Professor Lis Neubeck, in the School of Health and Social Care, is studying the recovery of patients after suffering from cardiovascular disease.

Physical exercise is a critical factor in preventing additional cardiac events so a lot of research is being conducted on how to encourage patients to stay active.

“Technology is changing the way people access healthcare,” Prof Neubeck says. “It is possible to reach more people than ever before, but we need to have valid and reliable ways of testing technology that keep pace with developments.”

One strand of her research asks: Do fitness trackers motivate patients to exercise more and help overcome their cardiac problems?

Are Fitbits accurate?

A first step is to determine whether the UK’s most popular fitness tracking device, Fitbit, is at all accurate and therefore worth incorporating as part of a recovery programme.

Prof Neubeck and her PhD student, Muaddi Alharbi conducted a recent study that worked with a group of cardiac patients and their families, equipped them with Fitbits along with the current ‘gold standard’ activity monitor, and compared how both devices tracked participant activity over four days.

Sadly, one patient managed to lose their Fitbit during the study. Their results were excluded.

For those who retained their devices, the results showed that Fitbits are ‘valid, reliable and inexpensive’ activity monitoring devices.

Overall Fitbit reliability was good despite a number of measurement inaccuracies. For example, step count is progressively more inaccurate as more steps are taken. However, this is outweighed by the greater inaccuracy of the most common alternative: self-reporting.

Fitbits inflate step count - but that’s ok.

Most patients overstate their activity level when asked directly. People struggle to be objective about their own exercise habits.

Fitbits overstate step count. As more steps are taken the tracking technology tends to incorrectly register more activity.

This means that both methods are inaccurate, so what’s the difference?

Fitbits may overstate step count, but Prof Neubeck’s study found that they are 99% reliable in identifying patients who did not achieve at least 10,000 steps a day and 150 minutes of vigorous activity each week.

While patients may inadvertently misrepresent their own activity levels when asked, the study concludes that Fitbits are ‘not likely to misclassify inactive people’, and that’s key.

Do health apps and fitness trackers motivate people to be more active?

Another strand of Prof Neubeck’s research is to investigate whether health apps actually motivate cardiac patients to exercise more.

Designed for smartphones, MyHeartMate is a social game that promotes healthy living. The app allows users to create a ‘digital heart’. Interactive content then helps users to adopt the key lifestyle habits that prevent additional cardiac events.

This is an application of the recent trend towards the ‘gamification’ of activities that encourage us to adopt healthy lifestyles; much like health trackers awarding ‘badges’ when users cover noteworthy distances.

If people are intrinsically motivated by challenges, even when they are digital, why not use these incentivising techniques to improve cardiovascular health? Prof Neubeck’s research is moving us in this direction one step at a time.

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