, Cabanas AM, Dotor-Castilla ML, Galindo-Canales M, Miguel-Tobal F, Fern\u0026aacute;ndez-P\u0026eacute;rez C, et al. Are activity wrist-worn devices accurate for determining heart rate during intense exercise? Bioengineering. 2023;10(2):254.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-sports-science-medicine-and-rehabilitation","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ssmr","sideBox":"Learn more about [BMC Sports Science, Medicine and Rehabilitation](http://bmcsportsscimedrehabil.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ssmr/default.aspx","title":"BMC Sports Science, Medicine and Rehabilitation","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Step test, cardiorespiratory endurance, exercise testing, physical fitness","lastPublishedDoi":"10.21203/rs.3.rs-7147261/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7147261/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: A finger pulse monitor offers multiple advantages for monitoring heart rate during exercise in comparison to chest worn monitors, including: enhanced testing efficiency; less invasive, particularly for vulnerable populations (e.g. children); and, reduced cost. The purpose of this study was to establish the test-retest reliability of a finger pulse device for monitoring heart rate during a 3-minute step test (3MST\u003csub\u003e30\u003c/sub\u003e) to estimate cardiorespiratory endurance in a lab and school setting, and to compare indices of reliability with a chest worn heart rate monitor.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: Participants (N= 29; male = 16; age: 15.83 ± .66) completed the 3MST\u003csub\u003e30 \u003c/sub\u003eon two occasions, in a lab setting (T1) and in a school setting (T2), one week apart. Participants wore a Braun® finger pulse monitor and a Polar® H7 chest strap heart rate monitor.\u0026nbsp; Heart rate in beats per minute (BPM) was recorded on both devices at 1-minute, 2-minutes, 3-minutes, and one minute following test completion. Equivalence testing was used to analyse the data for differences between the two devices by using the TOSTER R package.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: Absolute mean differences between devices and settings were clinically insignificant, with the smallest variance at the 1-minute post recording (finger pulse p = .012; chest strap = .041). There were no statistically significant differences in heart rate measurement between settings.\u003c/p\u003e\n\u003cp\u003eConclusions: This study demonstrates that finger pulse monitoring is a reliable and valid tool for measuring heart rate during sub-maximal exercise in lab and school settings.\u0026nbsp;\u003c/p\u003e","manuscriptTitle":"Finger pulse monitoring is a reliable and valid tool for measuring heart rate during exercise among adolescents in lab and school settings","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-01 09:27:08","doi":"10.21203/rs.3.rs-7147261/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision 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