The role of wearables in tackling the world's epidemic of inactivity
- Wits University
From smartwatches to advanced medical sensors, wearable tech is transforming how researchers understand human movement. But not all wearables are created equal.
In the global context, where not all wearables are created equal and not all data is accurate, can they really help solve the growing global burden of chronic disease?
This was posed by Professor Dale Eslinger at the School of Sport, Exercise and Health Sciences at the University of Loughborough, who delivered a lecture at Wits University titled Nudging, Judging, or Fudging: Can wearable technologies help us with our Sport and Exercise Medicine endeavours?
Eslinger posited that as rates of obesity, diabetes and other lifestyle-related diseases continue to rise globally, the challenge is no longer to simply encourage people to exercise, but rather to find better ways to measure, understand and support movement in daily life. Wearable technologies could feasibly be a tool to help meet that challenge.
But modern technologies can have widespread positive and negative influences on human behaviour. “We rely on measurements that may not accurately reflect reality,” said Eslinger.
This approach is what Eslinger refers to as "fudging". One should instead by, "judging" – using validated technologies to objectively quantify movement, sedentary behaviour and exercise.
The answer lies in understanding the limitations of specific applications and how this might affect your research.
"You would not buy a new 3-Tesla MRI [radiological diagnostic imaging device] without wanting to know the validity of that device," he said. "Yet we grab wearables off the shelf and put them on people, expecting the [device] company to have done all the work."
When it comes to obesity and other chronic diseases, wearable technologies equipped with accelerometers (an electromechanical sensor that measures physical acceleration) can offer researchers and clinicians detailed insights into how people move throughout the day, helping them evolve beyond subjective estimates to evidence-based measurement.
However, wearables are just one part of an interdisciplinary solution to complex problems.
"If we look for a silver bullet, we've already failed because there isn't one," he says. Instead, what’s needed is a broader understanding of movement and health. While the Exercise is Medicine movement successfully encouraged clinicians to discuss exercise with patients, Eslinger prefers the term "movement as medicine".
"We use movement as medicine a lot because it includes walking the dog and taking the stairs and parking further away as much as it does getting on a treadmill," he explains. "You don't have to wear Lycra to be doing physical activity and getting health benefits."
This approach recognises a full movement continuum that includes sleep, sedentary behaviour, light activity, moderate physical activity, and vigorous exercise. The amount of movement needed depends on the symptoms.
"If you say movement is medicine, I'm going to tell you what dose of movement you need," he says. "For breast cancer, for mental health, for obesity — whatever the condition — we should be trying to figure out what the dose is."
Eslinger describes this approach as bringing the precision of medicine into exercise science, allowing researchers and clinicians to better understand how different types and amounts of movement affect health.
By combining movement data with measures such as blood glucose levels, wearables could create what Eslinger calls "teachable moments,” which are opportunities to encourage healthier decisions at the point when they matter most.
Wearables, he argues, are most powerful when they move beyond simply counting steps. Their real value lies in helping researchers avoid "fudging" the data, enabling clinicians to accurately "judge" movement patterns, and ultimately "nudging" people towards healthier lives.