Wearable activity trackers improve physical activity and function in hospitalized adults

Key takeaways:

• Wearable activity trackers were linked to a mean difference of 826 daily step counts per day vs. usual care.
• Trackers were not linked to pain, mental health or hospital efficiency outcomes, however.

Wearable activity trackers were linked to higher physical activity and improved physical function in hospitalized adults, although they did not influence hospitalization outcomes like risk for readmission, a recent study found.

According to Kimberley Szeto, BClinExPhys, a PhD candidate at the University of South Australia, and colleagues, periods of hospitalization are often characterized by low levels of physical activity (PA).

“This is often despite patients’ ability to walk independently and is understood to lead to increased mortality, functional decline, frailty, and disability,” they wrote in JAMA Network Open.

Although interventions such as wearable activity trackers (WATs) have been linked to improved PA and health biomarkers, “their association with hospitalization and patient PA, clinical outcomes (eg, physical function), and hospital efficiency outcomes (eg, [length of stay]) are less understood,” Szeto and colleagues wrote.

The researchers aimed to fill gaps in the literature by conducting a systematic review and meta-analysis of 15 studies, 11 of which were randomized controlled trials. Overall, the analysis included 1,911 hospitalized patients who used WATs.

The studies had been published between 2013 to 2021, and the mean age of patients ranged from 51 to 81 years.

The study’s primary outcomes were overall PA — measured by either daily PA or daily step counts — and sedentary behavior (SB), which was measured by daily minutes of SB. Secondary outcomes included physical function, mental health and hospital efficiency.

Szeto and colleagues found that, compared with usual care, there was a significant association between WAT interventions and:

• higher overall PA (standardized mean difference [SMD] = 0.35; 95% CI, 0.15-0.54);
• less SB (mean difference = –35.46; 95% CI, –57.43 to –13.48); and
• improved physical function (SMD = 0.27; 95% CI, 0.08-0.46).

According to the researchers, WAT interventions did not affect mental health or pain outcomes, nor did they impact hospital length of stay or readmissions, which “may seem surprising in light of previous data [linking] higher patient PA with improved hospital efficiency outcomes,” they wrote.

“However, previous associations were found under observational conditions, not experimental conditions,” they wrote. “Similarly, readmission is also likely to be associated with various factors not addressed by WAT interventions.”

Ultimately, the study’s finding that WATs were linked to a mean difference of 826 daily step counts vs. usual care was “substantial, given that increasing daily step counts by even 250 to 500 steps have been associated with reduced risk for adverse hospital outcomes,” Szeto and colleagues wrote.

The researchers acknowledged several study limitations. For example, most of the studies had small sample sizes — ranging from 41 to 255 participants — and there were limited data on readmissions and clinical outcomes.

The researchers concluded that “as health care becomes increasingly digitized, further exploration of the clinical outcomes and cost-effectiveness of WATs in different groups who are hospitalized will be crucial for guiding their use and maximizing their potential benefits.”