Utility of Fitbit devices among children and adolescents with chronic health conditions: a scoping review

Abstract

Background: While Fitbit ® devices were initially intended for leisurely, consumer use, there has been recent interest among scientific and medical communities in the prospective use of Fitbit devices for clinical and research purposes. Those who have chronic health conditions are often required to spend considerable amounts of money and time undergoing physiological tests and activity monitoring to support, stabilize, and manage their health. This disease burden is only amplified in pediatric populations. Devices that are used to collect these data can be invasive, uncomfortable, and disconcerting. Using the Fitbit tracker to acquire such biometric data could ease this burden. Our scoping review seeks to summarize the research that has been conducted on the utilization of Fitbit devices in studies of children and adolescents with chronic health conditions and the feasibility, accuracy, and potential benefits of doing so.Methods: Searches were conducted on PubMed for articles relating pediatric health to Fitbit device usage (using a Boolean search strategy). The eligibility criteria included trials being clinical and/or randomized controlled and articles being in English. Once articles were obtained, they underwent screening and exclusion processes and were charted for their titles, authors, objectives, results, and respective chronic illnesses. In the subsequent full-text review, further charting was conducted, collecting study designs, Fitbit parameters, feasibility, accuracy, and related health and clinical outcomes.Results: Fitbit trackers were unanimously demonstrated to be feasible devices in this population for physical activity monitoring and were determined to be potentially beneficial in measuring and improving overall wellbeing and physical health in children with chronic illness. Nevertheless, sufficient evidence was not found in support of Fitbit accuracy. Additional biases were identified against the population of children with chronic health conditions that may further enable inaccurate data.Conclusions: While Fitbit devices may be beneficial for those interested in improving physical health, discretion is advised for those seeking to collect accurate and/or medically necessitated data. Given the existing literature evaluated, medical-grade technologies are preferred in instances of the latter, as Fitbit devices have not been found to provide reliably accurate data.

The Use of Wearable Technologies in the Assessment of Physical Activity in Preschool- and School-Age Youth: Systematic Review

“…A lot of systematic reviews have been published in recent years related to the subject of this review, where the authors [ 73 ] found that the PA level is also influenced by the students’ friends’ PA level, demonstrating that team sports and community life can increase the PA level, promoting the reduction of the obesity-related problems. Another study also verified that using Fitbit devices may benefit increasing the level of PA during recreational activities [ 74 ]. The mobile applications for this subject are more related to the measurements of weight, height, age, gender, goals, and calories needed for calculations, diet diaries and food databases including calories, calories burned and calorie intake [ 75 ].…”

Measuring Physical Activity in Children Who Do Not Walk and With Cerebral Palsy: An Exploratory Case Series

“…One of the challenges associated with evaluating PA intensity using HR monitors is that HR values are not solely reflective of physical movement and vary secondary to physiologic, emotional, or homeostatic changes. Furthermore, the use of Fitbit models has not been shown to be reliable when measuring HR in individuals with greater levels of disability in SCI54 and children with chronic disorders 42. Additionally, PA monitors cannot differentiate active vs passive movement and therefore cannot ascertain a child’s movement autonomy as compared to caregiver assistance during routine tasks.…”

“…"HRpeak" value was the highest HR value in beats per minute (bpm) seen within the 24-hour period of each day of observation. The Fitbit has been shown to be comparable to research-grade models for HR monitoring in typically developing children 41 and feasible for use in children with developmental disorders 42 and individuals who use wheelchairs for primary mobility. 43 Eating and activity journals.…”

“…Furthermore, the use of Fitbit models has not been shown to be reliable when measuring HR in individuals with greater levels of disability in SCI 54 and children with chronic disorders. 42 Additionally, PA monitors cannot differentiate active vs passive movement and therefore cannot ascertain a child's movement autonomy as compared to caregiver assistance during routine tasks. Future studies that incorporate behavioral observation via video recording could potentially address this challenge.…”

Wearable activity trackers in young people with haemophilia: What needs to be considered?

“…Activity trackers such as Fitbit and Garmin devices were initially intended for consumer use, however, there has been increasing interest among scientific and medical communities in their prospective use for clinical and research purposes. 10,11 The purpose of this study was to explore the most effective, practical and acceptable way to measure PA in young people with haemophilia and to compare agreement in daily step count and time spent in mod- Participants were provided with a Fitbit Charge 3 and a Garmin Vivosport device for 2 weeks each (in random order) and an ActiGraph GT9X-BT for the same 4-week period and asked to wear the devices as much as possible during waking hours. In line with the protocol by…”