Interventions Using Wearable Activity Trackers to Improve Patient Physical Activity and Other Outcomes in Adults Who Are Hospitalized

Abstract

ImportanceLow levels of physical activity during hospitalization are thought to contribute to a range of poor outcomes for patients. Using wearable activity trackers during hospitalization may help improve patient activity, sedentary behavior, and other outcomes.ObjectiveTo evaluate the association of interventions that use wearable activity trackers during hospitalization with patient physical activity, sedentary behavior, clinical outcomes, and hospital efficiency outcomes.Data SourcesOVID MEDLINE, CINAHL, Embase, EmCare, PEDro, SportDiscuss, and Scopus databases were searched from inception to March 2022. The Cochrane Central Register for Controlled trials, ClinicalTrials.gov, and World Health Organization Clinical Trials Registry were also searched for registered protocols. No language restrictions were imposed.Study SelectionRandomized clinical trials and nonrandomized clinical trials of interventions that used wearable activity trackers to increase physical activity or reduce sedentary behavior in adults (aged 18 years or older) who were hospitalized were included.Data Extraction and SynthesisStudy selection, data extraction, and critical appraisal were conducted in duplicate. Data were pooled for meta-analysis using random-effects models. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed.Main Outcomes and MeasuresThe primary outcomes were objectively measured physical activity or sedentary behavior. Secondary outcomes included clinical outcomes (eg, physical function, pain, mental health), and hospital efficiency outcomes (eg, length of stay, readmission).ResultsFifteen studies with a total of 1911 participants were included, representing various surgical cohorts (4 studies), stroke rehabilitation (3 studies), orthopedic rehabilitation (3 studies), mixed rehabilitation (3 studies), and mixed medical (2 studies). All studies were included in meta-analyses. There was a significant association between wearable activity tracker interventions with higher overall physical activity (standardized mean difference, 0.35; 95% CI, 0.15 to 0.54; I2 = 72%; P < .002) and less sedentary behavior (mean difference, −35.46 min/d; 95% CI, −57.43 to −13.48 min/d; I2 = 0; P = .002), and a significant association between wearable activity tracker interventions with improvements in physical function (standardized mean difference, 0.27; 95% CI, 0.08 to 0.46; I2 = 0; P = .006) compared with usual care. There was no significant association between wearable activity tracker interventions with pain, mental health, length of stay, or readmission risk.Conclusions and RelevanceIn this systematic review and meta-analysis, interventions that used wearable activity trackers with patients who are hospitalized were associated with higher physical activity levels, less sedentary behavior, and better physical functioning compared with usual care.

Measuring Health: Wearables in Fitness Tracking, Stress Relief, and Sleep Management

“…Wearable activity trackers support behaviour modification strategies, such as self-observation and goal establishment [19], and their utilisation has been linked to heightened levels of physical activity [20,21]. Moreover, the utilisation of wearable activity trackers has demonstrated a correlation with enhanced physiological results, including decreased BMI and lowered blood pressure [22].…”

Relationship between independence in activities of daily living at discharge and physical activity at admission of older postoperative hip fracture rehabilitation inpatients: A retrospective case‐control study

“…Because the ability of patients with hip fractures to stand and walk is temporarily impaired immediately after surgery (Hofbauer et al., 2021), making it difficult to measure physical activity at the time of rehabilitation admission (Pommerich et al., 2023), the relationship between physical activity at the time of rehabilitation admission and ADL at discharge is unclear. An activity monitor, such as an activity tracker using a triaxial accelerometer, can detect human body movements during the free‐living activities as well as walking (Szeto et al., 2023), allowing continuous sampling of physical activity in older adults with residual ADL disabilities after hip fracture surgery.…”

The Wearable Activity Tracker Checklist for Healthcare (WATCH): a 12-point guide for the implementation of wearable activity trackers in healthcare

“…They can be used to assess patient physical activity levels and enhance the delivery of physical activity interventions by supporting behaviour change strategies such as goal setting, self-monitoring, and behavioural feedback [ 16 ]. There is a substantial evidence base demonstrating that wearable activity trackers are effective for increasing physical activity across a wide range of healthy and clinical populations, age groups, and settings [ 17 , 18 ].…”