Can a Wearable Fitness Tracker Help Patients With COPD?

Photo Credit: Withings.

Wearable fitness trackers are all the rage these days.  Many of these trackers have the ability to track steps, mileage, calories, heart rate and sleep patterns.  As a physician who treats patients with COPD and other lung diseases, one in particular caught my eye.  The Withings Pulse is one of the few wearable fitness trackers that includes a pulse oximeter.  The nice folks at Withings sent me one so I could try it out.

  I played with it for about two months, all the while thinking about how a patient with COPD might make use of this device to help with their COPD symptoms and management.  To be clear, this article is not intended to be a tech review of the device. If that’s what you’re looking for, some pretty good ones are here or here (the latter includes excellent photos of the pulse ox device)

But first, a word about pulse oximetry.

Pulse oximeters are a very handy way to help understand the cause of shortness of breath.  Patients with COPD may have shortness of breath for many reasons, only one of which is low oxygen levels.  Just because a patient is short of breath when exerting oneself doesn’t necessarily mean that oxygen is the problem.  A pulse oximeter can help determine if low oxygen is the problem.  In fact, a diagnostic test (called a 6-minute walk) is nothing more than using a pulse oximeter to detect a patient’s oxygen level when they walk.

If the number drops below 88%, then supplemental oxygen is needed.

Some patients do not have low oxygen levels when they are sitting or resting, but as soon as they start moving around, or exercising, the levels drop.  Often times, the exercise level tested in a doctor’s office doesn’t “catch” these episodes of low oxygen.

  I recommend that my patients with significant shortness of breath test their oxygen levels at home, in their normal environment.  Many pulse oximeters are available, the most reliable ones are approximately the same cost as the Withings Pulse, so when considering all the added features a Withings Pulse can offer (such as step tracking, distance tracking, calorie counting, etc) it makes sense that this device could be a good deal for patients struggling with COPD symptoms. 

So, how might the Withings Pulse be useful for a patient with COPD or other lung disease?  Here’s what I learned during my two month testing period of the Withings Pulse.

  1. It’s extremely unobtrusive and portable.  Normal pulse oximeters are often clunky and not terribly well suited for keeping in one’s pocket.  The Withings Pulse has the nice advantage of being available as a very small, light, flat device that slides into a wristband or unobtrusive clip for your clothing.  This is a great feature for a pulse oximeter.
  1.  It's effortless to record your pulse oximeter readings even while you’re out and about.  The Withings Pulse syncs wirelessly with a smartphone and the very easy to use Withings Health Mate app.  Even for non-tech savvy patients, with a little help getting started, this device is easy to set up and set on autopilot.  Every time you put your finger on the red sensor to get your oxygen level, it syncs to your smartphone.  This is great because you don’t have to worry about stopping what you’re doing to record your readings.  You can just measure and look at them later, and share them with your healthcare provider by showing them the readings in the app for help interpreting them.
  2. It’s a great supplement for patients who are finishing up their pulmonary rehabilitation programsPulmonary rehab programs have been found to improve patients’ symptoms and help increase walking distance for patients with COPD.  One of the reasons for this may be that supervised exercise provides some confidence.  Having a fitness tracker with a built-in pulse oximeter can help augment a pulmonary rehabilitation program by helping the patient keep track of their exercise and oxygen levels during that exercise.  Fitness trackers can help you see progress in your efforts with even the smallest amounts of exercise.  Setting a steps goal and using your tracker to monitor how far you get can be really motivating.  Even better, is that the Withings Pulse has the pulse oximeter right there for you to use, so if your symptoms get bad and you get nervous or anxious about continuing, it’s simple to check your oxygen level to decide if you need to rest, or push yourself to go a little further. 

I also noticed a few potential problems with the Withings Pulse, however, that I should mention.

  1. It takes practice.  I had a hard time getting the pulse oximeter to read my oxygen level the first few times I used it.  When I gave it to friends to try out, they had the same issue.  The good news is that once I learned the ‘touch’, I had fewer problems.
  2. It seems slower to give the reading than most pulse oximeters.  I got a little inpatient at times waiting for my oxygen level.
  3. At times, the heart rate was inaccurate.  I noticed that occasionally the heart rate readings were very high, even though I was sitting at a table.
  4. Sliding the pulse oximeter in and out of the holder may be challenging for those with arthritis or difficulty using their fingers.  For elderly patients, the wristband is probably not the best option, and I would recommend using the clothing clip.  The device nestles nicely into the clip, but it may be challenging for some.
  5. It doesn't have a waveform tracing (sometimes called a 'pleth') which helps you determine if a low reading is truly accurate.  The waveform is very helpful to have when you have a low reading.  If the waveform bounces up and down, then you can be more certain that the low reading is truly accurate.  Without a waveform, its hard to know if a low reading is "real".

The Bottom Line:

All in all, I think wearable fitness trackers are a great way to motivate people to get up, move around, and take control of their health.  The Withings Pulse oximeter is a great way for patients with COPD to feel more comfortable exercising. This article is in no way based on scientific evidence, and I look forward to reading research studies about how best to use wearable fitness trackers for patients with COPD.  My quick search for research articles didn’t turn up anything substantial, but since there is so much research on the use of fitness trackers in other groups of patients, I doubt the science is very far behind. 

Always be sure to check with your healthcare provider before embarking on an exercise program and always make sure to have your rescue inhaler (albuterol) with you when you exercise.

A Withings Pulse was provided free of charge by Withings so I could do the research needed for this article.

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