Wearable Technology and Physical Activity in Chronic Disease: Opportunities and Challenges.

Abstract

Increased physical activity (PA) is associated with the prevention and delayed onset of many noncommunicable chronic conditions, such as heart disease, diabetes, and cancer, and health benefits, for example reduced risk of disease progression, secondary chronic conditions, and mortality, for individuals with chronic conditions.1 PA is also associated with reduced cognitive dysfunction and functional limitations and enhanced mental health and quality of life.2 Thus, identifying strategies to increase activity in high-risk individuals, as in those with at least one major risk factor, and those with chronic conditions remains a priority. An abundance of technological devices exist to collect and analyze PA data and support the health of high-risk individuals and those with chronic conditions. Devices that are worn on the person, consumer-targeted, and worn continuously to quantify motion during the 24 hour day offer many promising opportunities to advance chronic disease research and clinical practice. These “wearables” include fitness bands, smart watches, and jewelry that log users’ activity metrics (i.e., step counts, energy expenditure) plus a range of other physiological and behavioral factors and can be used with a tablet/smartphone app or website that provides users with a summary of collected data. Wearables are designed and marketed as tools to motivate users to increase PA to improve health by allowing them to easily self-monitor behavior, a key element to successful behavior change.3 In 2013, 84 million wearables were sold; one in ten Americans own a device4 and annual sales are projected to be >$50 billion by 2018.5 This burgeoning industry has been met with both excitement and skepticism. Wearables represent a scalable opportunity to collect activity data in free-living conditions, unobtrusively, with greater frequency, lower cost, and higher volume than ever before.6 Wearables have significant potential to facilitate improvements in health behaviors. However, their capacity to translate external motivations into internal ones for sustainable behavioral changes and clinical value is still unknown.3 This article aims to: (1) summarize current and potential uses for wearables; (2) discuss challenges to using wearables; and (3) identify future directions for researchers and clinicians for chronic disease prevention and management.