Wearable Physical Activity Monitor Research Articles

Effect of Intrapersonal and Interpersonal Behavior Change Strategies on Physical Activity Among Older Adults

Despite guidelines that recommend physical activity (PA), little is known about which types of behavior change strategies (BCSs) effectively promote sustained increases in PA in older adults who are insufficiently active. To determine whether intrapersonal BCSs (eg, goal setting) or interpersonal BCSs (eg, peer-to-peer sharing or learning) combined with the Otago Exercise Program (17 strength and balance exercises and a walking program that are learned and individually tailored, with instruction to perform 3 times per week at home or location of choice) and a wearable PA monitor help older adults sustain increases in their PA. This 2 × 2 factorial randomized clinical trial (Community-Based Intervention Effects on Older Adults' Physical Activity) of community-dwelling older adults 70 years or older with PA levels below minimum national PA guidelines was conducted in urban community centers. Dates of enrollment were from November 17, 2017, to June 15, 2021, with final follow-up assessments completed on September 2, 2022. Participants were randomized to intrapersonal (eg, goal setting) BCSs, interpersonal (eg, problem-solving with peer-to-peer sharing and learning) BCSs, intrapersonal and interpersonal BCSs, or an attention control group. All interventions included a PA monitor and 8 weekly small-group meetings with discussion, practice, and instructions to implement the exercise program and relevant BCSs independently between meetings and after the intervention. The primary outcome was daily minutes of objectively measured total PA (light, moderate, or vigorous intensities) averaged over 7 to 10 days, measured at baseline and after the intervention at 1 week, 6 months, and 12 months. Among 309 participants (mean [SD] age, 77.4 [5.0] years; 240 women [77.7%]), 305 (98.7%) completed the intervention, and 302 (97.7%) had complete data. Participants receiving PA interventions with interpersonal BCS components exhibited greater increases in total PA than did those who did not at 1 week (204 vs 177 PA minutes per day; adjusted difference, 27.1 [95% CI, 17.2-37.0]; P < .001), 6 months (195 vs 175 PA minutes per day; adjusted difference, 20.8 [95% CI, 10.0-31.6]; P < .001), and 12 months (195 vs 168 PA minutes per day; adjusted difference, 27.5 [95% CI, 16.2-38.8]; P < .001) after the intervention. Compared with participants who did not receive interventions with intrapersonal BCS components, participants who received intrapersonal BCSs exhibited no significant changes in total PA at 1 week (192 vs 190 PA minutes per day; adjusted difference, 1.8 [95% CI, -8.6 to 12.2]; P = .73), 6 months (183 vs 187 PA minutes per day; adjusted difference, -3.9 [95% CI, -15.0 to 7.1]; P = .49), or 12 months (177 vs 186 PA minutes per day; adjusted difference, -8.8 [95% CI, -20.5 to 2.9]; P = .14) after the intervention. Interactions between intrapersonal and interpersonal BCSs were not significant. In this randomized clinical trial, older adults with low levels of PA who received interpersonal BCSs, the exercise program, and a PA monitor exhibited significant increases in their PA for up to 12 months after the intervention. Intrapersonal BCSs elicited no significant PA changes and did not interact with interpersonal BCSs. Our findings suggest that because effects of a PA intervention on sustained increases in older adults' PA were augmented with interpersonal but not intrapersonal BCSs, approaches to disseminating and implementing the intervention should be considered. ClinicalTrials.gov Identifier: NCT03326141.

Standardizing Continuous Physical Activity Monitoring in Patients with Cervical Spondylosis.

Prospective cohort study. To use a commercial wearable device to measure real-life, continuous physical activity in patients with CS and to establish age-adjusted and sex-adjusted standardized scores. Patients with cervical spondylosis (CS) often present with pain or neurologic deficits that result in functional limitations and inactivity. However, little is known regarding the influence of CS on the patient's real-life physical activity. This study included 100 English-speaking adult patients with cervical degenerative diseases undergoing elective spine surgery at Stanford University who owned iPhones. Patients undergoing surgery for spine infections, trauma, tumors, or lumbar degenerative disease were excluded. Activity two weeks before surgery was expressed as raw daily step counts. Standardized z-scores were calculated based on age-specific and sex-specific values of a control population. Responses to patient-reported outcome measures (PROMs) surveys assessed convergent validity. Functional impairment was categorized based on predetermined z-score cut-off values. Thirty CS with a mean (±SD) age of 56.0 (±13.4) y wore an Apple Watch for ≥8 hours/day in 87.1% of the days. The mean watch wear time was 15.7 (±4.2) hours/day, and the mean daily step count was 6400 (±3792). There was no significant difference in activity between 13 patients (43%) with myelopathy and 17 (57%) without myelopathy. Test-retest reliability between wearable step count measurements was excellent (ICC β=0.95). Physical activity showed a moderate positive correlation with 36-Item Short Form Survey Physical Component Summary, EuroQol-5-dimension visual analog scale, and Patient-Reported Outcomes Measurement Information System Physical Function Subscale. Activity performance was classified into categories of "no impairment" [step count=9640 (±2,412)], "mild impairment" [6054(±816)], "moderate impairment" [3,481 (±752)], and "severe impairment" [1,619 (±240)]. CS patients' physical activity is significantly lower than the general population or the frequently stated goals of 7000 to 10,000 steps/day. Standardized, continuous wearable physical activity monitoring in CS is a reliable, valid, and normalized outcome tool that may help characterize functional impairment before and after spinal interventions.

The Validity of a Novel Low-Cost, Wearable Physical Activity Monitor in a Laboratory Setting

Introduction: Wearable physical activity monitors are popular and may provide a more accurate data than subjective methods. The present study assessed the validity of a novel, low-cost wearable physical activity monitor (Movband 3) relative to established measures. Methods: Participants (N = 19) completed four treadmill stages (1.5, 3.0, 4.0, 6.0 MPH) while wearing the Movband 3 and the validated Actigraph GT1M monitor. Oxygen consumption (VO2 ml/kg/min) and heart rate (beats/min) were recorded. The relationship between Movband data and established measures was assessed via Pearson’s correlations. Tests of agreement were performed for actual and Movband miles traveled. Results: There were large, positive, significant (p &lt; 0.001) effect sizes for the associations between Movband counts and Actigraph counts (r = 0.72), VO2 (r = 0.59), and heart rate (r = 0.63). There was also a large, positive, significant (p &lt; 0.001) association between actual and Movband miles (r = 0.97). However, the difference (Δ) between Movband and actual miles was greater than a null hypothesis of zero (∆ = 0.77 ± 0.45 miles or 31.8%, t = 7.4, p &lt; 0.001). Conclusion: While there was evidence to support the validity of the Movband 3 for the assessment of physical activity intensity this device did not provide an accurate measure of miles traveled.

Use of a physical activity monitor to track perioperative activity of radical cystectomy patients. Our first glimpse at what our patients are doing before and after surgery.

To optimize recovery after radical cystectomy (RC), providers stress the importance of ambulation and adequate rest. However, little is known about the activity and sleep habits of patients undergoing RC. Therefore, we utilized a wearable physical activity monitor (PAM) in the perioperative period to provide the first objective data on physical activity and sleep habits for RC patients. We prospectively identified patients ≥60 years old with planned RC. Participants completed a 4-week prehabilitation exercise program prior to surgery. They wore a PAM for 7-day intervals: at baseline, after prehabilitation, at postoperative day (POD) 30 and POD90. We tracked physical activity via metabolic equivalents (METs). METs were categorized by intensity: light (MET 1.5-<3), moderate (MET 3-<6), and vigorous (MET ≥6). We calculated daily step totals. We tracked hours slept and number of sleep awakenings. We correlated activity and sleep with self-reported quality of life (QOL). Forty-two patients completed prehabilitation and RC. Moderate intensity exercise decreased at POD30 (61 minutes/d at baseline, 30 minutes/d at POD30, P = 0.005). Physical activity did not significantly differ for light or vigorous activity at any timepoint. RC did not significantly affect sleep. Sleep and physical activity were associated with mental and physical QOL, respectively. This is the first study utilizing patient-worn monitors in RC to track physical activity and sleep. This study gives patients and providers a better understanding of postcystectomy recovery expectations. With these results in mind, interventions may be implemented to optimize activity and sleep in the perioperative period.

Factors associated with long-term wearable physical activity monitor user engagement.

Wearable physical activity monitors (PAMs) have potential to positively influence physical activity. However, high rates of disengagement have been reported, which dampens enthusiasm, as these devices are unlikely to impact habitual physical activity if they are not worn for a sustained period of time. The purpose of this study was to identify demographic and device-use characteristics (e.g., data sharing) associated with sustained device engagement. Current PAM users (n = 418; mean age: 35.0 ± 12.5; 78% female) from across the USA were recruited online and completed a baseline web-based survey in 2015-2016 comprising questions about demographics and device use. Participants were followed-up again in 2017, at which time they reported whether or not they still used a PAM. Sustained PAM engagement was defined as those who continued use at follow-up. The median follow-up time was 15.5 (±3.7) months. In fully adjusted models, the following were significantly associated with long-term engagement: age (odds ratio [OR]: 1.03; 95% confidence interval [CI]: 1.01-1.05, p = .014), Hispanic ethnicity (OR: 3.67; 95% CI: 1.20-11.26, p = .023), running as a preferred exercise (OR: 1.82; 95% CI: 1.02-3.24, p = .043), wanting to monitor health variables as a reason for choosing to use a PAM (OR: 1.73; 95% CI: 1.02-2.92, p = .042), and sharing data from the PAM publicly on social media (e.g., Facebook and Twitter; OR: 5.11; 95% CI: 1.64-15.93, p = .005). A number of sociodemographic and use characteristics were associated with sustained device use over a median follow-up of 1.3 years. One modifiable factor that may lead to longer device engagement is encouraging users to share data publicly.

Feedback on Physical Activity Through a Wearable Device Connected to a Mobile Phone App in Patients With Metabolic Syndrome: Pilot Study.

BackgroundLittle is known of the effect of wearable devices on metabolic impairments in clinical settings. We hypothesized that a wearable device that can monitor and provide feedback on physical activity may help resolve metabolic syndrome.ObjectiveThis study aimed to examine the objective effects of the use of these devices on metabolic syndrome resolution.MethodsPatients diagnosed with metabolic syndrome were recruited. Participants were prescribed regular walking using a wearable device (Coffee WALKIE +Dv.3, GC Healthcare CI, Korea) on their wrist for 12 weeks. Participants received self-feedback on the amount of their exercise through an app on their mobile phone. The information on physical activities of the participants was uploaded automatically to a website. Thus, a trained nurse could provide individuals with feedback regarding the physical activity via telephone consultation on alternate weeks. Blood pressure (BP), body composition, fasting plasma glucose, and lipid profiles were recorded. The primary outcome was metabolic syndrome resolution. The secondary outcome was an improvement in the components of metabolic impairment.ResultsOf the 53 participants recruited, 20 participants with a median age of 46 (range 36-50) years completed the trial. There was no significant difference in the amount of calorie expenditure at weeks 4, 8, and 12. After 12 weeks, metabolic syndrome was resolved in 9 of 20 participants (45%), and the mean number of metabolic impairment components per person decreased from 3.4 to 2.9. Particularly, the mean systolic and diastolic BP decreased from mean 136.6 (SD 18.5) mm Hg to mean 127.4 (SD 19.5) mm Hg and from mean 84.0 (SD 8.1) mm Hg to mean 77.4 (SD 14.4) mm Hg (both P=.02), respectively.ConclusionsThis study found that a 12-week intervention via feedback, based on a wearable physical activity monitor, helped metabolic syndrome patients to be more engaged in regular walking and it improved impaired metabolic components, especially in BP. However, some practical challenges regarding patients’ adherence and sustained engagement were observed.

Does Sharing Wearable Physical Activity Monitor Data with Others Lead to Longer User Engagement?

Does Sharing Wearable Physical Activity Monitor Data with Others Lead to Longer User Engagement?

Improving Physical Activity Through Adjunct Telerehabilitation Following Total Knee Arthroplasty: Randomized Controlled Trial Protocol.

Physical activity remains low and nearly unchanged from preoperative levels following total knee arthroplasty (TKA), and this is thought to underlie long-term functional limitations, secondary health problems, and higher health care costs after TKA. Our objective is to determine whether a telehealth-based intervention could improve physical activity and functional outcomes after TKA. The design is a 2-arm, parallel, assessor-blinded, randomized controlled trial with baseline, midintervention, postintervention, and 6-month follow-up assessments. The setting is one academic medical center and one Veterans Affairs health care system. One hundred US military veterans (aged 50-85 years) scheduled for unilateral TKA will participate in this study. The telehealth-based intervention to change physical activity behavior will be delivered through 10 sessions each of 30 minutes over a 12-week period. Participants will be provided with a wearable physical activity monitor to receive feedback on step count and guide goal-setting. Control participants will receive telehealth-based education on nonbehavioral aspects of health for the same frequency and duration as the intervention group. For both groups, telehealth sessions will occur concurrently with standardized outpatient rehabilitation. The primary outcome will be change in physical activity, assessed as daily step counts measured using an accelerometer-based sensor. Secondary outcomes will be measured using the Life-Space Assessment questionnaire and change in physical function (30-Second Chair-Stand Test, Timed "Up & Go" Test, Six-Minute Walk Test, Western Ontario and McMaster Universities Osteoarthritis Index, and Veterans RAND 12-Item Health Survey). Participant and interventionist blinding is not possible. This trial will assess the efficacy of a novel behavior-change intervention to improve physical activity and physical function in patients after TKA. Effective physical activity behavior change could provide clinicians with a technique to augment current practice and resolve poor physical activity outcomes, long-term health problems, and high costs following TKA.

Development of Wearable Physical Activity Monitoring System

Development of Wearable Physical Activity Monitoring System

The Validity Of A Novel, Low-cost, Wearable Physical Activity Monitor In A Laboratory Setting

The Validity Of A Novel, Low-cost, Wearable Physical Activity Monitor In A Laboratory Setting

Feasibility and Acceptability of a Wearable Technology Physical Activity Intervention With Telephone Counseling for Mid-Aged and Older Adults: A Randomized Controlled Pilot Trial.

BackgroundAs adults age, their physical activity decreases and sedentary behavior increases, leading to increased risk of negative health outcomes. Wearable electronic activity monitors have shown promise for delivering effective behavior change techniques. However, little is known about the feasibility and acceptability of non-Fitbit wearables (Fitbit, Inc, San Francisco, California) combined with telephone counseling among adults aged more than 55 years.ObjectiveThe purpose of our study was to determine the feasibility, acceptability, and effect on physical activity of an intervention combining a wearable physical activity monitor, tablet device, and telephone counseling among adults aged 55-79 years.MethodsAdults (N=40, aged 55-79 years, body mass index=25-35, <60 min of activity per week) were randomized to receive a 12-week intervention or to a wait list control. Intervention participants received a Jawbone Up24 monitor, a tablet with the Jawbone Up app installed, and brief weekly telephone counseling. Participants set daily and weekly step goals and used the monitor’s idle alert to notify them when they were sedentary for more than 1 h. Interventionists provided brief counseling once per week by telephone. Feasibility was measured using observation and study records, and acceptability was measured by self-report using validated items. Physical activity and sedentary time were measured using ActivPAL monitors following standard protocols. Body composition was measured using dual-energy x-ray absorptiometry scans, and fitness was measured using a 6-min walk test.ResultsParticipants were 61.48 years old (SD 5.60), 85% (34/40) female, 65% (26/40) white. Average activity monitor wear time was 81.85 (SD 3.73) of 90 days. Of the 20 Up24 monitors, 5 were reported broken and 1 lost. No related adverse events were reported. Acceptability items were rated at least 4 on a scale of 1-5. Effect sizes for most outcomes were small, including stepping time per day (d=0.35), steps per day (d=0.26), sitting time per day (d=0.21), body fat (d=0.17), and weight (d=0.33).ConclusionsThe intervention was feasible and acceptable in this population. Effect sizes were similar to the sizes found using other wearable electronic activity monitors, indicating that when combined with telephone counseling, wearable activity monitors are a potentially effective tool for increasing physical activity and decreasing sedentary behavior.Trial registrationClinicaltrials.gov NCT01869348; https://clinicaltrials.gov/ct2/show/NCT01869348 (Archived by WebCite at http://www.webcitation.org/6odlIolqy)

The effect of a wearable physical activity monitor (Fitbit One) on physical activity behaviour in women: A pilot study

Introduction. With wearable technology topping both the 2016 and 2017 American College of Sports Medicine (ACSM) Fitness Trends survey, research in this area is needed to help determine the importance of such devices. Purpose. To determine the effect of wearing a popular, commercially-available wearable activity monitor (i.e., Fitbit One) upon physical activity behaviour relative to a group who was not utilizing such a monitor. Methods. A sample of 19 healthy adult women completed the Human Activity Profile survey to assess physical activity behaviour pre – and post – intervention. For the intervention, nine participants received a Fitbit One accelerometer to wear for six weeks, while the remaining participants (control group) did not receive an accelerometer. Results. There were no significant differences (p ≥ 0.16) in physical activity. However, the control group reduced physical activity by ≥20% from pre to post intervention whereas the Fitbit One group was largely unchanged (0.5% - 2.4% decrease). Conclusion. While wearing a physical activity monitor did not increase physical activity behaviour it may help maintain it.