Wearable Technology: Health And Fitness Trackers And The Next Stage In Their Advancement

ABSTRACT

New fitness trackers and smart watches are released to the consumer market every year. These devices are equipped with different sensors, algorithms, and accompanying mobile apps. With recent advances in mobile sensor technology, privately collected physical activity data can be used as an addition to existing methods for health data collection in research. Furthermore, data collected from these devices have possible applications in patient diagnostics and treatment. With an increasing number of diverse brands, there is a need for an overview of device sensor support, as well as device applicability in research projects.

We searched for devices and brand names in six wearable device databases. For each brand, we identified additional devices on official brand websites. The search was limited to wrist-worn fitness wearables with accelerometers, for which we mapped brand, release year, and supported sensors relevant for fitness tracking. In addition, we conducted a Medical Literature Analysis and Retrieval System Online (MEDLINE) and ClinicalTrials search to determine brand usage in research projects. Finally, we investigated developer accessibility to the health data collected by identified brands.

From the results, We identified 423 unique devices from 132 different brands. Forty-seven percent of brands released only one device. Introduction of new brands peaked in 2014, and the highest number of new devices was introduced in 2015. Sensor support increased every year, and in addition to the accelerometer, a photoplethysmograph, for estimating heart rate, was the most common sensor. Out of the brands currently available, the five most often used in research projects are Fitbit, Garmin, Misfit, Apple, and Polar. Fitbit is used in twice as many validation studies as any other brands and is registered in ClinicalTrials studies 10 times as often as other brands.

TABLE OF CONTENT

TITLE PAGE

APPROVAL PAGE

DEDICATION

ACKNOWLEDGEMENT

ABSTRACT.

TABLE OF CONTENT

LIST OF ABBREVIATIONS

CHAPTER ONE

INTRODUCTION

• BACKGROUND OF THE STUDY
• AIM OF THE STUDY
• SCOPE OF THE PROBLEM
• APPLICATION OF THE STUDY
• BENEFITS OF “WEARABLE TECHNOLOGY IN HEALTHCARE
• PROBLEM AND LIMITATION OF THE STUDY
• SIGNIFICANCE OF THE STUDY

CHAPTER TWO

REVIEW OF RELATED LITERATURE

• WHAT IS WEARABLE TECHNOLOGY?
• EVOLUTION OF WEARABLE TECHNOLOGY IN HEALTHCARE
• THE FUTURE OF “WEARABLE TECHNOLOGY”
• HISTORICAL BACKGROUND OF WEARABLE TECHNOLOGY
• CHALLENGES AND OPPORTUNITIES FOR WEARABLES BEYOND FITNESS TRACKING
• FROM FITNESS TRACKING GADGETS TO REGULATED MEDICAL DEVICES

CHAPTER THREE

METHODOLOGY

• INTRODUCTION
• STUDY AREA
• RESEARCH DESIGN
• POPULATION OF THE STUDY
• INSTRUMENT
• SURVEY METHOD
• DATA COLLECTION
• VALIDITY OF STUDY

CHAPTER FOUR

RESULT ANALYSIS

4.1.     RESULT ANALYSIS

4.2      DISCUSSION

CHAPTER FIVE

CONCLUSION AND REFERENCES

• CONCLUSION
• REFERENCES

 CHAPTER ONE

1.0                                          INTRODUCTION

1.1                            BACKGROUND OF THE STUDY

The World Health Organization recommends 150 min of moderate intensity physical activity (PA) each week for adults and 60 min for children and adolescents [1]. However, 25% of adults and more than 80% of adolescents do not achieve the recommended PA targets [1]. Results from the Tromsø Study, the longest running population study in Norway, shows that only 30.4% of women and 22.0% of men reach the recommended target [2].

Low PA is currently the fourth leading risk factor for mortality worldwide [3]. Even though there is limited evidence that using wearable fitness trackers will improve health [4,5], these devices are still popular, and new fitness devices appear on the consumer market regularly. In 2016, vendors shipped 102 million devices worldwide, compared with 82 million in 2015 [6]. Fifty-seven percent of these devices were sold by the top five brands: Fitbit, Xiaomi, Apple, Garmin, and Samsung. The first quarter of 2017 shows an increase of 18% in devices sold, compared with the same period in 2016 [7]. With a large number of available devices and brands, it is difficult to navigate through an ever-growing list of brands and devices with different capabilities, price, and quality.

Available sensors and internal interpreting algorithms determine device output. Sensor data are, in most devices, reduced to a limited set of metrics before being transferred to the user’s mobile phone. In addition, limited space affects how long the device can collect data before such a transfer is needed. Data are stored locally, and in many cases, uploaded to brand specific or open cloud–based health repositories. Accessing these data by third-party apps and comparing them is not always possible. These interoperability challenges were recently identified in a study by Arriba-Pérez et al [8]. They suggested ways to handle these issues, but they did not make any brand or device recommendations. Several studies have compared activity-tracking wearables. As an example, Kaewkannate and Kim [9] did a comparison of four popular fitness trackers in 2016. They compared devices objectively and subjectively. Data were thoroughly collected, but because of the rapid release of new devices, these four devices will be among the most popular only for a relatively short time. A comparison of brands is also of interest because brands from larger companies are, compared with small start-ups and crowd funded brands, likely to survive longer. In addition, it is of interest to know which brands support the various available programming options. Sanders et al [10] did a literature review on articles using wearables for health self-monitoring and sedentary behavior and PA detection. They reviewed various aspects of these devices, but they gave no details about device sensor support and suitability in research.

Sensors

A plethora of devices promises to measure PA in new and improved ways. These devices use different sensors and algorithms to calculate human readable metrics based on sensor output. Traditional step counters use pedometers to detect daily step counts. Although cheap and energy efficient, pedometers are not as accurate as accelerometers, which is the current standard for collecting PA data [11]. All modern fitness trackers and smartwatches have an accelerometer. Compared with research tools (eg, ActiGraph [12]), these devices are considered less accurate for some measurements [13,14]. However, they are generally less invasive, cheaper, have more functionality, are more user-friendly, and are increasingly being used in research. Most accelerometer-based fitness wearables measure acceleration in three directions [15] and can be used to estimate type of movement, count steps, calculate energy expenditure (EE) and energy intensity, as well as estimate sleep patterns and more. The validity and reliability of these metrics varies. Evenson et al [14] did a review in 2015 and found high validity for steps but low validity for EE and sleep. Furthermore, they found reliability for steps, distance, EE, and sleep to be high for some devices.

In addition, some wearables have gyroscopes, magnetometers, barometers, and altimeters. A gyroscope can potentially increase device accuracy by measuring gravitational acceleration, that is, orientation and angular velocity, and better estimate which activity type a person is performing [16]. A magnetometer is a digital compass [15] and can improve motion tracking accuracy by detecting the orientation of the device relative to magnetic north. Magnetometers improve accuracy by compensating for gyroscope drift, a problem with gyroscopes where the rotation axis slowly drifts from the actual motion and must be restored regularly. Accelerometers, gyroscopes, and magnetometers are often combined into an inertial measurement unit (IMU). Most mobile phones use IMUs to calculate orientation, and an increasing number of fitness wearables include this unit to give more accurate metrics. Barometers or altimeters detect changes in altitude [15] and can be used to improve some metrics (eg, EE), as well as report additional metrics (eg, climbed floors).

Photoplethysmography (PPG) is a relatively new technique in wearables. PPG is an optical technique to estimate HR by monitoring changes in blood volume beneath the skin [17]. A light-emitting diode projects light onto the skin, which is affected by the HR and reflected back to the sensor. However, movement, ambient light, and tissue compression affect the light, resulting in signal noise, and cleaning algorithms often use accelerometer data to assist HR estimation [18]. There is some evidence that gyroscopes could be used [19] to reduce PPG signal noise, so we are likely to see more devices in the future equipped with PPG sensors. To further enrich the PA data collection, some devices have a built in global positioning system (GPS) receiver. This is especially true for high-end fitness trackers and sports watches specifically targeting physically active people. With a GPS, it is possible to track more data, including position, speed, and altitude.

Algorithms and Mobile Apps

Raw data from sensors must be converted into readable metrics to be meaningful for the user. Many devices only display a limited set of metrics directly on the device (eg, today’s step count or current HR) and rely on an accompanying mobile app to show the full range of available metrics (eg, historic daily step count and detailed HR data). Although the physical sensors in these devices are very similar, the algorithms that interpret sensor output are unique for most vendors. These algorithms are often company secrets, and they can be changed without notice. In addition, the quality and supported features of the accompanying mobile apps varies, and the total user experience will therefore differ. Each additional sensor included in a device can be used to add additional types of metrics for the user or supply internal algorithms with additional data to improve accuracy of already available metric types. However, additional sensors affect price and power consumption.

Device Types

There are many similarities between different types of devices, and they may be difficult to categorize. We will use the term wearable in this paper as a common term for wrist-worn devices that can track and share PA data with a mobile phone.

A smartwatch is a wrist-worn device that, mostly, acts as an extension to a mobile phone and can show notifications and track PA and related metrics. Modern smartwatches often include a touch screen and can support advanced features and display high resolution activity trends [15]. Fitness trackers (ie, smart band or fitness band), normally worn on the wrist or hip, are devices more dedicated to PA tracking. A fitness tracker is typically cheaper than a smartwatch because of less expensive hardware and often fewer sensors. Due to this, it generally also has better battery life and a limited interface for displaying tracking results [15].

Other terms are also used, for example, sports watch and GPS watch, which can be considered merges between smartwatches and fitness trackers. In addition, there are hybrid watches (ie, hybrid smartwatches) that have a traditional clockwork and analogue display that have been fitted with an accelerometer. An accompanying mobile app is needed to access most data, but daily step counts are often represented as an analogue gauge on the watch face.

Wearable Usage Scenario

Wearables come forward as a new alternative to tracking PA in research (compared with, eg, ActiGraph), especially when it is desired to collect measurements for a prolonged period of time. In an intervention study, continuous data collecting from wearables would allow researchers to better track changes in PA and adjust the intervention accordingly. Wearables can also be used in epidemiological research as a tool for tracking PA for an extended period. This could reveal detailed PA changes in a population over time. In both scenarios, there are several potential important requirements to consider when choosing a device for the study, including usability, battery life, price, accuracy, durability, look and feel, and data access possibilities.

1.2                                       AIM OF THE STUDY

The main aim of this study was to examine how the consumer market for wearables has evolved, and analyze and summarize available devices that can measure PA and heart rate (HR). Moreover, we aim to identify brands that are used extensively in research projects, and compare and consider their relevance for future studies.

1.3                                    SCOPE OF THE STUDY

The study was to examine the availability of wrist-worn fitness wearables and analyze availability of relevant fitness sensors from 2011 to 2017. Furthermore, the study was designed to assess brand usage in research projects, compare common brands in terms of developer access to collected health data, and features to consider when deciding which brand to use in future research.

1.4                            APPLICATIONS OF THE STUDY

Fitness: The wearables industry offers the fitness world several types of devices and applications. Consumers can choose from a multitude of tracking devices, sensors, software apps and wearable apparel technology. From gamification of club activities to full-body suits retrofitted with sensors to track physiological data, consumers and athletes can gain more insight into their fitness goals and progress. One startup, California-based GOQii, is pioneering a wearable fitness band paired with remote personalized coaching.

Healthcare: The healthcare sector has already witnessed solutions for wearable technology. “The sky’s the limit when it comes to wearable tech in healthcare and potential innovations extend way beyond activity trackers,” Forbes contributor Unity Stoakes writes. “We’re already seeing sensors that improve quality of life, enable home diagnostics, make virtual health and remote monitoring possible, and that’s just the tip of the iceberg.”

Wearables include a headband and software platform for brain injury detection, a wristband that monitors blood oxygen wirelessly, smart patches for remote monitoring and home diagnosis, a tattoo-like plastic patch that can monitor vital signs and a smart contact lens that can monitor the user’s blood sugar levels. The grant is expected to further research and develop a wearable capable of providing deep brain stimulation, a common method of treatment typically requiring heavy physician involvement.

Other Industries: Wearable technology is poised to impact several sectors of the economy. According to a PricewaterhouseCoopers report, certain sectors stand out as having the largest opportunity for wearable technology solutions, aside from fitness and healthcare.

• Entertainment, media and communications companies likely have the best opportunity for advancement and growth. Media and entertainment can become more immersive and fun. Wearables can integrate social media updates. Video games can become more visually and physically engaging. And advertising can take advantage of highly targeted placements with greater relevancy.
• Retail experiences can be enhanced through wearable technology. Consumers desire a better customer service experience and want rewards for being loyal customers. In-store merchandising and promotional spending by brands can help fund retailers and improve the shopping experience.
• Technology “stands at the epicenter of the wearables movement,” according to PricewaterhouseCoopers. Users would like their workplace to integrate wearable technology for increased efficiency and productivity at work. Wearable tech can also boost payment processing on the financial back end. Finally, many customers wish for wearables that make technology simpler to use.

1.5 BENEFITS OF “WEARABLE TECHNOLOGY IN HEALTHCARE

Wearable technology has touched multiple areas but Healthcare has been the major benefiter of this technology. By deploying wearables technologies, hospitals and clinics can achieve benefits across multiple levels and roles. Some such benefits can be enumerated as:

1. Encourages Proactive Healthcare

With wearable tech, there is potential for a more proactive approach to healthcare. This is because wearables can be used to take action in the early stages instead of reacting to health issues after they begin causing problems. For people that are already prone to health problems, irregularities can be detected before they become problems.

2. Keeps Patients Engaged

People will become much more engaged with their own health if they are able to use wearable tech to monitor themselves. Users will be able to stay informed about their health condition by getting access to real-time data which is continuously collected from a wearable device.

3. Performs Many Different Functions

There are many different types of wearable devices already on the market, with different use cases. Consumer-focused devices are the most common, but there are many others, especially in the medical field. As wearables continue to become more common, more medical uses for these devices will surely be developed.

4. Benefits Healthcare Providers and Employers

Wearable technology has the potential to provide enormous benefits to healthcare providers. By using wearable devices to monitor patient data over a long period of time, medical professionals can get a better view of the issues that are affecting their patient. They can then use the data to make a more accurate diagnosis than they would have been able to without using the device.

5. Monitors Vulnerable Patients

Healthcare providers can also use wearable tech to monitor vulnerable patients who are prone to medical issues. If they are at risk but not seriously ill enough to be in the hospital, wearable tech can be used to monitor them at home to ensure no problems occur.

6. Improve Patient Care and Satisfaction

Provide surgeons and physicians with critical information to improve decision-making process while increasing opportunities for patient connection. Examples include using smart glasses to view patient vitals and relevant information during surgical procedures without taking eyes off the patient.

7. Strengthen Operational Bottom Line

Facilitate cost savings by equipping building and custodial staff with wearable devices that increase productivity.

1.6                PROBLEM AND LIMITATION OF THE STUDY

Here are a few challenges of Wearables:

One of the principal worries concerning wearables is its legitimacy and dependability. Clinical researches on observing gadgets have likenesses to purchase wearables include pedometers.

They are also implementing a cell phone application to help possible ways of life and weight.

It is also an answer for home telemonitoring. Clinical settings use these customary observing gadgets.

However the exactness of present-day wearable’s is not quite up to the mark. Next to zero data is accessible to affirm the legitimacy of these wearable devices.

It is mainly under free-living conditions. There have been an increasing number of tests on the legality of wearables.

However, the consistent quality and validity of wearable gadgets is a matter of concern.

We are witnessing ongoing examinations to exhibit great potential of such devices. However, one must address the absence of consistent quality and certainty.

Such an approach is vital before launching a gadget for any clinical application or setting. Furthermore, consistent quality likewise represents another danger, concerning security.

There is a plausible risk that clients end up being dependent on the gadgets. They may also get stuck to their robotized frameworks.

1.7                             SIGNIFICANCE OF THE STUDY

Wearable innovation yields critical patient information for enhanced administrations by social insurance suppliers. Wearable processes information from daily exercises.

The doctors can use them in diagnosing or treating patients. Wearable’s likewise offered a practical approach to convey data.

In this way, it guarantees a sterile domain to impart information. The wearable devices offer a first individual perspective of the client to the restorative expert.

In this way, it guarantees a sterile domain to impart information. The wearable devices offer a first individual perspective of the client to the restorative expert.

The Costs are moderate and affordable as per an individual’s budget. Numerous wearable changes that are accessible available are very user-friendly.

Somebody may use wearable innovation, is for better care. For a similar reason, a specialist might need to track a man’s information every day.

A patient too would profit by evaluated well-being to enhance finding and treatment.

The fast development in change has surprisingly upgraded the extent of remote wellbeing checking. It is the case in the present period.

Here ongoing wellbeing observing framework assumes a fundamental part. The thought behind making the structures is to lower the cost, simplicity of use, exactness, etc.

Most significantly it is also about information security. It encourages a two-route correspondence between the specialist and the patient.

The principle motivation behind these wellbeing checking frameworks is to give the most recent data. These frameworks have two interfaces, one for patients and another for the specialist.

The patient interface includes wearable sensors which separate restorative data of the patients. It transmits to an Android-based listening port employing Bluetooth.

The listening port exchanges this data to the web server. There it forms information to demonstrate reporting about the specialist’s interface.

Wearable devices for physically fit: Quality wearable gadgets are helping individuals with a fitness regime. Few of them are making progress toward individual fulfillment while some for intensity.

Wellness wearable, for example, Wellness trackers help in checking or following wellness related measurements, for example, walking a distance or running, calorie utilization, etc. At times you can also check your pulse and nature of resting.

These trackers are gadgets or applications, an essential feature of healthcare mobile app development. They function remotely on a PC or phone for the constant following of wellbeing related information.

Such trackers are predominant in games or wellness monstrosities, or overweight individuals. It enables them to screen physical exercises or a get-healthy plan

Endless Infections Avoidance utilizing Wearables: Infinite infection administration isn’t only a test, yet a weight to the human services framework. Majority of therapeutic services spends money on curing incessant sicknesses.

They are the most well-known, exorbitant, and preventable of all medical issues. These incorporate diabetes, asthma, coronary illness, and constant torment from different causes.

They require an interest in observing, consistency, and social changes. Using such innovation one can avoid those diseases.

It can speak with a phone application and web-based interface using Wi-Fi, Bluetooth. The gadget has a connection to the upper middle of the abdominal area.

The link is possible using the skin-safe ointment. It tracks side effects of asthmatic assaults.

The device can also monitor including heart bearing rate, coughing rate, pulse, and body temperature.

Wearables in Elderly Care: There has been a fast development of the elderly population. It is a reason for large increment in the interest for human services administrations.

For the most part, the senior people have more medical issues. It is in contrast with others. Older people are living longer and confronting new financial, therapeutic services, and own living difficulties.

A significant percentage of people have a restriction on eye-vision, hearing, mobility, correspondence, and perception. They need individual attention consideration.