Wearable devices to improve physical activity and reduce sedentary behaviour: an umbrella review

Background: Several systematic reviews (SRs), with and without meta-analyses, have investigated the use of wearable devices to improve physical activity, and there is a need for frequent and updated syntheses on the topic. Objective: We aimed to evaluate whether using wearable devices increased physical activity and reduced sedentary behaviour in adults. Methods: We conducted an umbrella review searching PubMed, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, MedRxiv, Rxiv and bioRxiv databases up to February 5th, 2023. We included all SRs that evaluated the efficacy of interventions when wearable devices were used to measure physical activity in adults aged over 18 years. The primary outcomes were physical activity and sedentary behaviour measured as the number of steps per day, minutes of moderate to vigorous physical activity (MVPA) per week, and minutes of sedentary behaviour (SB) per day. We assessed the methodological quality of each SR using the Assessment of Multiple Systematic Reviews, version 2 (AMSTAR 2) and the certainty of evidence of each outcome measure using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations). We interpreted the results using a decision-making framework examining the clinical relevance and the concordances or discordances of the SR effect size. Results: Fifty-one SRs were included, of which 38 included meta-analyses (302 unique primary studies). Of the included SRs, 72.5% were rated as 'critically low methodological quality'. Overall, with a slight overlap of primary studies (corrected cover area: 3.87% for steps per day, 3.12% for MVPA, 4.06% for SB) and low-to-moderate certainty of the evidence, the use of WDs may increase PA by a median of 1,312.23 (IQR 627-1854) steps per day and 57.8 (IQR 37.7 to 107.3) minutes per week of MVPA. Uncertainty is present for PA in pathologies and older adults subgroups and for SB in mixed and older adults subgroups (large confidence intervals). Conclusions: Our findings suggest that the use of WDs may increase physical activity in middle-aged adults. Further studies are needed to investigate the effects of using WDs on specific subgroups (such as pathologies and older adults) in different follow-up lengths, and the role of other intervention components

A Survey of Wearable Biometric Recognition Systems

The growing popularity of wearable devices is leading to new ways to interact with the environment, with other smart devices, and with other people. Wearables equipped with an array of sensors are able to capture the owner’s physiological and behavioural traits, thus are well suited for biometric authentication to control other devices or access digital services. However, wearable biometrics have substantial differences from traditional biometrics for computer systems, such as fingerprints, eye features, or voice. In this article, we discuss these differences and analyse how researchers are approaching the wearable biometrics field. We review and provide a categorization of wearable sensors useful for capturing biometric signals. We analyse the computational cost of the different signal processing techniques, an important practical factor in constrained devices such as wearables. Finally, we review and classify the most recent proposals in the field of wearable biometrics in terms of the structure of the biometric system proposed, their experimental setup, and their results. We also present a critique of experimental issues such as evaluation and feasibility aspects, and offer some final thoughts on research directions that need attention in future work

A survey of wearable biometric recognition systems

The growing popularity of wearable devices is leading to new ways to interact with the environment, with other smart devices, and with other people. Wearables equipped with an array of sensors are able to capture the owner's physiological and behavioural traits, thus are well suited for biometric authentication to control other devices or access digital services. However, wearable biometrics have substantial differences from traditional biometrics for computer systems, such as fingerprints, eye features, or voice. In this article, we discuss these differences and analyse how researchers are approaching the wearable biometrics field. We review and provide a categorization of wearable sensors useful for capturing biometric signals. We analyse the computational cost of the different signal processing techniques, an important practical factor in constrained devices such as wearables. Finally, we review and classify the most recent proposals in the field of wearable biometrics in terms of the structure of the biometric system proposed, their experimental setup, and their results. We also present a critique of experimental issues such as evaluation and feasibility aspects, and offer some final thoughts on research directions that need attention in future work.This work was partially supported by the MINECO grant TIN2013-46469-R (SPINY) and the CAM Grant S2013/ICE-3095 (CIBERDINE

Smart technologies and beyond: exploring how a smart band can assist in monitoring children’s independent mobility & well-being

The problem which is being investigated through this thesis is not having a device(s) or method(s) which are appropriate for monitoring a child’s vital and tracking a child’s location. This aspect is being explored by other researchers which are yet to find a viable solution. This work focuses on providing a solution that would consider using the Internet of Things for measuring and improving children’s health. Additionally, the focus of this research is on the use of technology for health and the needs of parents who are concerned about their child’s physical health and well-being. This work also provides an insight into how technology is used during the pandemic. This thesis will be based on a mixture of quantitative and qualitative research, which will have been used to review the following areas covering key aspects and focuses of this study which are (i) Children’s Independent Mobility (ii) Physical activity for children (iii) Emotions of a child (iv) Smart Technologies and (v) Children’s smart wearables. This will allow a review of the problem in detail and how technology can help the health sector, especially for children. The deliverable of this study is to recommend a suitable smart band device that enables location tracking of the child, activity tracking as well as monitoring the health and wellbeing of the child. The research also includes an element of practical research in the form of (i) Surveys, the use of smart technology and a perspective on the solution from parents. (ii) Focus group, in the form of a survey allowing opinions and collection of information on the child and what the parents think of smart technology and how it could potentially help with their fears. (iii) Observation, which allows the collection of data from children who were given six activities to conduct while wearing the Fitbit Charge HR. The information gained from these elements will help provide guidelines for a proposed solution. In this thesis, there are three frameworks which are about (i) Research process for this study (ii) Key Performance Indicators (KPIs) which are findings from the literature review and (iii) Proposed framework for the solution, all three combined frameworks can help health professionals and many parents who want an efficient and reliable device, also deployment of technologies used in the health industry for children in support of independent mobility. Current frameworks have some considerations within the technology and medical field but were not up to date with the latest elements such as parents fears within today’s world and the advanced features of technology

Multimodal biometric monitoring technologies drive the development of clinical assessments in the home environment

Biometric Monitoring Technologies (BioMeTs) attracted the attention of the health care community because of their user-friendly form factor and multi-sensor data collection capabilities. The potential benefits of multimodal remote monitoring for collecting comprehensive, longitudinal, and contextual datasets spans therapeutic areas, and both chronic and acute disease settings. Importantly, multimodal BioMeTs unlock the ability to generate rich context data to augment digital measures. Currently, the availability of devices is no longer the main factor limiting adoption but rather the ability to integrate fit-for-purpose BioMeTs reliably and safely into clinical care. We provide a critical review of the state of art for multimodal BioMeTs in clinical care and identify three unmet clinical needs: 1) expanding the abilities of existing ambulatory unimodal BioMeTs; 2) adapting standardized clinical test protocols ("spot checks'') for use under free living conditions; and 3) novel applications to manage rehabilitation and chronic diseases. As the field is still in an early and quickly evolving state, we make practical recommendations to 1) select appropriate BioMeTs; 2) develop composite digital measures; and 3) design interoperable software to ingest, process, delegate, and visualize the data when deploying novel clinical applications. Multimodal BioMeTs will drive the evolution from in-clinic assessments to at-home data collection with a focus on prevention, personalization, and long-term outcomes by empowering health care providers with knowledge, delivering convenience, and an improved standard of care to patients

Development and implementation of a remote monitoring and coaching intervention delivered using digital health technology for people with a history of cancer.

There is a need to improve care practices to optimally enhance physical health and health- related quality of life in people with a history of cancer. Intensive treatment of cancer can impact patients both acutely and chronically as long-term or late effects well after treatment completion. As a result, both patients with cancer and cancer survivors need additional support Supportive cancer care, including survivorship and rehabilitation services focuses on developing strategies to support survivors’ well-being and recovery during and after cancer treatment. However, despite the evidence-based benefits of these services, many barriers still exist that may restrict patients with cancer from participation and engagement. One possible solution to these challenges is the use of digital health technologies. The aim of this research was to explore current gaps in knowledge regarding digital health enabled supportive cancer care and design and develop a digital health enabled intervention, specifically tailored to the needs of people with a cancer diagnosis. The experience culminated in the implementation of a 10-week prospective cohort trial, focused on the feasibility and acceptability of a patient-provider tracking and exercise coaching portal. As evidenced by the research studies presented within this thesis, findings suggest that patient-centric supportive care can be provided to cancer patients using a digital health enabled approach. Further, remote monitoring and individual exercise coaching can feasibly be offered to patient populations who may not be able to conveniently access support services, or who choose to access these services remotely. Several recommendations for future research and future directions were provided to further this area of research

Digital phenotyping through multimodal, unobtrusive sensing

The growing adoption of multimodal wearable and mobile devices, such as smartphones and wrist-worn watches has generated an increase in the collection of physiological and behavioural data at scale. This digital phenotyping data enables researchers to make inferences regarding users’ physical and mental health at scale, for the first time. However, translating this data into actionable insights requires computational approaches that turn unlabelled, multimodal time-series sensor data into validated measures that can be interpreted at scale. This thesis describes the derivation of novel computational methods that leverage digital phenotyping data from wearable devices in large-scale populations to infer physical behaviours. These methods combine insights from signal processing, data mining and machine learning alongside domain knowledge in physical activity and sleep epidemiology. First, the inference of sleeping windows in free-living conditions through a heart rate sensing approach is explored. This algorithm is particularly valuable in the absence of ground truth or sleep diaries given its simplicity, adaptability and capacity for personalization. I then explore multistage sleep classification through combined movement and cardiac wearable sensing and machine learning. Further, I demonstrate that postural changes detected through wrist accelerometers can inform habitual behaviours and are valuable complements to traditional, intensity-based physical activity metrics. I then leverage the concomitant responses of heart rate to physical activity that can be captured through multimodal wearable sensors through a self-supervised training task. The resulting embeddings from this task are shown to be useful for the downstream classification of demographic factors, BMI, energy expenditure and cardiorespiratory fitness. Finally, I describe a deep learning model for the adaptive inference of cardiorespiratory fitness (VO2max) using wearable data in free living conditions. I demonstrate the robustness of the model in a large UK population and show the models’ adaptability by evaluating its performance in a subset of the population with repeated measures ~6 years after the original recordings. Together, this work increases the potential of multimodal wearable and mobile sensors for physical activity and behavioural inferences in population studies. In particular, this thesis showcases the potential of using wearable devices to make valuable physical activity, sleep and fitness inferences in large cohort studies. Given the nature of the data collected and the fact that most of this data is currently generated by commercial providers and not research institutes, laying the foundations for responsible data governance and ethical use of these technologies will be critical to building trust and enabling the development of the field of digital phenotyping.I was funded by GlaxoSmithKline and the Engineering and Physical Sciences Research Council. I was also supported by the Alan Turing Institute through their Enrichment Scheme

Survey on virtual coaching for older adults

Virtual coaching has emerged as a promising solution to extend independent living for older adults. A virtual coach system is an always-attentive personalized system that continuously monitors user's activity and surroundings and delivers interventions - that is, intentional messages - in the appropriate moment. This article presents a survey of different approaches in virtual coaching for older adults, from the less technically supported tools to the latest developments and future avenues for research. It focuses on the technical aspects, especially on software architectures, user interaction and coaching personalization. Nevertheless, some aspects from the fields of personality/social psychology are also presented in the context of coaching strategies. Coaching is considered holistically, including matters such as physical and cognitive training, nutrition, social interaction and mood.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No. 769830

Preventive computing technology for successful aging

A pervasive societal and personal concern is how we can maintain or improve our quality of life as we age. The purpose of this thesis is to assess the current state of technology as it is (or can be) used in everyday life to support healthy and happy older adults by maintaining physical fitness, cognitive health, and emotional fulfillment. In addressing this problem, much focus has been placed on assistive technology, replacing or compensating for functionality that has declined or been lost, or creating a “safe zone.” Our focus is on technology that is not assistive in this sense, but rather supportive in expanding capabilities to remain independent in their current environment. If older adults can retain their capabilities, the need for a myriad of assistive technologies would be postponed. Therefore, the alternative perspective we offer is more preventive and proactive