Evaluation of Photoplethysmography-Based Monitoring of Respiration Rate During High-Intensity Interval Training: Implications for Healthcare Monitoring

Monitoring respiration rate (RR) is crucial in various healthcare settings, particularly during demanding (physical) activities where respiratory dynamics are critical indicators of health status. This study aimed to evaluate the accuracy of photoplethysmography (PPG)-based monitoring of RR during high-intensity interval training (HIIT) and its potential applications in healthcare. Between January and March 2024, healthy volunteers participated in a cycling HIIT session with increasing resistance levels. The RR measurements obtained using the PPG-based CardioWatch 287-2 (Corsano Health) were compared with an ECG patch-derived (Vivalink) reference. Subgroup analyses were conducted based on skin type and sex. A total of 35 participants contributed 1794 paired RR measurements. The PPG algorithm for RR monitoring showed an average root mean square (Arms) error of 2.13 breaths per minute (brpm), a bias of -0.09 brpm, and limits of agreement (LoA) from -4.28 to 4.09 brpm. Results were consistent across the different demographic subgroups. The CardioWatch 287-2 therefore demonstrated reliable RR monitoring during HIIT, supporting its potential use in healthcare settings for continuous, non-invasive respiratory monitoring, particularly in physical rehabilitation and chronic respiratory condition management.