Interpretation of Firstbeat reports
Select the desired language before logging in into the program by clicking the flag icon above the credentials.
What should be done if the client has not received the e-mail with the link to the Measurement journal and Personal information forms?
Make sure the client’s e-mail address has been entered correctly to the person’s profile. Check the status of the links in the assessment view under ‘Before measurement’. It shows when the link has been sent and if it is valid or not.
What should be done if the client wants to continue filling the journal after the assessment has closed, but the link is no longer valid?
The e-mail with the appropriate link can be re-sent by clicking the ‘Re-send the link…’ button in the assessment main view. Re-sending the link gives the client 7 extra days for filling in the journal.
What should be done when downloading the data to the Firstbeat AnalysisServer, the program states that there is a connection problem with the Bodyguard?
If using the Bodyguard 2 (new model):
First make sure that the device is connected to the USB port. Check that green and orange LED-lights are on (orange may be flashing to indicate that the battery is recharging). If the green LED-light is not on, try re-plugging the device to another USB port.
Check that either the Firstbeat Uploader or the Uploader Plugin is installed to the computer. If the Uploader Plugin is just installed, make sure to restart the web browser. Then test the connection again.
If still no connection, please check the device drivers have been correctly installed. Driver can be checked from the computer’s Control Panel under ‘Device manager’. Firstbeat Bodyguard 2 appears on the list as ‘FirstBeat USB devices’. If the device does not appear in the list, please re-install the driver.
If these guidelines did not help, please contact the support.
If using the Bodyguard 1 (older model):
First make sure that the Bodyguard is connected to the computer with a downloading cable that includes the Firstbeat interface.
See if at least the green and blue LED-lights are ON. These lights indicate that the device is communicating with the computer. If one or both of these lights is not on, try re-plugging the Bodyguard to the downloading cable. Make sure that the cable is tightly attached to the USB interface.
If the green and yellow LED-lights are flashing alternately, it means that the battery is empty or almost empty and the device is charging. Wait until the flashing stops and only the green LED-light stays on. Then test the connection again.
Make sure that the Firstbeat Uploader program, which is required for data download, is installed on the computer. The Uploader can be installed here. The software can also be downloaded from Analysis Server by selecting ‘Tools’ > ‘Download Uploader’.
If the problem persists, it is recommended to reset the device. A short video about resetting the Bodyguard can be viewed here. Please note that resetting does not empty the device memory.
If these guidelines did not help, please contact the support.
Measurement starting time can be changed under the Measurements tab in Individual assessments. Open ’Individual assessments’ under the ‘Assessments’ tab and select ‘Measurements’. Click the desired measurement from the list and the ‘Change start time’ button below the chart activates. Give new start time and save the dialog.
The assessment start and end dates can be changed from the assessment main view. Open the desired assessment and click ‘Edit’ button on the left. Give new dates and save the changes. Changing the start and end dates does not affect the device preparation or the ability to measure.
Username and password can be changed in ‘My settings’. Sign into Firstbeat Analysis Server and click ‘My settings’ on the top right hand corner. From the opening dialog select ‘Credentials’. Give new password and save the dialog.
If the password is lost or forgotten, it can be reset from the login page. Click the link ‘Forgot password?’ and enter a username. The new password is sent to the email address added for the given username.
Physical workload report can be selected under ’Custom assessments’. Create a new assessment for a client, select ’Custom assessment’ and go through the assessment process as usual. After clicking ‘Create reports’ button, a dialog opens that shows the available reports for creations. Select the desired reports and click ‘OK’. The physical workload report is created either from the work time, i.e. the time that is marked as work in the journal or from the whole day. The setting can be changed from ‘My settings’ > ‘Assessment options’.
How is a group report from individual assessments created?
A group report can be created from individual assessment in the ‘Group reporting’ tool. Select ‘Assessments’ > ‘Group reporting’. This tool lists all the group reports created in the customer account. To create a new report, select ‘Create group report’. Select ‘Add assessments’. After all the desired assessment have been added to the report select the report settings, group reports to be created and click ‘Create reports’.
Interpretation of Firstbeat reports
Heart rate variability (HRV) means the variation in time in milliseconds (ms) between consecutive heartbeats. The heart does not beat completely regularly. For example at rest, it is normal that the person’s heart rate increases during inhalation and decreases during exhalation. The R-waves detectable in the ECG graph describe the contraction of the heart’s left ventricle, and the time between consecutive R-waves is called an R-R interval (RRI).
The heart’s functioning is electrical activity that can be measured with an electrocardiogram (ECG). When the electrical impulse reaches a certain part of the cardiac muscle (myocardium), it causes the ventricles to contract, which is the heartbeat. Thus, heartbeat means the contraction of the ventricles, whereas ECG reflects all of the cardiac muscle’s electrical activity.
How does the method determine / differentiate between stress, recovery and physical activity? Do the journal markings affect these determinations?
Determination of stress and recovery state is affected by heart rate level, breathing frequency, heart rate variability and oxygen uptake. The person’s background information determines the individual level of each state. When oxygen uptake increases to over 20% of the person’s maximal capacity, the analysis starts to identify different levels of physical activity and no longer determines whether the state is stress or recovery. The journal markings have no effect on detection of different states. However, they help the client remember the events of the day and give more depth to the feedback discussion by allowing reflection on the events that tend to cause stress or recovery.
The program calculates the maximum heart rate with the formula 210 – (0.65 x age). If there is a higher value during the measurement period than what the formula provides, the program asks if you want to update the newly found max heart rate to the background information. It is recommended to update the new value. If the program suggests, for example, a max heart rate of 220, it is a good idea to visually inspect the data and make sure that the value was found from a reliable data segment (and not e.g. from an error peak).
The maximum heart rate might need to be increased (that is, update it to a higher value under personal information, save it and re-create the reports), if the person’s heart rate during the measurement is very high / close to their estimated maximum heart rate during normal physical activity (not some kind of maximal effort). If the heart rate actually goes higher than the estimated value, the program will automatically suggest that the max value should be updated. In situations when the person’s heart rate level is generally high throughout the day, without the person engaging in actual physical activity (the analysis might show several hours of physical activity), it’s sometimes advisable to increase the maximum heart rate by 10-20 beats. Increasing the maximum heart rate in these types of situations improves the accuracy of the calculation of health promoting physical activity and training effect.
Resting heart rate is calculated as the average value (from 50 consecutive heartbeats) from the lowest found heart rate. For measurements that are conducted during the same time period (e.g. a year), it’s advisable to use the same resting heart rate. Resting heart rate can be either the lowest measured value or a value that the specialist has re-defined. To get a reliable value, it is important that the measurement includes normally- or well-slept nights. It is recommended to drop the measured resting heart rate by 2-4 beats if there are clear signs that the person is not in a normal or recovered state during the measurement. This can be justified if one or more of the following conditions are fulfilled: The person A) feels especially stressed (e.g. based on the pre-questionnaire), B) has consumed 3 or more portions of alcohol on the day when the lowest heart rate value was found, C) has been ill during the measurement period (e.g. fever) D) has rated his/her sleep as bad during the night when the lowest heart rate value was found.
The client has been physically very active during the measurement, but receives very few health promoting physical activity points. How do I explain this discrepancy?
The most typical explanation for the ”discrepancy” is that the heart rate during the physical activity has been so low that it does not fulfill the criteria of health promoting physical activity (HPPA). HPPA is determined as time periods during which oxygen uptake was over 40 % of estimated max VO2 for at least 4 minutes consecutively. Thus, for example short interval type exercise, weight training, Pilates or yoga, or very light intensity endurance activities (e.g. walking the dog) are often not of sufficient aerobic intensity to have a significant health effect on the cardiovascular system. However, a comprehensive exercise program should include a variety of different types of exercise, and it’s good to remind the client of this. The HPPA report only rates the health effects of aerobic / heart rate increasing exercise.
The stress and recovery chart and the figure that evaluates sleep quality (RMSSD) show conflicting results. Why is this?
In a fairly typical “conflict” situation there is not much recovery in the stress and recovery chart (i.e. stress state is present during sleep and share of recovery during sleep is poor), but the index that describes sleep quality (RMSSD) is at a good level. In these cases, it usually implies an acute stress state that is more readily reflected in heart rate level, and the presence of stress or recovery state, but not yet in heart rate variability. RMSSD is a value that describes how large heart rate variability is, and it reacts more slowly than heart rate. Especially young and physically fit people can have strong heart rate variability, even if other signs of acute stress are present. The “conflict situation” can also be the other way around, so that the stress chart looks pretty good or good during sleep (a lot of recovery), but RMSSD is very low (poor or hardly moderate). In these cases, it’s good to find out more about the person’s overall situation and make sure that there is no illness or longer-term overload in the background. It should also be determined if the measured resting heart rate value is reliable enough and decrease it if one or more of the conditions during which it’s appropriate to drop the resting heart rate is fulfilled (see question How is the resting heart rate calculated and in which situations should it be decreased?) The person’s age affects the result strongly; heart rate variability can be naturally rather low when you are older (age is taken into account in the reference values). Certain medications and illnesses can also reduce heart rate variability.
There is a lot of error (“missing heart rate”) in the measurement. What factors can cause this and how much error can there be for the result to still be considered reliable?
The percent of measurement error (missing heart rate) per day is found in the reports by the heart rate graph. In a measurement of good quality, there are less than 10 % of missing heart rate, of moderate quality 10-15 %. When there are more than 15 % of missing heart rate, the reliability starts to be compromised, and at the latest when the percent is > 20 % on all measurement days, Firstbeat recommends making a new measurement. If there is a long measurement break (several hours), it shows up as increased missing heart rate %, but does not otherwise affect the reliability of results. The most typical error comes from bad electrode contact (hair has not been removed from the electrode site or the skin is greasy or dirty, or the wires are too tight and cause constant “pull” on the electrodes); in these cases, there is usually constant error throughout the measurement or at least when the person is moving about. If there is little or no error during sleep, the reason is usually bad contact, which becomes more obvious when the person is moving. If there is steady error throughout the measurement day and night (50-70 % or more), a technical flaw with the device is suspected. A high percent of missing heart rate (e.g. 30-40 %) can also imply ectopic beats of the heart or other irregularities in heart function, which prevents reliable detection of the R-wave. This is suspected especially if the other possible causes have been ruled out and there is no indication of bad electrode contact. In these cases, it’s good to check the Specialist report, to see if the program’s automatic detection has discovered signs of ectopic beats.
The Firstbeat analysis program is not designed to be a tool for detecting arrhythmias. However, if there are signs of ectopic heartbeats (or other irregularity) in the measurement, the Specialist report (a summary tool for the professional) will display a red text: “There is indication that the measurement contains ectopic beats. Ectopic beats are common, but further tests are recommended to establish their cause.” When this text shows up on the Specialist report, and if the client was not previously aware of possible ectopic beats, we recommend having an electrocardiogram (ECG) in order to make further conclusions. The ectopic beat text is displayed if there are more than 800 ectopic beats on 2 out of 3 measurement days.
The accelerometer data improves the ability of the analysis to recognize whether an increased activation level in the body is caused by mental stress or physical activity. This improves the accuracy especially with unfit people, with whom even slight activation can increase the heart rate significantly, and also with very fit people, who typically do not show much of a heart rate reaction to light exercise.