Wearable Technology and Physical Activity Behavior Change in Adults With Chronic Cardiometabolic Disease: A Systematic Review and Meta-Analysis

Objective: To evaluate the effectiveness of wearable device interventions (eg, Fitbit) to improve physical activity (PA) outcomes (eg, steps/day, moderate to vigorous physical activity [MVPA]) in populations diagnosed with cardiometabolic chronic disease. Data Source: Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, an electronic search of 5 databases (Medline, PsychINFO, Scopus, Web of Science, and PubMed) was conducted. Study Inclusion and Exclusion Criteria: Randomized controlled trials (RCTs) published between January 2000 and May 2018 that used a wearable device for the full intervention in adults (18+) diagnosed with a cardiometabolic chronic disease were included. Excluded trials included studies that used devices at pre-post only, devices that administered medication, and interventions with no prospective control group comparison. Data Extraction: Thirty-five studies examining 4528 participants met the inclusion criteria. Study quality and RCT risk of bias were assessed using the Cochrane Collaboration Tool. Data Synthesis: Meta-analyses to compute PA (eg, steps/day) and selected physical dispersion and summary effects were conducted using the raw unstandardized pooled mean difference (MD). Sensitivity analyses were examined. Results: Statistically significant increases in PA steps/day (MD = 2592 steps/day; 95% confidence interval [CI]: 1689-3496) and MVPA min/wk (MD = 36.31 min/wk; 95% CI: 18.33-54.29) were found for the intervention condition. Conclusion: Wearable devices positively impact physical health in clinical populations with cardiometabolic diseases. Future research using the most current technologies (eg, Fitbit) will serve to amplify these findings.