What's in a Wearable? Tracking Health and Performance

How can devices improve brain health? Let's discuss.

Posted Oct 01, 2018

Proponents of wearables that track the links between brain activity and bodily well-being tout their potential in helping improve overall health.  At the recent Brain Health and Performance Summit, presented by The Ohio State University Wexner Medical Center’s Neuroscience Research Institute and The Stanley D. and Joan H. Ross Center for Brain Health and Performance, experts discussed how wearables are currently being used for health and performance monitoring.

Devices that monitor basic health indicators are widely available—most smartphones can track the number of daily steps taken and estimate caloric burn with surprising accuracy. “We’re now used to measuring ourselves and monitoring ourselves,” Josh Hagen, Ph.D., MS, the director of the Human Performance Innovation Center at West Virginia University explained. “Now we can actually measure physiology in real time, and we can get a lot more insights from day to day.”

Since there are well-established links between cognitive health and even moderate amounts of daily exercise, rudimentary, real-time information about physical activity may serve as a window into the brain’s well-being. Wearables that track more granular information, such as sleep quality or changes in a wearer’s heart-rate, can help form a more detailed picture of an individual’s physical and neurological health.

Mark Stephenson, MS, ATC, CSCS, CSPS, Director of Sports Science at NeuroSport Science, Inc. and a consultant for the National Football League’s Detroit Lions, noted that almost all individual health data is now considered to have brain health implications. “The key to all this is a brain-first approach,” Stephenson explained, using the example of an athlete's process of preparing for an upcoming game. “It’s the brain that drives the engine.” As Stephenson posited, there are connections between physical health and an athlete’s mental state that better monitoring—either through wearables or post-practice and post-game questionnaires—could help disentangle. “Mood is the hardest thing to assess on a daily basis,” Stephenson said, discussing the importance of identifying and addressing sources of stress over the course of game preparation.

As Stephenson hinted, sports represent an ideal context for testing the possible uses of wearables and other methods of tracking daily health. Sports provide controlled environments, an easily-studied population that’s under constant medical observation, and repetitive events that create intense physical and mental strain and can be closely documented and analyzed. Ted Lambrinides, Sport Science Consultant for the NFL-Zebra Player Tracking Program, explained that chips embedded in shoulder pads allow coaches to review players’ positions at every moment of each game. “We can tell where a player lined up on every play of every game, along with what their exact movement patterns were on that play,” Lambrinides said. This “invisible tracking system” does not record any biometric information, but it can reveal player performance at unprecedented levels of nuance.  This furnishes data that can later be cross-checked against a player’s health status or various physical or mental stressors.

NFL players are relatively easy to track: They are in a profession in which the recording of individual data is practically obligatory, and even part of their industry’s business model. But it can be difficult to convince the vast majority of people who are not professional athletes of the possible benefits of wearables and individual health data—and even harder to get them to actually use wearables for long periods of time.

Mitesh Patel, MD, MBA, MS, a professor of medicine and health care management at the University of Pennsylvania and Director of the Penn Medicine Nudge Unit, the world’s first behavioral design team embedded within a health system, noted that only five percent of American adults actually use wearables.  According to Patel, half of people who purchase wearables quickly stop using them. He argued that for health professionals, developing an incentive structure for using wearables will be a crucial part of integrating their use into patient care.

Patel noted that it is possible that many people are carrying a powerful health measurement device in their pockets already. Patel recalled that in 2015, a team of University of Pennsylvania researchers found that certain smartphones applications measured distance more accurately than a popular wearable device.

The panelists agreed that wearable technology has already advanced to the level of providing tangible benefits to a broad range of consumers and that technological advances will ultimately broaden those positive impacts.  Specifically, they can help people better assess the effectiveness of their workouts, encourage them to work out more frequently and more efficiently, provide a more complete picture of brain and overall health, and identify potential health warning signs.   

However, they universally agreed that even continued technological progress will not solve wearables’ biggest shortcoming to date—their low level of consumer adoption—and that more effective strategies are needed to put these tools in the hands of consumers, to incentivize their use, and to leverage the data captured from the devices to create customized health interventions and behavioral plans.