Fitness trackers and ‘wearables’ are becoming ubiquitous.
Fitness tracker “wearables” have become mainstream, with sales projected to reach $19 billion by 2018. If you don’t have one, many of your patients probably do, particularly this time of year when fitness goals are at the forefront of many New Year’s resolution lists. Wearables can track a lot of things, and people are claiming that they save lives. Are they all that? First, here’s a brief overview of wearables types and their uses.
Popular wearable brands include Fitbit (with 79% of sales), Jawbone, Nike, Apple (Apple Watch is a smart watch that has fitness tracker functionality), Garmin, and Misfit. Prices run from about $50 to as much as you want to spend: an Apple Watch costs from $275 to more than $10,000, depending on the model.
Increased functions. Wearables have far surpassed their pedometer function. They do all count steps, but now they also track sleep and heart rate and have increasingly more bells and whistles. The newer Fitbits and the new watchOS operating system for the Apple Watch even have “breathe” functions, intended to remind the wearer to take a few minutes several times a day and breathe to promote relaxation.
Wearables (including smart watches) now have extra features such as replaceable bands and the ability to alert the wearer about incoming texts and calls, if the tracker has the ability to connect with a smart phone via Bluetooth. Most can serve as watches, although some have no screen.
Which, if any, fitness tracker is best for you (or a patient or family member)? It’s best to clarify your goals and do some research before diving in and buying a wearable, because otherwise you may end up like me, with a dust-gathering collection. Because one of my wearables gathering dust is an Apple Watch, it has been a pricey journey.
Questions to ask yourself before buying:
- What features do I want? Spend the most time on this question. If you’re not a die-hard fitness fanatic, the actual fitness-tracking functions may not be very important to you. If you’re happy with a simple step counter, that’s good to know. Do you want a device that passes on notifications from your smartphone? If so, do you need to see details of the notifications, or is it enough to know that you have a notification? Do you want to track your sleep? Do you want the wearable to also serve as a watch? Do you need to collect data for later reference? (For example, I have an issue with my heart rate, and having access to 24-hour heart rate tracking is incredibly important to me.)
- How much battery life do I want? An Apple Watch may get through an entire day without needing to be charged, but it definitely won’t make it through a day and a night, whereas my Fitbit Charge 2 goes three to five days without needing a charge, and it charges quickly when I do charge it. How much time and effort are you willing to spend ensuring your wearable has juice?
- Do I want or need integration with my smartphone? Most wearables integrate with Android and iOS, but there are exceptions—notably, if you have an Android phone, cross the Apple Watch off your list. If you are into tracking your fitness stats, investigate the smartphone interfaces available to you. I find the Fitbit app easy to navigate and the iOS Health app to be somewhat irritating, but obviously that’s a very individual opinion.
- Will I need to purchase additional items to make the wearable do what I want? This question is rapidly becoming less important, but it is worth noting that, for example, some heart rate trackers require you to wear a band around your chest in addition to the wearable on your wrist.
- How much do I want to spend? As mentioned previously, the range is huge here, and the sky is the limit. A small tracker with no screen will run you less than $100, but a wearable with device notifications will cost more.
- How important are the cosmetics of the device? Wearables can be quite large, with big screens that allow great detail, or they can be slim and low profile, in many cases with no screen at all. Many have swappable bands. If you’re an administrative nurse, you may not want a huge wearable with a neon green sports strap.
I prefer the Fitbit Charge 2. It reliably passes on notifications from my phone, it tracks my steps and continuous heart rate and seems to be very reliable with both, it is small and low profile on my little wrists, it has swappable bands, and the battery life is impressive and convenient. It has a bunch of features I don’t use much, like the stopwatch, sleep tracker, and alarm, but it offers the best match for what I want versus what I don’t, and the price point is very acceptable. It requires no maintenance or tinkering after the initial (simple) setup, whereas wearables like the Pebble, recently purchased by Fitbit, and the Apple Watch constantly need fine-tuning and workarounds.
The health apps alternative.
Of course, one alternative is to avoid wearables altogether and use smartphone apps that have many of the same functions. Smartphones can now track steps taken while carrying the phone, and tracking steps in this way allows GPS monitoring, which remains nonstandard in wearables. That means that by carrying a phone during a run or bike ride, wearers can also keep track of what distance they covered.
But do they work?
Finding the right wearable (or app) is half the battle, but do they make us healthier? With such widespread adoption, one would think so. From a common sense standpoint, anything that motivates people to get up and move should be beneficial.
Wearables have gamified fitness by setting, for example, a step goal and letting users earn badges and other signs of achievement when they reach it. People can challenge each other and follow each other online to track each other’s progress. This increases the likelihood that wearables users will increase their daily activity.
Health alerts. Above and beyond encouraging us to be more active, thus improving our health, fitness trackers may alert us to dire medical situations. The fancier the tracker, the more information it has to help you identify a problem. For example, people have claimed that the Apple Watch saved their lives by alerting them that their heart rates were extremely high. By these means, the Watch may have helped them avoid lasting damage from varied conditions, including heart attacks, rhabdomyolysis, and pulmonary emboli.
Despite the anecdotal nature of the evidence, these claims are impressive. On the one hand, similar results could be achieved by people simply taking their own pulse the old-fashioned way. On the other hand, people seem more willing to pay attention to an electronic result, and wearables track this information automatically.
Research on fitness trackers is ongoing. Finally, studies have also investigated the use of fitness trackers in various patient populations to determine whether, for example, their use in young or older people actually increases motivation or adherence to an activity regimen or helps them manage a chronic illness. A quick PubMed search turns up a growing body of research on the possible uses of these devices for improving health in a number of patient populations.
An offshoot of these studies is the idea that because people are tracking so much of their health data, that information can be used for data mining. More research will certainly appear using these concepts.
The health benefits of being active are impossible to dispute, and wearables encourage more activity. But as technology becomes more sophisticated, wearables may increasingly save lives by serving as early-warning systems or by providing data for research on treatments and prevention.
Do you or your patients have a wearables success story? Share in the comments!