Assessing the usability of wearable devices to measure gait and physical activity in chronic conditions: a systematic review

Abstract

Background The World Health Organisation’s global strategy for digital health emphasises the importance of patient involvement. Understanding the usability and acceptability of wearable devices is a core component of this. However, usability assessments to date have focused predominantly on healthy adults. There is a need to understand the patient perspective of wearable devices in participants with chronic health conditions. Methods A systematic review was conducted to identify any study design that included a usability assessment of wearable devices to measure mobility, through gait and physical activity, within five cohorts with chronic conditions (Parkinson’s disease [PD], multiple sclerosis [MS], congestive heart failure, [CHF], chronic obstructive pulmonary disorder [COPD], and proximal femoral fracture [PFF]). Results Thirty-seven studies were identified. Substantial heterogeneity in the quality of reporting, the methods used to assess usability, the devices used, and the aims of the studies precluded any meaningful comparisons. Questionnaires were used in the majority of studies (70.3%; n = 26) with a reliance on intervention specific measures (n = 16; 61.5%). For those who used interviews (n = 17; 45.9%), no topic guides were provided, while methods of analysis were not reported in over a third of studies (n = 6; 35.3%). Conclusion Usability of wearable devices is a poorly measured and reported variable in chronic health conditions. Although the heterogeneity in how these devices are implemented implies acceptance, the patient voice should not be assumed. In the absence of being able to make specific usability conclusions, the results of this review instead recommends that future research needs to: (1) Conduct usability assessments as standard, irrespective of the cohort under investigation or the type of study undertaken. (2) Adhere to basic reporting standards (e.g. COREQ) including the basic details of the study. Full copies of any questionnaires and interview guides should be supplied through supplemental files. (3) Utilise mixed methods research to gather a more comprehensive understanding of usability than either qualitative or quantitative research alone will provide. (4) Use previously validated questionnaires alongside any intervention specific measures.

Health-Related Telemonitoring Parameters/Signals of Older Adults: An Umbrella Review

“…Evidently, the systems tend to be increasingly simple, user-friendly, and less intrusive; so the individual can carry out their normal tasks throughout the day, without the system interfering. In this sense, the places identified through different devices, allowed the user to quickly forget their use, enabling monitoring and evaluation in a real context without feeling the pressure of being evaluated, avoiding the modification of values [ 21 , 26 , 27 , 28 , 31 , 48 , 49 , 52 ].…”

On-Field Deployment and Validation for Wearable Devices

“…33,37,69,75 Wearable devices are being deployed to measure characteristics of gait and physical activities across a broad range of health conditions, 35,65,66 but the assessment of usability is very limited. 33 Searches using combinations of ''usability'', ''head impact'', ''on-field'', and ''concussion'' identified few papers that reported on the system usability of head acceleration devices. Tierney et al.…”

“…Wearable head acceleration measurement devices intersect with many disciplines, including ‘Digital health’ and ergonomics/human factors, and are not limited to biomechanics, sports science, or medicine. 33 , 37 , 69 , 75 Wearable devices are being deployed to measure characteristics of gait and physical activities across a broad range of health conditions, 35 , 65 , 66 but the assessment of usability is very limited. 33 Searches using combinations of “usability”, “head impact”, “on-field”, and “concussion” identified few papers that reported on the system usability of head acceleration devices.…”

Measuring the Usability of eHealth Solutions for Patients With Parkinson Disease: Observational Study

“…Think-alouds and qualitative interviews were the most frequently used methods in the usability testing of eHealth solutions [11]. For patients with PD specifically, usability assessments have mainly relied on questionnaires as well as adherence monitoring and mostly reported positive results for sensor systems and smartphone/tablet apps [12][13][14][15]. Although mixed methods approaches have become more common recently, there is substantial heterogeneity in the methods, and only a minority of studies focused specifically on the usability.…”

“…Although mixed methods approaches have become more common recently, there is substantial heterogeneity in the methods, and only a minority of studies focused specifically on the usability. In the broader context of chronic conditions, a recent systematic review concluded that the usability of wearable devices is poorly measured and reported [ 15 ]. Furthermore, there is no consensus regarding the methodology to assess usability in older adults, even though investigations about the sensitivity of different methods have been explicitly recommended [ 16 ].…”