Fitness

Using Fitness Trackers in Adults with Cardiometabolic Conditions


Editor: David L. Joffe, BSPharm, CDE, FACA

Fitness trackers are affordable and popular, but do they correlate with better physical activity levels in people with diabetes or other cardiometabolic conditions?

Low physical activity levels are a modifiable risk behavior for individuals with cardiometabolic conditions and present an excellent opportunity for intervention. Early death could potentially be avoided by addressing the lack of physical activity. Various public health guidelines recommend achieving and maintaining health-enhancing levels of physical activity; however, increasing physical activity in individuals with cardiometabolic conditions is a very challenging task.

Wearable activity trackers may encourage individuals with cardiometabolic conditions to facilitate their physical activity levels and lifestyle patterns. These devices contain basic activity trackers such as pedometers and accelerometers. These activity trackers have gained popularity for motivating people to become more active and monitoring activity levels among individuals with various chronic conditions such as cardiometabolic conditions. In addition, the activity trackers are simple to use and relatively affordable. However, it is unknown whether interventions involving activity trackers correlate with better physical activity levels among individuals with cardiometabolic conditions in the short and long term. Therefore, this updated systematic review and meta-analysis examines whether interventions utilizing activity trackers are linked to short- and long-term improvement of physical activity levels and health status, including blood glucose levels, blood pressure, cholesterol levels, body weight, and body mass index. Metaregression is also utilized to determine whether a link with elevated physical activity level in the intervention group vs. comparator group is affected by the type of wearable tracker, setting daily goals or evaluation length, patient age, sex, or index conditions. Adults 18 or older with type 2 diabetes, prediabetes, obesity or overweight, and CVD were allowed in the study. Individuals that have had a stroke or undergone surgery were excluded from the study. The intervention program included randomized clinical trials or cluster randomized clinical trials.  The study included two groups of participants: one group receiving usual care and another utilizing wearable physical activity trackers. The primary outcome was the correlation of the use of an activity tracker with physical activity levels. The secondary effects were body weight, blood glucose levels, blood pressure, and cholesterol levels. 

Two reviewers determined the risk of bias in each study; blinding participants and personnel was not a part of the risk bias assessment because many studies failed to report this domain. After all, it was impossible to blind participants while they were utilizing the technology device. Study authors were contacted via email when data was unclear or missing.  Studies with insufficient primary data were rejected from the meta-analysis but not from the review. The systematic review and meta-analysis determined that interventions utilizing wearable activity trackers were linked with significant improvement in physical activity among the population with cardiometabolic conditions compared with people receiving usual care. Interventions that used activity trackers and set up regular consultation with a health care professional yielded the strongest association with physical activity improvement. The physical activity improvement was more noticeable in male participants.

Pedometer use had a significant association with improved physical activity when utilized in the context of intervention, including consultations with a health care professional compared with self-monitoring excluding consultations. Pedometers often receive criticism due to not measuring daily steps precisely enough but may be better designed for short-term use in patients with high-risk conditions to reach a specific number of steps per day. To conclude, in this systematic review and meta-analysis of individuals with cardiometabolic conditions, interventions that included health care consultants to the use of activity trackers were significantly correlated with greater levels of physical activity. Comprehending how to improve this intervention for even greater physical activity in the long term may contain implications in the care of individuals with cardiometabolic conditions.

Practice Pearls:

  • A significant portion of the population experiences cardiometabolic conditions such as diabetes.
  • Wearable activity / fitness trackers may encourage individuals with cardiometabolic conditions to facilitate their physical activity levels and lifestyle patterns.
  • Interventions that utilized activity trackers and set up regular consultation with a health care professional yielded the strongest association with physical activity improvement.

References for “Interventions Utilizing Fitness Trackers Among Adults with Cardiometabolic Conditions”:
Hodkinson, Alexander et al. “Interventions Using Wearable Physical Activity Trackers Among Adults with Cardiometabolic Conditions: A Systematic Review and Meta-analysis.”
JAMA network open vol. 4,7 e2116382. 1 Jul. 2021.

Brickwood, Katie-Jane et al. “Consumer-Based Wearable Activity Trackers Increase Physical Activity Participation: Systematic Review and Meta-Analysis.” JMIR mHealth and uHealth 

 

Emmanuella Louissaint, PharmD candidate, LECOM College of Pharmacy

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