An umbrella review of systematic reviews of the impact of wrist-worn wearables on health outcomes
Clinical Snapshot
PICO Framework
| P — Population | Humans across diverse populations including adults, individuals with cardiometabolic conditions, and cancer survivors |
| I — Intervention | Interventions incorporating wrist-worn wearable devices with feedback (primarily Fitbit, Polar, ActiGraph) |
| C — Comparator | Varied control groups (standard care, no intervention, alternative interventions) |
| O — Outcomes | Health promotion (health behaviors, disease risk perception), morbidity, mortality, functioning, physical activity, cardiometabolic risk markers, quality of life, depression/anxiety, pain |
Bottom Line
This umbrella review of 39 systematic reviews encompassing 98 studies provides moderate-quality evidence that wrist-worn wearable devices consistently increase physical activity across diverse populations. However, the evidence for other health outcomes including cardiometabolic markers, quality of life, depression, anxiety, and pain remains limited and inconsistent. Most underlying systematic reviews were rated as low confidence due to methodological flaws including inadequate risk-of-bias assessment and heterogeneity consideration. While wearable devices show promise for promoting physical activity, clinicians should be cautious about recommending them for other health outcomes until higher-quality evidence emerges. The heterogeneous nature of interventions and control groups limits definitive conclusions. Australian clinicians may consider wearables as adjuncts to physical activity promotion in primary care and chronic disease management, but should not rely on them as standalone interventions for broader health outcomes.
Key Findings
P Value: Not reported
Effect Size: Not specified in abstract
Primary Outcome: Physical activity increase consistently demonstrated across diverse populations
Nnt Or Sensitivity: Not applicable for umbrella review format
Confidence Interval: Not reported
Clinical Application
High feasibility given widespread availability of consumer wearable devices (Fitbit, Polar, ActiGraph) in Australian market Relevant to Australian preventive health initiatives, chronic disease management programs, and potential integration with My Health Record. No specific PBS implications as devices are consumer-purchased Adults, individuals with cardiometabolic conditions, cancer survivors - broadly applicable to Australian primary care and specialist practice
Abstract
We conducted an umbrella review to synthesize the evidence on the effectiveness of interventions incorporating wrist-worn wearables' feedback on diverse health outcomes including health promotion (i.e., health behaviors and disease risk perception) morbidity, mortality, functioning, and other health-related metrics in humans. We searched in MEDLINE, Web of Science, Embase, and Cochrane Library until March 18, 2025, for eligible systematic reviews. After screening 9,487 citations, we identified 39 systematic reviews, which included 98 original studies (1 observational study, 95 randomized controlled trials, and 1 pre-post study). The reviews primarily focused on adult populations, individuals with cardiometabolic conditions, and cancer survivors. The original interventional studies mainly included Fitbit (40.2%), Polar (12.4%), and ActiGraph (10.3%) devices. Over 80% of the clinical trials involved complex behavioral interventions with wearable-based feedback, and the control groups varied. Most systematic reviews were rated as low confidence, with common flaws including inadequate consideration for risk-of-bias and heterogeneity. Interventions incorporating wrist-worn activity trackers increased physical activity in diverse populations. The effect of interventions incorporating wrist-wearables' feedback on cardiometabolic risk markers, quality of life, depression/anxiety, and pain was limited and remained inconsistent. Our findings rely on existing systematic reviews, which may vary in quality, review methodologies, and comprehensiveness. There is also potential for missing more recent evidence not yet captured in these reviews. These limitations should be considered when interpreting our results. Acknowledging these caveats, wrist-worn wearables seem to increase physical activity and may have additional benefits that require further study.
References
- 1.Glisic, M., Llane, A., Stojic, S., Llanaj, E., Roa-Díaz, Z. M., Raguindin, P. F., Kastrati, L., Weed, L., Turakhia, M. P., Ashley, E., Muka, T., & Ioannidis, J. P. A. (2026). An umbrella review of systematic reviews of the impact of wrist-worn wearables on health outcomes. Physiological Reviews. https://doi.org/10.1152/physrev.00049.2024
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