New Garmin “High Intensity Exercise” monitoring and what it showed my body is doing

This is both interesting and slightly worrying. I got a Garmin Vivostyle watch/activity tracker for my birthday last year and it does all sorts of very useful things to help me keep an eye on what’s going on with my poor beleaguered body in an attempt to spot at least some form of pattern to my symptoms. It tracks heart rate, stress levels, something called a “body battery” which uses your heart rate variability measurement (HRV) to predict and track your energy levels (something I’ve found extremely useful for ME) and a host of other stuff like sleep and O2 sats. It also has a high heart rate warning so I get a buzz on my wrist if my heart rate gets too high when I’m not doing anything too strenuous.

Anyway, they’ve recently updated the phone app and the watch software to include an “exercise intensity tracker”. Apparently according to the WHO we’re all supposed to do about 150 minutes a week of high intensity exercise, which means exercise intense enough that you can’t really talk during it. So more than jogging, more like intense aerobics or sprinting, obviously something well out of the capabilities of most ME peeps, and certainly much, much more than I could do with severe ME that leaves me stuck in bed most of the time. My watch works out how long I spend in this “high intensity” mode using the heart rate data it collects and an algorithm comparing my resting heart rate and my heart rate during activity (I’m quoting Garmin’s explanation here, I’m sure someone will understand exact what they do to get these results!).

Bearing in mind that I have severe ME and have spent the last six weeks pretty much in bed 24/7 (and my heart rate goes from mid fifties to up to between 105 to 130 literally just from standing up due to POTS), the graph it showed me today is pretty astounding and looking at these figures it’s no wonder I’m feeling dreadful despite doing sweet FA for the last six weeks.

My body is doing the equivalent of high intensity exercise the entire time I’m awake. Instead of the 2.5 hours a week of intense exercise recommended for healthy people by the WHO, according to this, last week I did over 85 HOURS in one week of “high intensity exercise”, or at least my heart and body did, even in bed. An entire week is only 168 hours so I spent half the week, or my entire waking time, with my poor body in a state comparable to high intensity exercise, exercise so vigorous that if I was doing it for real I wouldn’t have breath to speak. And this is while I was pretty much doing nothing but being in bed 24/7.

While it’s quite shocking to see just how hard my poor body is working at the moment even when I’m in bed the whole time, it’s also really validating to see it in actual data rather than just feeling it subjectively. Although I still feel like hammered crap, regardless of whether it’s subjective or objective...

I try and do the HR pacing to avoid PEM as far as I can but unfortunately for me, I can go over the HR limit just from standing up so it’s no wonder I spend most of my time in bed. But this new thing on my watch really shows in stark detail just how much work my body is doing even when I’m actually doing virtually nothing at all and am flat on my back to boot. Somewhat sobering, tbh.

Not really sure what to make of it but thought others might be interested to see an actual data representation of how hard our bodies work even when we appear to be doing very little. And I can thoroughly recommend the Vivostyle if anyone is thinking of an activity tracker that isn’t a typical sports watch.

Here’s the screenshots of the app - the bar graph is the activity one for last week and the line graph is my heart rate over the same week (click on image to see full size pic).

I’d be interested in people’s thoughts on this.



Edited to change photos from full size to thumbnails and add instructions on how to view.

 

Though I did think it was quite funny that this is literally the only activity/exercise goal I’ve ever met using the Garmin .

 

I noted something very similar a couple of years ago - I could rack up over 100 intensity minutes while lying on a sofa for an hour. These numbers could also be absurdly high whilst unconscious, not sleeping, unconscious/shut down.

I seem to remember a figure of over 2000 IMs in a week, doing very little other than drinking, eating and sleeping.

My experiences were all posted on here back then - I suspect I may have been slightly obsessed by the absurdity of it lol

My body was clearly up to something.

I am, and have been for a 'while' unable to tolerate wearing the watch (Garmin vivoactive 3 I think) so I have no idea what the numbers are now.

 

Interesting. I have a Fitbit, which seems to measure much less than your Garmin. However it regularly tells me I’m having cardio workouts, when clearly I’m not! Maybe it’s just that we have elevated HR on low intensity activity?

I’ll admit, I’m tempted to upgrade my Fitbit to something like your Garmin. Stats still fascinate me.
For example my Fitbit tells me my the annual average of all my daily stepcounts!

 

My Polar tells me I run a lot. I think the algorithms just aren't made to account for tachycardia and they misinterpret any high heart rate as being the result of exercise. To get a heart rate of 160 a healthy person would have to run quite fast. I just need to walk slowly to the bathroom. You'd think they'd have the technology to ascertain speed of movement but probably nobody ever thought of including it into the algorithm because all the developers are fit and healthy and blissfully ignorant of any other state.

Incidentally, my Oura ring used to tell me that I could reach my activity goal by walking 10km today. It just assumed I actually had an activity goal. But a few months ago the app got updated and there's now a rest mode that tells me to "Take it easy!". Much better.

 

I have the vivoactive 3 and get very similar results. My heart rate can go from about 60 if I am sitting down to 130 just by standing up. I got the watch so that I could use the “stress” function. I had read that you can use this to give an indication of when you need to rest. Ie if you think you are having a good day and might do something slightly more active but the watch is saying that your body is under high stress then you shouldn’t really do it. I have found that it works quite well and some days my body is definitely under much less stress.
There is a really interesting video by physios for ME on YouTube that goes into the science no this is based on.

 

I have a Fitbit and have noticed the same variability in heart rate although on a different scale. In fact I can reasonably predict my ME symptom variability/envelope changes from a combination of steps and how many minutes I spend in my allowable “active” heart rate zone (84-117 bpm).

I’m mild, have a base heart rate of 58 bpm and can normally do around 2500 steps per day with my most active tasks being showering and climbing stairs to go to bed. I may do light housework, pottering type jobs but this is very light and only at the weekend. I normally try and restrict my active heart rate to under 100bpm so well below my anaerobic threshold. At the moment I’m on reduced steps (1500) due to a relapse. However my “active” heart rate zone minutes are actually higher than before.

So when I’m in stable 2500 steps-mode I will do on average 30-50 hrs of “active” heart rate zone per month.

At my reduced 1500 steps, cutting out showers every day and spending 90% of my waking hrs seated or horizontal I’m doing 40-50hrs per month. The difference in physical exertion is reduced by at least 50% but my heart rate activity is higher.

I also get periods of activity measured when I’m sat down with legs raised when I’m in PEM before the relapse.

The relapse was triggered by a cold and I can see base heart rate rising by up to 10bpm higher than normal during the period of the cold and then falling back to a few bpm above my base rate. I’ve noticed that digestion seems to trigger massive rises in heart rate, more so than before the relapse. By far the worse though is alcohol. I am now experiencing tachycardia/hot flushes and brain fog episodes around 1-2hrs after consuming around 250ml of wine during a meal. I never drank excessively before the relapse; now though, just a couple of small glasses of wine with a meal and my heart rate just overreacts with episodes lasting hrs into the night following an early evening meal.

I would be interested to see a study on this heart rate variability. The problem will be getting consistent measures of “activity” to relate back to steps and heart rate though particularly as this is not a consistent response.

 

Really good to have other people’s experiences of this too, and glad,if that’s the right word, that I’m not alone!

I’ve persuaded my daughter to get a Garmin as well - they’re not cheap, unfortunately, but I’m very impressed by mine although I did go for the upgraded aluminium body and gorilla glass casing as I have a tendency to batter anything on my hands and wrists due to clumsiness. She’s in the process of having whatever-it-is that’s causing her terrible fatigue and pain levels diagnosed and tested for so this will be actual data we can wave under the various medics noses and hopefully she won’t be dismissed in the same way I was.

@Keela Too i can really recommend the Garmin - I was looking for a health tracker rather than an activity tracker (for obvious reasons!) and after extensive research I decided on this one. It also looks very much like a watch and isn’t obviously anything other than that which I wanted purely for aesthetic reasons and because I like simple devices that don’t scream “tech” at you , but that’s just personal preference. The colour screen is hidden and shows up when you tap the face. I’ve found, like @Sbag, that the stress monitoring is helpful, but the “body battery” is even more so and can, to a certain extent, predict when I’m going to have a bad day. I think they work on the same metrics though with the stress thing being more immediate and the body battery being the longer term version of the same thing.

One thing I will say about activity trackers on wrists is that in my experience they are terrible at step tracking if you don’t do very many. I’ve had several different ones and they’re all rubbish at this, even though they’re supposed to take into account the hand movements we all naturally do which are often added on as steps taken. The trouble seems to be that they accept a roughly 10% error rate for counting steps, which, when you do thousands of steps a day isn’t really a major problem, but if you only do hundreds then that 10% suddenly becomes a huge number. I was getting measurements of well over 50% more from my various wrist trackers when a pocket pedometer was registering steps in the low hundreds - as I was hoping to use this data in my disability benefits claim it was a bit of a disappointment, but if you want an accurate step counter then this won’t be it, at least until they improve the algorithm used.

@Trish, that’s a really interesting idea, and one I might well follow up when I’ve recovered from this present relapse. I will definitely ask them for some more detail on how they arrive at these numbers. Originally I was going to set the heart rate target ranges within the app to the much lower ones I use for HR pacing and use the app as a tracking system, but now I think that the comparison to a “normal” person that it currently shows might be even more useful and interesting to keep an eye on.


@arewenearlythereyet you actually sound more moderate than mild to me with those levels of activity but like you I’d be interested in a study in HRV and whether it can help us monitor and perhaps predict our energy levels and PEM episodes a little more. I have to say that whatever the Garmin algorithm does, it does seem to be useful in that a combination of using the stress monitor for short term, instant readings and the body battery one for 24hr periods allows a little more predictability than before. The stress monitor is particularly useful for me because I find it goes off even when I don’t feel stressed. But physical stress, like pain or discomfort which I struggle with from arthritis and endometriosis as well as from ME, can and often does trigger an episode of PEM which is one of the reasons I have had to fight so hard to make people understand about the level of pain relief I need. I can feel my body start to go into shock mode, with cold clammy sweats and dizziness and other weird stuff if I’m in significant pain or if I’ve had to seriously overdo it because of some crisis or other so being able to actually measure and show this with real, actual, not-in-any-way-subjective data has been extremely useful.

I’ve always had a slightly slower resting HR than most people, even before I was ill, at around the low sixties mark but since then it’s got lower and is now usually around 52/53 but I’ve noticed a significant variation in how high it goes and this also seems to be reflected in how I’m feeling. A much higher jump when upright or for things like going up the stairs correlates with feeling worse, and also with aches in the big muscle groups and a feeling of drain and “light-headedness” in my arms and legs (I’m sure there’s a technical term for this but it’s the only way I can think to describe how it feels, almost like dizziness in my muscles. It’s a fatigue thing?).

Thanks everyone, apologies if I’ve missed you in this reply, I value everyone’s ideas and inputs but I’m very foggy today and shattered to boot. Must be all that high intensity exercise I’m doing...

Take care, all x

 

It's all very odd; I have the opposite problem, in that I often struggle to get my heart rate up.

This is my Fitbit chart for the other day, when I spent most of the afternoon gardening/having a rest/gardening. The 'peak' was when I had to lift and move two 60 litre bags of very wet compost weighing around 30kg each.

I was at the limit of my physical capabilities, but I could barely break 100 BPM.



I too notice that my RHR goes up in PEM, @Blueskytoo. It goes up to about 61, whereas it's mid 50s when I'm rested. It's a very reliable sign that I need to do better with my pacing.

 

It's the POTS. I also often feel like I'm doing strenuous work when in reality I'm just sitting there. I'm not as severely ill so I don't have to lie in bed much during the day.

Low blood volume or blood pooling or similar things could create conditions in the body where the heart has to work very hard. That's how I explain it to myself.

 

High intensity minutes, for no obvious reason, were a pretty good indication, if one were needed, that I was PEM'd. Or, at much lower levels, that I was about to be so should stop, everything.

They did not occur, on the same scale, whilst actually doing things, but afterwards - if they were seen during doing stuff then it was a pretty good indication that I shouldn't be, that I had already overdone things.

e.g. whilst walking to the local supermarket, or back from it, I could pick up upto 30 intensity minutes, normally lower, but if I'd overdone things then just sitting, lying, or being unconscious on the sofa could cause an increase of 100+ (I think the highest I saw was around 240) in under an hour.

On the version of the software in my garmin, 1 intensity minute is one minute (after the first 10) of 'moderate' level exercise - allegedly a brisk walk where conversation is still possible. However 2 intensity minutes per minute can be gained for high intensity activity, after the first 10 minutes, - hard breathless activity, like HIIT etc.

So in an hour the maximum number of IMs possible should be no more than 100. 60 minus the 10 minutes before it starts counting/qualifying, times 2. It was not uncommon for me to get more than 100 IMs in an hour so...dunno lol

They don't work the way they say they do.

The 'stress' indicator is actually 2 things, on garmin anyway. The indicator on the watch is monitoring one thing, and in the 'connect' software another - the 'stress' panel in the app doesn't seem to just be an aggregate of the more instant watch readings.

It (the watch version) is not, as the name implies, anything to do with stress, but it appears to be some form of calculation based on inverse HRV. The app version does seem to be meant as some form of 'fitness to train' indicator, or at least it's inverse.

 

Medically uneducated though I am, it seems to me it is saying exactly what might be expected for someone with ME/CFS? Symptoms of significant physical challenge from very modest physical effort. Sounds worthy of a study or two. Did I hear recently of such a study? @PhysiosforME maybe? Something here in S4ME I think.

 

@Blueskytoo

I want one that i can set so that it continuously monitors my HR and alerts me when i go over 100 & under 60... does yours do that?
Also it needs to be able to do that without being hooked up to an app as i only have a very old iphone 5 that i use for necessary apps only. The whole smartphone/tablet thing is simply beyond me, its laptop or nothing basically. So although i can* access an iphone it's old & i wouldnt be looking at it regularly, i want it to just let me know when i'm over or under although the HRV function sounds really good i might get into looking at that over time.

If you think yours fits the bill for what i'm wanting can you pls tell me which exact model of garmin is it please - could i trouble you to find it on amazon & link it if you are able pls, because there are many different garmin models all with slightly different functionality.

 

The vivoactive 3 cannot do that, it claims it can, but in practice it doesn't really work, and it's best effort is 'annoying'.

It also randomly alerts, using the same method (buzzing/vibration on wrist) when certain, non user settable, 'goals' (such as climbing a flight of stairs, or walking a random distance) are reached - and this cannot be turned off unless all alerts are turned off.

The 'goal' alerts are exactly the same vibration as those for HR alarms.

 

I thought the vivoactive 3 could do that, well I know you can set a maximum heart rate and it buzzes if you go over that (I had to turn it off as it was always buzzing ). Not sure about the minimum alert. But you don’t need to use a phone to be able to see that.

there are a couple of Facebook groups dedicated to heart rate monitoring for ME/CFS. One of them had a spreadsheet of the different watches and compared them all.

 

It can, sort of - but what you may not be aware of is the delay, minutes, not instant, and once it starts going off then it goes off randomly - more than a little irritating.

 

how maddening!

thats worth knowing, because the delay makes it useless really. I want it to tell me when i go over my threshold, straight away.