Wearable Activity Trackers in the Management of Rheumatic Diseases: Where Are We in 2020?

In healthcare, physical activity can be monitored in two ways: self-monitoring by the patient himself or external monitoring by health professionals. Regarding self-monitoring, wearable activity trackers allow automated passive data collection that educate and motivate patients. Wearing an activity tracker can improve walking time by around 1500 steps per day. However, there are concerns about measurement accuracy (e.g., lack of a common validation protocol or measurement discrepancies between different devices). For external monitoring, many innovative electronic tools are currently used in rheumatology to help support physician time management, to reduce the burden on clinic time, and to prioritize patients who may need further attention. In inflammatory arthritis, such as rheumatoid arthritis, regular monitoring of patients to detect disease flares improves outcomes. In a pilot study applying machine learning to activity tracker steps, we showed that physical activity was strongly linked to disease flares and that patterns of physical activity could be used to predict flares with great accuracy, with a sensitivity and specificity above 95%. Thus, automatic monitoring of steps may lead to improved disease control through potential early identification of disease flares. However, activity trackers have some limitations when applied to rheumatic patients, such as tracker adherence, lack of clarity on long-term effectiveness, or the potential multiplicity of trackers.

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The Acceptability, Feasibility and Effectiveness of Wearable Activity Trackers for Increasing Physical Activity in Children and Adolescents: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126211 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6211

Author(s):

Amy V. Creaser ◽

Stacy A. Clemes ◽

Silvia Costa ◽

Jennifer Hall ◽

Nicola D. Ridgers ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Children And Adolescents ◽

Behaviour Change Techniques ◽

Physically Active ◽

Self Monitoring ◽

Start Date ◽

Activity Trackers ◽

Wearable Activity Trackers

Wearable activity trackers (wearables) embed numerous behaviour change techniques (BCTs) that have previously been shown to increase adult physical activity (PA). With few children and adolescents achieving PA guidelines, it is crucial to explore ways to increase their PA. This systematic review examined the acceptability, feasibility, and effectiveness of wearables and their potential mechanisms of action for increasing PA in 5 to 19-year-olds. A systematic search of six databases was conducted, including data from the start date of each database to December 2019 (PROSPERO registration: CRD42020164506). Thirty-three studies were included. Most studies (70%) included only adolescents (10 to 19 years). There was some—but largely mixed—evidence that wearables increase steps and moderate-to-vigorous-intensity PA and reduce sedentary behaviour. There were no apparent differences in effectiveness based on the number of BCTs used and between studies using a wearable alone or as part of a multi-component intervention. Qualitative findings suggested wearables increased motivation to be physically active via self-monitoring, goal setting, feedback, and competition. However, children and adolescents reported technical difficulties and a novelty effect when using wearables, which may impact wearables’ long-term use. More rigorous and long-term studies investigating the acceptability, feasibility, and effectiveness of wearables in 5 to 19-year-olds are warranted.

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B.01 Impact of work-hours and sleep on well-being and burnout for physicians-in-training: the prospective RATE Study

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2017.72 ◽

2017 ◽

Vol 44 (S2) ◽

pp. S10-S10

Author(s):

D Mendelsohn ◽

I Despot ◽

PA Gooderham ◽

A Singhal ◽

GJ Redekop ◽

...

Keyword(s):

Physical Activity ◽

Job Satisfaction ◽

Well Being ◽

Work Hours ◽

Surgical Residents ◽

Activity Trackers ◽

Steps Per Day ◽

Wearable Activity Trackers ◽

Rate Study ◽

The Impact

Background: Wearable activity trackers are an innovative tool for measuring sleep and physical activity. The Resident Activity Tracker Evaluation (RATE) is a prospective observational study evaluating the impact of work-hours, sleep, and physical activity on resident well-being, burnout, and job satisfaction. Methods: Residents were recruited from: 1. general surgery and orthopedics (SURG), 2. internal medicine and neurology (MED) and 3. anesthesia and radiology (RCD). Groups 1 and 2 do not enforce on-call duration restrictions and group 3 had 12-hour restricted-call durations (RCD). Participants wore FitBit activity trackers for 14 days and completed four validated surveys assessing self-reported health, sleepiness, burnout, and job satisfaction. Results: Fifty-nine residents completed the study. 778 days of activity and 244 on-call periods were tracked. Surgical residents worked 24 more hours per week than non-surgical residents (84.3 vs 60.7). Surgical residents had 7 less hours of sleep per week and reported significantly higher Epworth Sleepiness scores. Nearly two-thirds of participants (61%) scored high burnout on the Maslach depersonalization subscore. Total steps per day and self-reported well-being, burnout, and job satisfaction were comparable between the groups. Conclusions: Despite a positive correlation between work-hours and sleepiness, burnout and well-being were similar among residents. Physical activity did not prevent burnout. These findings are relevant to work-hours policies.

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The Use of Wearable Activity Trackers Among Older Adults: Focus Group Study of Tracker Perceptions, Motivators, and Barriers in the Maintenance Stage of Behavior Change (Preprint)

10.2196/preprints.9832 ◽

2018 ◽

Author(s):

Anastasia Kononova ◽

Lin Li ◽

Kendra Kamp ◽

Marie Bowen ◽

R.V. Rikard ◽

...

Keyword(s):

Physical Activity ◽

Social Support ◽

Older Adults ◽

Focus Groups ◽

Short Term ◽

Activity Tracker ◽

Activity Trackers ◽

Maintenance Stage ◽

Wearable Activity Trackers

BACKGROUND Wearable activity trackers offer the opportunity to increase physical activity through continuous monitoring. Viewing tracker use as a beneficial health behavior, we explored the factors that facilitate and hinder long-term activity tracker use, applying the transtheoretical model of behavior change with the focus on the maintenance stage and relapse. OBJECTIVE The aim of this study was to investigate older adults’ perceptions and uses of activity trackers at different points of use: from nonuse and short-term use to long-term use and abandoned use to determine the factors to maintain tracker use and prevent users from discontinuing tracker usage. METHODS Data for the research come from 10 focus groups. Of them, 4 focus groups included participants who had never used activity trackers (n=17). These focus groups included an activity tracker trial. The other 6 focus groups (without the activity tracker trial) were conducted with short-term (n=9), long-term (n=11), and former tracker users (n=11; 2 focus groups per user type). RESULTS The results revealed that older adults in different tracker use stages liked and wished for different tracker features, with long-term users (users in the maintenance stage) being the most diverse and sophisticated users of the technology. Long-term users had developed a habit of tracker use whereas other participants made an effort to employ various encouragement strategies to ensure behavior maintenance. Social support through collaboration was the primary motivator for long-term users to maintain activity tracker use. Short-term and former users focused on competition, and nonusers engaged in vicarious tracker use experiences. Former users, or those who relapsed by abandoning their trackers, indicated that activity tracker use was fueled by curiosity in quantifying daily physical activity rather than the desire to increase physical activity. Long-term users saw a greater range of pros in activity tracker use whereas others focused on the cons of this behavior. CONCLUSIONS The results suggest that activity trackers may be an effective technology to encourage physical activity among older adults, especially those who have never tried it. However, initial positive response to tracker use does not guarantee tracker use maintenance. Maintenance depends on recognizing the long-term benefits of tracker use, social support, and internal motivation. Nonadoption and relapse may occur because of technology’s limitations and gaining awareness of one’s physical activity without changing the physical activity level itself.

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Daily Physical Activity and Sleep Measured by Wearable Activity Trackers during the Coronavirus Disease 2019 Pandemic: A Lesson for Preventing Physical Inactivity during Future Pandemics

Applied Sciences ◽

10.3390/app11219956 ◽

2021 ◽

Vol 11 (21) ◽

pp. 9956

Author(s):

Hidetaka Hamasaki

Keyword(s):

Physical Activity ◽

Physical Inactivity ◽

The Body ◽

Daily Physical Activity ◽

Healthcare Organizations ◽

Activity Tracker ◽

Activity Trackers ◽

Wearable Activity Trackers ◽

Wearable Activity Tracker ◽

The Impact

Wearable activity trackers are devices that are comfortably worn on the body and are designed to be effective in monitoring daily physical activity and improving physical fitness of the wearer. This review aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on physical activity measured using wearable activity trackers and discuss future perspectives on wearable activity trackers during pandemics. Daily physical activity was significantly decreased during the COVID-19 pandemic. The implementation of strict public health measures, such as total lockdown, can decrease people’s physical activity by 50% or more of that prior to the lockdown. Physical inactivity is significantly associated with several health problems, including obesity, diabetes, cardiovascular disease, and cancers; therefore, an effective healthcare system to prevent physical inactivity during pandemics should be established. It is essential to create a network between healthcare organizations and wearable activity tracker users to monitor real-time health status and prepare for the future pandemic.

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Parental Perspectives of a Wearable Activity Tracker for Children Younger Than 13 Years: Acceptability and Usability Study

JMIR mhealth and uhealth ◽

10.2196/13858 ◽

2019 ◽

Vol 7 (11) ◽

pp. e13858 ◽

Cited By ~ 14

Author(s):

Kelly A Mackintosh ◽

Stephanie E Chappel ◽

Jo Salmon ◽

Anna Timperio ◽

Kylie Ball ◽

...

Keyword(s):

Physical Activity ◽

Activity Levels ◽

Distance Information ◽

Activity Tracker ◽

Activity Trackers ◽

Activity Promotion ◽

Parental Perspectives ◽

Physical Activity Levels ◽

Wearable Activity Trackers ◽

Wearable Activity Tracker

Background There is increasing availability of, and interest in, wearable activity trackers for children younger than 13 years. However, little is known about how children and parents use these activity trackers or perceive their acceptability. Objective This study primarily aimed to ascertain parental perspectives on the acceptability and usability of wearables designed to monitor children’s physical activity levels. Secondary aims were to (1) identify practical considerations for future use in physical activity interventions and promotion initiatives; (2) determine use of different features and functions incorporated into the accompanying app; and (3) identify parents’ awareness of their child’s current physical activity levels. Methods In total, 36 children (18 boys and 18 girls) aged 7-12 years were asked to wear a wrist-worn activity tracker (KidFit) for 4 consecutive weeks and to use the accompanying app with parental assistance and guidance. Each week, one parent from each family (n=25; 21 mothers and 4 fathers) completed a Web-based survey to record their child’s activity tracker use, app interaction, and overall experiences. At the end of the 4-week period, a subsample of 10 parents (all mothers) participated in face-to-face interviews exploring perceptions of the acceptability and usability of wearable activity trackers and accompanying apps. Quantitative and qualitative data were analyzed descriptively and thematically, respectively. Thematic data are presented using pen profiles, which were constructed from verbatim transcripts. Results Parents reported that they and their children typically found the associated app easy to use for activity tracking, though only step or distance information was generally accessed and some difficulties interpreting the data were reported. Children were frustrated with not being able to access real-time feedback, as the features and functions were only available through the app, which was typically accessed by, or in the presence of, parents. Parents identified that children wanted additional functions including a visual display to track and self-monitor activity, access to the app for goal setting, and the option of undertaking challenges against schools or significant others. Other barriers to the use of wearable activity trackers included discomfort of wearing the monitor because of the design and the inability to wear for water- or contact-based sports. Conclusions Most parents reported that the wearable activity tracker was easy for their child or children to use and a useful tool for tracking their children’s daily activity. However, several barriers were identified, which may impact sustained use over time; both the functionality and wearability of the activity tracker should therefore be considered. Overall, wearable activity trackers for children have the potential to be integrated into targeted physical activity promotion initiatives.

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Parental Perspectives of a Wearable Activity Tracker for Children Younger Than 13 Years: Acceptability and Usability Study (Preprint)

10.2196/preprints.13858 ◽

2019 ◽

Author(s):

Kelly A Mackintosh ◽

Stephanie E Chappel ◽

Jo Salmon ◽

Anna Timperio ◽

Kylie Ball ◽

...

Keyword(s):

Physical Activity ◽

Activity Levels ◽

Distance Information ◽

Activity Tracker ◽

Activity Trackers ◽

Activity Promotion ◽

Parental Perspectives ◽

Physical Activity Levels ◽

Wearable Activity Trackers ◽

Wearable Activity Tracker

BACKGROUND There is increasing availability of, and interest in, wearable activity trackers for children younger than 13 years. However, little is known about how children and parents use these activity trackers or perceive their acceptability. OBJECTIVE This study primarily aimed to ascertain parental perspectives on the acceptability and usability of wearables designed to monitor children’s physical activity levels. Secondary aims were to (1) identify practical considerations for future use in physical activity interventions and promotion initiatives; (2) determine use of different features and functions incorporated into the accompanying app; and (3) identify parents’ awareness of their child’s current physical activity levels. METHODS In total, 36 children (18 boys and 18 girls) aged 7-12 years were asked to wear a wrist-worn activity tracker (KidFit) for 4 consecutive weeks and to use the accompanying app with parental assistance and guidance. Each week, one parent from each family (n=25; 21 mothers and 4 fathers) completed a Web-based survey to record their child’s activity tracker use, app interaction, and overall experiences. At the end of the 4-week period, a subsample of 10 parents (all mothers) participated in face-to-face interviews exploring perceptions of the acceptability and usability of wearable activity trackers and accompanying apps. Quantitative and qualitative data were analyzed descriptively and thematically, respectively. Thematic data are presented using pen profiles, which were constructed from verbatim transcripts. RESULTS Parents reported that they and their children typically found the associated app easy to use for activity tracking, though only step or distance information was generally accessed and some difficulties interpreting the data were reported. Children were frustrated with not being able to access real-time feedback, as the features and functions were only available through the app, which was typically accessed by, or in the presence of, parents. Parents identified that children wanted additional functions including a visual display to track and self-monitor activity, access to the app for goal setting, and the option of undertaking challenges against schools or significant others. Other barriers to the use of wearable activity trackers included discomfort of wearing the monitor because of the design and the inability to wear for water- or contact-based sports. CONCLUSIONS Most parents reported that the wearable activity tracker was easy for their child or children to use and a useful tool for tracking their children’s daily activity. However, several barriers were identified, which may impact sustained use over time; both the functionality and wearability of the activity tracker should therefore be considered. Overall, wearable activity trackers for children have the potential to be integrated into targeted physical activity promotion initiatives.

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Application of Activity Trackers among Nursing Home Residents—A Pilot and Feasibility Study on Physical Activity Behavior, Usage Behavior, Acceptance, Usability and Motivational Impact

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186683 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6683 ◽

Cited By ~ 1

Author(s):

Tina Auerswald ◽

Jochen Meyer ◽

Kai von Holdt ◽

Claudia Voelcker-Rehage

Keyword(s):

Physical Activity ◽

Nursing Home ◽

Nursing Home Residents ◽

Physical Activity Behavior ◽

Commercial Activity ◽

Activity Tracker ◽

Activity Trackers ◽

Usage Behavior ◽

Steps Per Day ◽

Activity Behavior

The aim of this study was to assess physical activity and sedentary behavior, as well as the usage behavior, usability, acceptance, and motivational impact of an applied activity tracker among nursing home residents. Physical activity and usage behavior were measured among 22 residents (68 to 102 years) by use of a commercial activity tracker worn during waking hours for 77 days on average. Usability, acceptance, and motivational impact of the tracker were examined using an adapted questionnaire. Participants walked, on average, 1007 ± 806 steps per day and spent, on average, more than 9 h (77.2% of their waking time) sedentary. The average steps/day increased significantly within the first five weeks of wearing the activity tracker. The acceptance rate was high (94.4%). The tracker was used for 65.4% of the individual study period, and usage behavior did not significantly change during the first five wearing weeks. Participants with a usage time of ≥50% walked significantly more steps per day than those with a lower usage. Overall, we were able to reveal that the residents were highly inactive and sedentary. The results support the feasibility of a long-term application of activity trackers to assess or even increase physical activity behavior.

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Consumer-Based Wearable Activity Trackers Increase Physical Activity Participation: Systematic Review and Meta-Analysis (Preprint)

10.2196/preprints.11819 ◽

2018 ◽

Author(s):

Katie-Jane Brickwood ◽

Greig Watson ◽

Jane O'Brien ◽

Andrew D Williams

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Physical Activity Participation ◽

Activity Participation ◽

Activity Levels ◽

Activity Tracker ◽

Activity Trackers ◽

Wearable Activity Trackers ◽

Wearable Activity Tracker ◽

Meta Analyses

BACKGROUND The range of benefits associated with regular physical activity participation is irrefutable. Despite the well-known benefits, physical inactivity remains one of the major contributing factors to ill-health throughout industrialized countries. Traditional lifestyle interventions such as group education or telephone counseling are effective at increasing physical activity participation; however, physical activity levels tend to decline over time. Consumer-based wearable activity trackers that allow users to objectively monitor activity levels are now widely available and may offer an alternative method for assisting individuals to remain physically active. OBJECTIVE This review aimed to determine the effects of interventions utilizing consumer-based wearable activity trackers on physical activity participation and sedentary behavior when compared with interventions that do not utilize activity tracker feedback. METHODS A systematic review was performed searching the following databases for studies that included the use of a consumer-based wearable activity tracker to improve physical activity participation: Cochrane Controlled Register of Trials, MEDLINE, PubMed, Scopus, Web of Science, Cumulative Index of Nursing and Allied Health Literature, SPORTDiscus, and Health Technology Assessments. Controlled trials of adults comparing the use of a consumer-based wearable activity tracker with other nonactivity tracker–based interventions were included. The main outcome measures were physical activity participation and sedentary behavior. All studies were assessed for risk of bias, and the Grades of Recommendation, Assessment, Development, and Evaluation system was used to rank the quality of evidence. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement were followed. A random-effects meta-analysis was completed on the included outcome measures to estimate the treatment effect of interventions that included an activity tracker compared with a control group. RESULTS There was a significant increase in daily step count (standardized mean difference [SMD] 0.24; 95% CI 0.16 to 0.33; P<.001), moderate and vigorous physical activity (SMD 0.27; 95% CI 0.15 to 0.39; P<.001), and energy expenditure (SMD 0.28; 95% CI 0.03 to 0.54; P=.03) and a nonsignificant decrease in sedentary behavior (SMD −0.20; 95% CI −0.43 to 0.03; P=.08) following the intervention versus control comparator across all studies in the meta-analyses. In general, included studies were at low risk of bias, except for performance bias. Heterogeneity varied across the included meta-analyses ranging from low (I2=3%) for daily step count through to high (I2=67%) for sedentary behavior. CONCLUSIONS Utilizing a consumer-based wearable activity tracker as either the primary component of an intervention or as part of a broader physical activity intervention has the potential to increase physical activity participation. As the effects of physical activity interventions are often short term, the inclusion of a consumer-based wearable activity tracker may provide an effective tool to assist health professionals to provide ongoing monitoring and support.

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How Are Wearable Activity Trackers Adopted in Older Adults? Comparison between Subjective Adoption Attitudes and Physical Activity Performance

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103461 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3461

Author(s):

Byung Cheol Lee ◽

Junfei Xie ◽

Toyin Ajisafe ◽

Sung-Hee Kim

Keyword(s):

Physical Activity ◽

Older Adults ◽

Vigorous Physical Activity ◽

Design Guidelines ◽

Step Counts ◽

Activity Tracker ◽

Athletic Ability ◽

Activity Trackers ◽

Wearable Activity Trackers

Wearable activity trackers can motivate older adults to engage in the recommended daily amount of physical activity (PA). However, individuals may not maintain their use of the trackers over a longer period. To investigate the attitudes of activity tracker adoption and their effects on actual PA performance, we conducted a three-month study. We gave activity trackers to 16 older adults and assessed attitudes on activity tracker adoption through a survey during the study period. We extracted participants’ PA measures, step counts, and moderate and vigorous physical activity (MVPA) times. We observed significant differences in adoption attitudes during the three different periods (χ2(2, 48) = 6.27, p < 0.05), and PA measures followed similar decreasing patterns (F(83, 1357) = 12.56, 13.94, p < 0.00001). However, the Pearson correlation analysis (r = 0.268, p = 0.284) and a Bland–Altman plot indicated a bias between two PA measures. Positive attitudes at the initial stage did not persist through the study period, and both step counts and length of MVPA time showed waning patterns in the study period. The longitudinal results from both measures demonstrated the patterns of old adults’ long-term use and adoption. Considering the accuracy of the activity tracker and older adults’ athletic ability, MVPA times are more likely to be a reliable measure of older adults’ long-term use and successful adoption of activity trackers than step counts. The results support the development of better activity tracker design guidelines that would facilitate long-term adoption among older adults.

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Patient Experience Connecting Mobile-Based Self-Monitoring of Diet and Physical Activity to Diabetes Educators through a Connected Interface in an Electronic System for Diabetes Education (Preprint)

10.2196/preprints.11905 ◽

2018 ◽

Author(s):

Jing Wang ◽

Brittney Lewis ◽

Linda Siminerio

Keyword(s):

Physical Activity ◽

Diabetes Education ◽

Smartphone Application ◽

Perceived Benefits ◽

Self Monitoring ◽

Activity Tracker ◽

Activity Trackers ◽

Diet And Exercise ◽

Diet And Physical Activity ◽

Diabetes Educators

BACKGROUND Smartphone applications and wearable activity trackers have become popular tools in recent years in managing chronic diseases such as diabetes. More recently, studies have focused on connecting patient-generated health data from mobile devices directly to health care providers and educators. However, not much is known regarding the patient experience in using these mobile devices for diabetes management, particularly the implications of allowing educators direct access to patients’ diet and exercise data. OBJECTIVE The objective of this study was to identify patients’ perceived benefits and concerns about using a smartphone application and wristband activity tracker to monitor diet and physical activity, as well as the perceived benefits and concerns of allowing educators access to such data. METHODS We conducted a qualitative, descriptive study as an axillary study to a clinical trial testing a connected interface to link patient self-monitoring diet and physical activity to a nationally used electronic diabetes education system. Our axillary study examined 13 type 2 diabetes patients’ views on perceived benefits and concerns about using a smartphone application and wristband activity tracker to monitor diet and physical activity for three months. A focus group interview was administered to obtain general and specific understanding of the use of smartphone applications and activity trackers during the study period. The central interview questions guiding the discussion included “What did you think about the UP24 wristband and app?”, “What are your thoughts about the connection of UP24 data with Chronicle, the Web-based diabetes education system, so that your diabetes educators can see your behavior?”, and “Has knowing that someone else has access to your diet and exercise data affected your behavior and self-monitoring?” The interviewer also asked specific questions to gain deeper understanding of the following topics: (1) the app and wristband features used to record and monitor diet and physical activity, (2) materials used for intervention orientation, (3) additional data (eg, weight and blood glucose) that participants would like to share with educators, and (4) suggestions for improvement in diabetes self-management and communication with educators and physicians. The focus group sessions were audio-recorded and transcribed. Transcribed data were analyzed to identify key themes based on interpretive coding procedures. RESULTS We identified 11 key themes under three major categories and described these themes with illustrative quotations. The three major categories of themes covered (1) self-monitoring themes: varied experience and self-monitoring patterns and adherence exist among patients using the wearable tracker and its companion smartphone application; (2) themes related to sharing self-monitoring of diet and physical activity data with diabetes educators: sharing self-monitoring diet influences patient self-monitoring adherence and dietary and activity changes, and communication with educators; and (3) research study-related themes: technical barriers, utilization of manuals and tutorial videos in beginning use of the connected health tools, and desired features on combining lifestyle data with glucose data and caregiver access. CONCLUSIONS Connected technology aiming to incorporate patient-generated health lifestyle data into clinical workflow should consider patient perspectives in terms of their experience and motivation for generating and sharing such data and technical barriers in using such tools.

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