Wearable technology is estimated to be a $6 billion dollar industry, which is likely going to continue to expand rapidly. For athletes and support staff engaged in elite sport, this can be both a help and a hindrance when trying to maximise athlete performance. Most would agree that technology such as heart rate monitoring and GPS has advanced the area of sport science and provided valuable information to monitor athletes to improve performance and reduce injury and illness risk. But with this ever increasing access to technology and with companies having the opportunity to make significant amounts of money, it is more important than ever that we can see the forest for the trees.
While there are numerous types of technology available, two of the more recent and popular devices are in the area of sleep monitoring and brain training/stimulation. With respect to sleep monitoring, most companies do not divulge their algorithms used to calculate sleep and wake and most have not validated their product against the gold standard of polysomnography. So while there may not be safety issues associated with these devices, it is clear that many of these devices may not be providing the athlete with accurate data. Importantly, how the athlete responds to having an abundance of readily available data on their sleep (accurate or not) is an important consideration. Athletes who may be susceptible to ‘over-analysis’ or may have issues with stress and anxiety, may find that daily information about their sleep is burdensome.
While there may not be safety issues associated with these devices, it is clear that many of these devices may not be providing the athlete with accurate data.
Of more serious concern are the number of devices now available which claim to stimulate or modify brain activity. While neurofeedback (brain training) has become increasingly legitimised in peer-reviewed interventions for medical conditions such as epilepsy and post-traumatic stress disorder, the availability of brain stimulation devices is rapidly increasing. While future research may prove that these devices do indeed enhance performance, it seems incongruous that these are marketed to elite athletes with very minimal research or proof of safety.
Is the device validated?
When companies market many of the wearables, they use particularly clever techniques. Impressive graphics, testimonials and figures, graphs and data that appears to such the devices have been tested and peer-reviewed. For athletes and staff looking for a competitive edge, this kind of information can be particularly enticing and hard to overlook. No one wants to be the last to take advantage of the next great advancement sport science.
This plays into the hands of the manufacturer and many elite sports institutions and clubs do not have the time to validate and test the equipment in their own population. Increasingly however, this is exactly what is needed.
While some companies do their own product testing, including reliability and validity, determining the usefulness in specific populations is the ultimate goal. A healthy scepticism of claims, evidence and testimonials, whilst still exploring potential uses and advantages may provide the most positive outcome.
The following recommendations when considering using wearable devices has recently been proposed  : 1) the primary driving principle should be to first do no harm, and direct implications on athlete health and safety should be of utmost and initial concern; 2) following such considerations, questions should be asked regarding the scientific basis for the device and a search for scientific evidence should occur; 3) if there is no or minimal scientific evidence, data should be collected in situ, in a controlled manner where possible; 4) implications for the athlete should always be considered (e.g., too much information, unnecessary information or information that may cause stress and anxiety).
Technology has great potential to have a positive and significant impact on athletes. However, we must always be cognisant of what information is valid and reliable, how much information is too much and that the wellbeing and safety of athletes is of principal concern.
Halson, S.L., J.M. Peake, and J.P. Sullivan, Wearable Technology for Athletes: Information Overload and Pseudoscience? Int J Sports Physiol Perform, 2016. 11(6): p. 705-706.