The aim of this review was to explore the acceptability, opportunities, and challenges associated with wearable activity-monitoring technology to increase physical activity (PA) behavior in cancer survivors. A search of Medline, Embase, CINAHL, and SportDiscus was conducted from 1 January 2011 through 3 October 2022. The search was limited to English language, and peer-reviewed original research. Studies were included if they reported the use of an activity monitor in adults (+18 years) with a history of cancer with the intent to motivate PA behavior. Our search identified 1832 published articles, of which 28 met inclusion/exclusion criteria. Eighteen of these studies included post-treatment cancer survivors, eight were on active cancer treatment, and two were long-term cancer survivor studies. ActiGraph accelerometers were the primary technology used to monitor PA behaviors, with Fitbit as the most commonly utilized self-monitoring wearable technology. Overall, wearable activity monitors were found to be an acceptable and useful tool in improving self-awareness, motivating behavioral change, and increasing PA levels. Self-monitoring wearable activity devices have a positive impact on short-term PA behaviors in cancer survivors, but the increase in PA gradually attenuated through the maintenance phase. Further study is needed to evaluate and increase the sustainability of the use of wearable technologies to support PA in cancer survivors.

UNASSIGNED: Long-term adherence to exercise is often poor for people with coronary heart disease (CHD) who have completed supervised, centre-based cardiac rehabilitation. The aim of this study is to assess the feasibility of a remotely prescribed, delivered and monitored cardiac rehabilitation intervention using a wearable device to support long-term adherence to exercise and physical activity during maintenance of cardiac rehabilitation.
UNASSIGNED: After completing cardiac rehabilitation, 30 participants with CHD, will be randomised (1:1) to an intervention (n = 15) or a usual care group (n = 15) in a 12-month feasibility randomised controlled trial (RCT). The intervention will comprise of an exercise consultation, personalised exercise prescription delivered via a wearable activity monitor using biometric feedback, regular monitoring via check-ins, and feedback text-messages for 6-months. Participants will be assessed at baseline (following completion of cardiac rehabilitation) and at three-, six-, and 12-months post-randomisation. The primary outcome will be feasibility, including assessment of eligibility, recruitment, adherence, and acceptability. Secondary outcomes will include exercise capacity, physical activity behaviours, cardiovascular disease risk and quality of life. Semi-structured interviews will be conducted at three-, six-, and 12-months post-randomisation (and with those who drop-out) to explore the acceptability of the study intervention and procedures. A questionnaire will be offered to those who decline participation.
UNASSIGNED: The MAINTAIN study will evaluate the feasibility of conducting a future definitive multi-centre RCT testing a remotely prescribed and monitored long-term mHealth maintenance exercise programme, versus usual care, for people with CHD who have completed cardiac rehabilitation.
UNASSIGNED: ClinicalTrials.gov, NCT05292287. Registered on 22/03/2022.

UNASSIGNED: Physical activity (PA) plays an important role in primary and secondary prevention of cardiovascular disease (CVD), functioning as a marker of disease progression and response to therapy. Real-world measurement of habitual PA is now possible through wearable activity monitors, however, their use in cardiovascular patients is not well described.
UNASSIGNED: We performed a systematic review to summarize how wearable activity monitors have been used to measure PA in patients with CVD, with 11 464 patients included across 108 studies. Activity monitors were primarily used in the setting of cardiac rehabilitation (46, 43%). Most often, triaxial accelerometers (70, 65%) were instructed to be worn at the hip (58, 54%) for 7 days (n = 54, 50%). Thirty-nine different activity monitors were used, with a range of accelerometer specific settings for collection and reporting of activity data. Activity was reported most commonly as time spent in metabolic equivalent-defined activity levels (49, 45%), while non-wear time was defined in just 16 (15%) studies.
UNASSIGNED: The collecting, processing, and reporting of accelerometer-related outcomes were highly heterogeneous. Most validation studies are limited to healthy young adults, while the paucity of methodological information disclosed renders interpretation of results and cross-study comparison challenging. While accelerometers are promising tools to measure real-world PA, we highlight current challenges facing their use in elderly multimorbid cardiology patients. We suggest recommendations to guide investigators using these devices in cardiovascular research. Future work is required to determine optimal methodology and consensus-based development of meaningful outcomes using raw acceleration data.

Step counts and oxygen consumption have yet to be reported during the 2-min walk test (2MWT) test in persons with lower-limb amputations (LLA). The purpose of this study was to determine step counts and oxygen consumption during the 2MWT in LLA. Thirty-five men and women walked for two minutes as quickly as possible while wearing activity monitors (ActiGraph Link on the wrist (LW) and ankle (LA), Garmin vivofit®3 on the wrist (VW) and ankle (VA), and a modus StepWatch on the ankle (SA), and a portable oxygen analyzer. The StepWatch on the ankle (SA) and the vivofit3 on the wrist (VW) had the least error and best accuracy of the activity monitors studied. While there were no significant differences in distance walked, oxygen consumption (VO2) or heart rate (HR) between sexes or level of amputation (p > 0.05), females took significantly more steps than males (p = 0.034), and those with unilateral transfemoral amputations took significantly fewer steps than those with unilateral transtibial amputations (p = 0.023). The VW and SA provided the most accurate step counts among the activity monitors and were not significantly different than hand counts. Oxygen consumption for all participants during the 2MWT was 8.9 ± 2.9 mL/kg/min, which is lower than moderate-intensity activity. While some may argue that steady-state activity has not yet been reached in the 2MWT, it may also be possible participants are not walking as fast as they can, thereby misclassifying their performance to a lower standard.

UNASSIGNED: The present review aimed to explore the range and characteristics of interventions that utilize WAM and descriptively summarize the efficacy of these interventions.
UNASSIGNED: A total of 65 articles (61 studies) were included in this review. Most of the WAM-based interventions (n=58) were designed to improve physical activity (PA). Interventions targeting sedentary behavior (SB) were much less common (n=12), and even less frequent were WAM-based sleep interventions (n=3). Most studies tested the feasibility of WAM-based interventions; hence, efficacy of these interventions in improving PA, SB, and/or sleep could not be conclusively determined. Nonetheless, WAM-based interventions showed considerable potential in increasing PA and decreasing SB.
UNASSIGNED: WAM-based PA interventions exhibited preliminary efficacy in increasing PA. Although not as many interventions were focused on SB, current interventions also showed potential in decreasing sedentary time. Meanwhile, more evidence is needed to determine the utility of WAM in improving sleep. Major challenges with including WAM as part of interventions are reduced engagement in using the devices over time and the rapid changes in technology resulting in devices becoming obsolete soon after completion of an efficacy trial.

One of the major changes in the updated physical activity (PA) guidelines is the recommendation for adults to simply move more and sit less throughout the day. This recommendation comes during a time of proliferation and advancement of personal health technologies that allow adults greater access to interventions to increase PA. Wearable activity monitors provide direct feedback of activity levels allowing users to reach PA targets throughout the day. Gamification of these and other devices can engage users and sustain their motivation to increase PA, along with the formation of social networks through social media platforms. This review will discuss and present an overview of current technologies that can be leveraged to increase PA in adults. Specific attention will be paid to wearable activity monitors, gamification and social network platforms that can help adults increase and sustain their PA levels to improve their overall health.

Elevated asleep heart rate (HR) is a risk factor for cardiovascular disease and other-cause morbidity and mortality. We assessed the accuracy of Fitbit Inc. PurePulse® photoplethysmography with reference to three-lead electrocardiography (ECG) in determining HR during sleep. HR of 35 (17 female) healthy adults 25.1 ± 10.6 years of age (mean ± SD) was continuously recorded throughout a single night of sleep. There was no significant difference in asleep HR mean (0.09 beats per minute [bpm], P = 0.426) between Fitbit photoplethysmography and ECG; plus, there was excellent intraclass correlation (0.998) and narrow Bland-Altman agreement range (2.67 bpm). The regression analysis of Bland-Altman plot of mean asleep HR indicates Fitbit tends to slightly overestimate reference values in the lower range of HR (HR < 50 bpm) by 0.51 bpm and slightly underestimate reference values in the higher range of HR (HR > 80 bpm) by 0.63 bpm. Mixed model analysis of epoch-by-epoch (5-min epochs) asleep HR showed significant \"U\" shape trend (P < 0.001) in amount of Fitbit error (absolute amount of difference between ECG and Fitbit values regardless of overestimation or underestimation) in regard to HR, i.e. smaller error in the medium range of HR (60-80 bpm) and slightly larger error for lower (<60 bpm) and higher (>80 bpm) ranges of HR. However, effect of age, body mass index, gender, and subjective sleep quality measured by Pittsburgh sleep quality index (good/poor sleepers) on error in estimating HR by the Fitbit method was not significant. It is concluded that Fitbit photoplethysmography suitably tracks HR during sleep in healthy young adults.

Physical activity is an important outcome in oncology trials. Physical activity is commonly assessed using self-reported questionnaires, which are limited by recall and response biases. Recent advancements in wearable technology have provided oncologists with new opportunities to obtain real-time, objective physical activity data. The purpose of this review was to describe current uses of wearable activity monitors in oncology trials.
We searched Pubmed, Embase, and the Cochrane Central Register of Controlled Trials for oncology trials involving wearable activity monitors published between 2005 and 2016. We extracted details on study design, types of activity monitors used, and purpose for their use. We summarized activity monitor metrics including step counts, sleep and sedentary time, and time spent in moderate-to-vigorous activity.
We identified 41 trials of which 26 (63%) involved cancer survivors (post-treatment) and 15 trials (37%) involved patients with active cancer. Most trials (65%) involved breast cancer patients. Wearable activity monitors were commonly used in exercise (54%) or behavioral (29%) trials. Cancer survivors take between 4660 and 11,000 steps/day and those undergoing treatment take 2885 to 8300steps/day.
Wearable activity monitors are increasingly being used to obtain objective measures of physical activity in oncology trials. There is potential for their use to expand to evaluate and predict clinical outcomes such as survival, quality of life, and treatment tolerance in future studies. Currently, there remains a lack of standardization in the types of monitors being used and how their data are being collected, analyzed, and interpreted.
Recent advancements in wearable activity monitor technology have provided oncologists with new opportunities to monitor their patients\' daily activity in real-world settings. The integration of wearable activity monitors into cancer care will help increase our understanding of the associations between physical activity and the prevention and management of the disease, in addition to other important cancer outcomes.