Wearable Trackers Linked to Increased Physical Activity in Cardiometabolic Patients

Alexander Hodkinson, PhD

Although wearable physical activity (PA) trackers may encourage an increase in PA levels, there is a gap in knowledge surrounding their use in patients who experience 1 or more cardiometabolic conditions, including diabetes and cardiovascular disease (CVD).

Investigators, led by Alexander Hodkinson, PhD, National Institute for Health Research, assessed the association of interventions using PA trackers, including accelerometers, fitness trackers, and pedometers, with PA levels in adults with cardiometabolic conditions.

They found interventions that combined wearable trackers with health professional consultations had associations with improvements in PA levels in the targeted patient population.

Study

Investigators performed a systematic review and meta-analysis of databases between January 2000 - December 2020.

Inclusion criteria included adults aged ≥18 years with type 2 diabetes (T2D), or risk of T2D, obesity or overweight status, and CVD.

Further, randomized controlled trials (RCTs) included in the study evaluated the use of wearable activity trackers.

However, exclusions included trials which assessed trackers only as measuring tools or PA before or after another intervention, required patients to be hospitalized, assessors were unblinded to the trackers, or if trackers were used to measure effect of pharmacological treatment on PA.

Investigators noted the study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines.

Primary outcomes included the association of the use of an activity tracker with PA levels, while secondary outcomes were body weight or BMI, blood glucose level, blood pressure, and cholesterol levels.

The team noted when the scale was different across each study, a standardized mean difference was calculated.

Results

Data show a total of 38 RCTs with 4203 participants were eligible in the review, with 29 trials evaluating pedometers and 9 evaluating accelerometers or fitness trackers.

Interventions were found to focus mainly on the association with PA level, prevention of disease, and weight management.

A total of 17 studies used a theoretical framework that consisted of social cognitive approaches (health belief model, theory of planned behavior, or transtheoretical model).

Further, 12 studies tested simple pedometer, accelerometer, or fitness tracker interventions, meaning they were provided with the tracker, but no additional support was provided by health care professionals.

A total of 26 studies tested interventions that involved consultation sessions, who were healthcare professionals with face-to-face consultations.

The investigators noted 4 studies did not provide enough outcome data, which left 34 trials (n = 3793 participants) for the meta-analysis.

Investigators observed across all studies involving interventions with wearable activity trackers versus comparators during a 15-week period.

There was a significant association between wearable tracker use and increased PA during a 15-week period (standardized mean difference, 0.72; 95% CI, 0.46 - 0.97; I2 = 88%; 95% CI, 84.3% - 90.8%; P < .001).

The team noted multivariable meta-regression showed association between increased PA levels and interventions that involved a face-to-face consultation with a healthcare professional (23 studies; β = −0.04; 95% CI, −0.11 to −0.01).

They also observed the data included men (23 studies; β = 0.48; 95% CI, 0.01 - 0.96), and assessed pedometer-based interventions (26 studies; β = 0.20; 95% CI, 0.02 - 0.32).

Conclusion

Investigators concluded interventions that combined activity trackers with complementary intervention components had a significant association with increased levels of PA.

“Understanding how to improve these interventions further for greater PA improvements in the longer term may have implications in the care of people with cardiometabolic conditions,” investigators wrote.

The study, “Interventions Using Wearable Physical Activity Trackers Among Adults With Cardiometabolic Conditions,” was published online in JAMA Network Open.