Wearable Activity Trackers in the Management of Rheumatic Diseases: Where Are We in 2020?

Abstract

In healthcare, physical activity can be monitored in two ways: self-monitoring by the patient himself or external monitoring by health professionals. Regarding self-monitoring, wearable activity trackers allow automated passive data collection that educate and motivate patients. Wearing an activity tracker can improve walking time by around 1500 steps per day. However, there are concerns about measurement accuracy (e.g., lack of a common validation protocol or measurement discrepancies between different devices). For external monitoring, many innovative electronic tools are currently used in rheumatology to help support physician time management, to reduce the burden on clinic time, and to prioritize patients who may need further attention. In inflammatory arthritis, such as rheumatoid arthritis, regular monitoring of patients to detect disease flares improves outcomes. In a pilot study applying machine learning to activity tracker steps, we showed that physical activity was strongly linked to disease flares and that patterns of physical activity could be used to predict flares with great accuracy, with a sensitivity and specificity above 95%. Thus, automatic monitoring of steps may lead to improved disease control through potential early identification of disease flares. However, activity trackers have some limitations when applied to rheumatic patients, such as tracker adherence, lack of clarity on long-term effectiveness, or the potential multiplicity of trackers.

The ideal mHealth-application for rheumatoid arthritis: qualitative findings from stakeholder focus groups

“…In recent years, an ongoing evolution in technology and digitalisation has resulted in an ever-increasing number of mHealth-applications [ 8 ]. In addition, wearable activity trackers (WATs) are emerging as a promising tool to monitor biometric data [ 9 ]. When routinely integrated into health care and linked to electronic medical patient files, these mHealth-applications and WATs could prove to be an added value in (tele)monitoring treatment adherence, adverse treatment effects or symptoms and disease activity in RA [ 10 ].…”

Technische Alltagshilfen in der Rheumatologie – Was ist sinnvoll, was ist bewiesen, welche Perspektiven gibt es?

“…Mehrere kürzlich erschienene Studien erachten Wearables als ein potentiell sinnvolles Messinstrument, um bei rheumatologischen Patienten die körperliche Aktivität zu messen 54 , aber auch den Patienten zu motivieren 55 . Auch in Kombination mit einem Physiotherapeuten kann die Nutzung eines Bewegungsmessers eine potentiell sinnvolle Intervention zur Schmerzreduktion und verbesserter Bewegungsgewohnheit darstellen 24 .…”

“…Die Standardisierung der Datenanalyse und -Interpretation ist massiv erschwert. Zudem sind regelmäßige Qualitätskontrollen notwendig, um die eHealth-Produkte zuverlässig und korrekt auf dem medizinischen Markt einsetzten zu können 54 55 58 . O’Brien et al (2020) konnten beispielsweise die Validität des Wearables activPAL3 μ ™ zur Messung von sitzender Tätigkeit und körperlicher Aktivität prüfen und entwickelten RA-spezifische Cut-Offs zur Quantifizierung der Intensität der Aktivität 59 .…”

“…Schlussendlich bedarf es weiterer Studien, um die Patientencompliance und langfristige Wirksamkeit dieser Produkte zu untersuchen 55 .…”

The Challenges of Telemedicine in Rheumatology

“…Patients also appreciate the ability to a more personalized care by selecting the outcomes that are most important to them, change and adapt their symptom monitoring as their disease progresses and their treatments change ( 22 ). Further, it is reported that regular monitoring of RA patients to detect disease flares improves outcomes, and a pilot study applying machine learning to activity tracker steps showed that physical activity was strongly linked to disease flares and that patterns of physical activity could be used to predict flares with great accuracy, with a sensitivity and specificity above 95% ( 23 ). In addition, patients and caregivers express a high level of satisfaction with the use of telemedicine without any complaints of loss of information compared to traditional consultations ( 24 ).…”