It’s not about the capture, it’s about what we can learn”: a qualitative study of experts’ opinions and experiences regarding the use of wearable sensors to measure gait and physical activity

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It’s not about the capture, it’s about what we can learn”: a qualitative study of experts’ opinions and experiences regarding the use of wearable sensors to measure gait and physical activity

• Alison Keogh,
• Kristin Taraldsen,
• Brian Caulfield &
• Beatrix Vereijken 

Journal of NeuroEngineering and Rehabilitation volume 18, Article number: 78 (2021) Cite this article

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Abstract

Background

The use of wearable sensor technology to collect patient health data, such as gait and physical activity, offers the potential to transform healthcare research. To maximise the use of wearable devices in practice, it is important that they are usable by, and offer value to, all stakeholders. Although previous research has explored participants’ opinions of devices, to date, limited studies have explored the experiences and opinions of the researchers who use and implement them. Researchers offer a unique insight into wearable devices as they may have access to multiple devices and cohorts, and thus gain a thorough understanding as to how and where this area needs to progress. Therefore, the aim of this study was to explore the experiences and opinions of researchers from academic, industry and clinical contexts, in the use of wearable devices to measure gait and physical activity.

Methods

Twenty professionals with experience using wearable devices in research were recruited from academic, industry and clinical backgrounds. Independent, semi-structured interviews were conducted, audio-recorded and transcribed. Transcribed texts were analysed using inductive thematic analysis.

Results

Five themes were identified: (1) The positives and negatives of using wearable devices in research, (2) The routine implementation of wearable devices into research and clinical practice, (3) The importance of compromise in protocols, (4) Securing good quality data, and (5) A paradigm shift. Researchers overwhelmingly supported the use of wearable sensor technology due to the insights that they may provide. Though barriers remain, researchers were pragmatic towards these, believing that there is a paradigm shift happening in this area of research that ultimately requires mistakes and significant volumes of further research to allow it to progress.

Conclusions

Multiple barriers to the use of wearable devices in research and clinical practice remain, including data management and clear clinical utility. However, researchers strongly believe that the potential benefit of these devices to support and create new clinical insights for patient care, is greater than any current barrier. Multi-disciplinary research integrating the expertise of both academia, industry and clinicians is a fundamental necessity to further develop wearable devices and protocols that match the varied needs of all stakeholders.

Background

The use of wearable sensor technology to track health behaviours and outcomes of care, using measures of physical activity and gait, has exponentially grown in recent years. Technological advancements have led to the development of smaller, less obtrusive wearable devices that can be used for both recreational and medical purposes, where benefits include the ability to remotely and objectively monitor health behaviours in the context of people’s own lives [1, 2]. In response, the World Health Organisation (WHO) recently created a Digital Health Strategy which recognises the opportunities that exist for digital health, including the ubiquitous presence of wearable devices, to enable improved health coverage and well-being globally [3]. For this to happen, digital health must be accessible, reliable, safe and sustainable [3].

The promise of wearable sensor technology is that it will help transform healthcare by providing access to real-world, objective data [4,5,6], yet to do this, wearable devices need to meet the needs of all stakeholders who will interact with them. Critical to this is that wearable devices are usable, not only for the participants who will wear them, but also for the researchers and clinicians who implement them, and who ultimately will drive their continued use in various contexts. The International Organization for Standardization (ISO) defines usability as “the effectiveness, efficiency, and satisfaction with which specified users achieve specified goals in particular environments” [7]. It has been suggested that for wearable devices to be accepted, they must be easy to wear, easy to use, affordable, contain relevant functionality and be aesthetically pleasing [8,9,10]. However, although a number of studies have evaluated participants’ perceptions of various wearable devices for gait or physical activity [11,12,13,14,15,16], to date, the experiences of researchers who use the data provided by them to address research questions, or assist in clinical decision making, is rarely assessed. Usability should not only be focused on those who wear them, but also those who interact with them to collect and analyse data.

A small number of studies have investigated the use of wearable devices by clinicians [1, 17,18,19], where barriers such as increased workloads, difficulty handling large volumes of data, and an inability to integrate data into health records have been highlighted. However, typically, these studies have focused on either a single clinical cohort or a single device. Furthermore, to date, no study has evaluated wearable sensor technology from the perspective of researchers who use them. Therefore, there is a wealth of potential learnings and experiences that remains untapped. Specifically, it is important to understand how researchers view the use of wearable devices in healthcare, their perceived barriers and facilitators, the learnings they have gained from participants, and the usability factors that researchers perceive to be the most important or influential when selecting a wearable device for a study. Given the rapid evolution of wearable sensor technology, it is necessary to understand the views of all stakeholders, so that clinically relevant, useful, validated and usable wearable devices can be developed for everyone who needs to interact with them. Therefore, the aim of this study was to explore the experiences and opinions of researchers from academic, industry and clinical contexts, in the use of wearable devices that measure gait and physical activity, across a range of clinical cohorts and ages.