Experimental Analysis on the Effect of Contact Pressure and Activity Level as Influencing Factors in PPG Sensor Performance.

Photoplethysmographic (PPG) sensors are small and cheap wearable sensors which open the possibility of monitoring physiological parameters such as heart rate during normal daily routines, ultimately providing valuable information on health status. Despite their potential and distribution within wearable devices, their accuracy is affected by several influencing parameters, such as contact pressure and physical activity. In this study, the effect of contact pressure (i.e., at 20, 60, and 75 mmHg) and intensity of physical activity (i.e., at 3, 6, and 8 km/h) were evaluated on a sample of 25 subjects using both a reference device (i.e., an electrocardiography-based device) and a PPG sensor applied to the skin with controlled contact pressure values. Results showed differing accuracy and precision when measuring the heart rate at different pressure levels, achieving the best performance at a contact pressure of 60 mmHg, with a mean absolute percentage error of between 3.36% and 6.83% depending on the physical activity levels, and a Pearson's correlation coefficient of between 0.81 and 0.95. Plus, considering the individual optimal contact pressure, measurement uncertainty significantly decreases at any contact pressure, for instance, decreasing from 15 bpm (at 60 mmHg) to 8 bpm when running at a speed of 6 km/h (coverage factor k = 2). These results may constitute useful information for both users and manufacturers to improve the metrological performance of PPG sensors and expand their use in a clinical context.