Effects of Commercially Available Wearable Devices on Physical Activity Promotion and Health in Children and Adolescents: Systematic Review
, Tomislav Stantić 2, Romina Herodek 3, Stevan Stamenković 3, Nenad Stojiljković 3,*, Boban Jelenković 1 and Goran Sporiš 4
Round 1
Reviewer 1 Report
The manuscript by Dankovic and colleagues, entitled “Effects of commercially available wearable devices on physical activity and health in children and adolescents: narrative review”, is a revision on the potential of commercially available wearable devices to motivate young people to adopt a more active lifestyle by reducing sedentary behaviors.
Overall, the manuscript is sound and the methodology used is quite solid.
There are some minor concerns:
-despite the title (narrative), this manuscript is more like a systematic review , as indicated throughout;
-Introduction (lines 52-53): the sentence is incomplete;
-Figure 1: there are two boxes where it is stated that “papers are removed for other reasons” without any other explanation; I would suggest adding some details in the figure legend;
-Results (lines 99-100 and lines 109-110): apart from the number of participants, the two sentences express the same concept;
-Table 1: Please replace “devies” with “devices” in the header
-Results (lines 148-181): in sections 3.3. and 3.4, the authors report the objective of the specific studies selected (e.g., “The study …assessed whether teens could use and would accept a wearable activity tracker”) without any other conclusive information; on the contrary, in sections 3.5 and 3.6 the authors follow a different pattern, providing the purpose and some conclusive information about the specific study cited. Please, complete section 3.3 and 3.4 accordingly.
-Discussion (lines 201-203): provide references to “previous research”
Author Response
May 24, 2023
MDPI Applied Sciences
Submitted to section: Biomedical Engineering
The Role of Wearable Technology in Sports Science and Medicine
Manuscript ID applsci-2409638
Patrick Han, Managing Editor
Mr.Robin Hou, Assistant Editor
Dear Editor,
Please find attached the revised version of our manuscript, entitled “Effects of Commercially Available Wearable Devices on Physical Activity Promotion and Health in Children and Adolescents: Systematic review”.
We thank the reviewers for their careful evaluation and helpful comments to our manuscript. We have carefully taken their comments into consideration in preparing our revision, which has resulted in a paper that is clearer, broader and more compelling.
Some changes were made to this paper in order to improve it. Please find below our point-by-point responses to each of the comments of the reviewers. All changes are marked in the text.
We hope that the revisions in the manuscript and our accompanying responses will be sufficient to make our manuscript suitable for publication in Applied Sciences.
Sincerely,
Miss Romina Herodek
Reviewer Comments:
Reviewer 1
Comments to the authors
- Despite the title (narrative), this manuscript is more like a systematic review, as indicated throughout.
Our response: Thank you for noticing the mistake and we agree with your comment. Therefore, we have revised the title.
- Introduction (lines 52-53): the sentence is incomplete.
Our response: We are sorry for not providing that information. Therefore, we have added the requested continuation of the sentence in revised version of the manuscript.
- Figure 1: there are two boxes where it is stated that “papers are removed for other reasons” without any other explanation; I would suggest adding some details in the figure legend
Our response: Based on your recommendations, we have added details in the figure legend.
- Results (lines 99-100 and lines 109-110): apart from the number of participants, the two sentences express the same concept
Our response: We agree with your comment so we have revised this paragraph.
- Table 1: Please replace “devies” with “devices” in the header
Our response: It was corrected as requested.
- Results (lines 148-181): in sections 3.3. and 3.4, the authors report
the objective of the specific studies selected (e.g., “The study
…assessed whether teens could use and would accept a wearable activity
tracker”) without any other conclusive information; on the contrary,
in sections 3.5 and 3.6 the authors follow a different pattern,
providing the purpose and some conclusive information about the
specific study cited. Please, complete section 3.3 and 3.4
accordingly.
Our response: You have raised an important point here. We agree with your comment. Moreover, this whole paragraph was revised according to suggestions. Fitbit Flex was used as wearable device and ActiGraph GT3X + accelerometer was used to assess physical activity. We agree that the mentioned part was not clearly explained so, to avoid any confusion, we deleted it and updated the rest properly.
- Discussion (lines 201-203): provide references to “previous research”
Our response: We are sorry for not providing that information. Hence, we have added the requested information in revised version of the manuscript
Reviewer 2 Report
The purpose of the review is ambiguous, and the authors need to clarify whether they intend to examine the effects of wearable devices on physical activity promotion or the research trend of wrist-worn activity monitors with children's physical activity. To make the review more significant to academia, the authors should consider revising the purpose of the review and clarifying the eligibility criteria for study selection.
Based on the stated purpose of the review to determine the “effects of commercially available wearable devices on physical activity and health in children and adolescents”, the authors should reconsider whether studies using research-based devices such as Actigraph and validation studies like Hao et al. (2021) should be included. The authors should perform a new screening to ensure that the selected studies examine the effects of wearing wearable devices on the change of physical activity and health in children and adolescents.
To improve the quality of the manuscript, the authors are advised to follow the PRISMA guidelines when revising the flow chart, remove duplicates during screening instead of identification, and add a downside arrow when necessary. Additionally, the authors should also specify the methods used to collect data from reports, including how many reviewers collected data, provide reasons and numbers for exclusion, etc. There are other issues in the guideline that should follow, especially for the results.
In the manuscript, several typos were found, such as the incorrect combination of Actigraph GT9X triaxial with the Fitbit Charge, which was written as "Fitbit ActiGraph GT9X triaxial wrist accelerometer Charge" in the main text and table. Other typos, such as "I(m)provement of the tolerance of..." in Table 1 on page 5, were also identified. The authors should correct these errors to improve the manuscript's quality.
Based on the feedback provided, it appears that the manuscript has several significant issues that need to be addressed. Given the significant issues identified, it is recommended that the manuscript be rejected until the authors adequately address the concerns raised.
Author Response
May 24, 2023
MDPI Applied Sciences
Submitted to section: Biomedical Engineering
The Role of Wearable Technology in Sports Science and Medicine
Manuscript ID applsci-2409638
Patrick Han, Managing Editor
Mr.Robin Hou, Assistant Editor
Dear Editor,
Please find attached the revised version of our manuscript, entitled “Effects of Commercially Available Wearable Devices on Physical Activity Promotion and Health in Children and Adolescents: Systematic review”.
We thank the reviewers for their careful evaluation and helpful comments to our manuscript. We have carefully taken their comments into consideration in preparing our revision, which has resulted in a paper that is clearer, broader and more compelling.
Some changes were made to this paper in order to improve it. Please find below our point-by-point responses to each of the comments of the reviewers. All changes are marked in the text.
We hope that the revisions in the manuscript and our accompanying responses will be sufficient to make our manuscript suitable for publication in Applied Sciences.
Sincerely,
Miss Romina Herodek
Reviewer 2
Comments to the authors
- The purpose of the review is ambiguous, and the authors need to clarify whether they intend to examine the effects of wearable devices on physical activity promotion or the research trend of wrist-worn activity monitors with children's physical activity. To make the review more significant to academia, the authors should consider revising the purpose of the review and clarifying the eligibility criteria for study selection.
Our response: Our idea was to examine the effects of wearable devices on physical activity promotion and health in children and adolescents so according to that we revised the title and the purpose of the review. As stated in the review ”The purpose of this review was to determine the effects of commercially available wearable devices on physical activity promotion and health in children and adolescents.”
- Based on the stated purpose of the review to determine the “effects of commercially available wearable devices on physical activity and health in children and adolescents”, the authors should reconsider whether studies using research-based devices such as Actigraph and validation studies like Hao et al. (2021) should be included. The authors should perform a new screening to ensure that the selected studies examine the effects of wearing wearable devices on the change of physical activity and health in children and adolescents.
Our response: Thank you for your detailed review of our manuscript and for providing some insightful and thought-provoking suggestions to strengthen our manuscript. Actigraph was used in combination with other wearable devices and used as main output (results) in research for measuring PA. We have, therefore, deleted it and updated the rest properly to avoid any confusion. Regarding the validation study Hao et al. (2021) we agree that is not completely suitable for this review in relation to the purpose so the study was deleted.
- To improve the quality of the manuscript, the authors are advised to follow the PRISMA guidelines when revising the flow chart, remove duplicates during screening instead of identification, and add a downside arrow when necessary. Additionally, the authors should also specify the methods used to collect data from reports, including how
many reviewers collected data, provide reasons and numbers for exclusion, etc. There are other issues in the guideline that should follow, especially for the results.
Our response: We have modified the flow chart according to recommendations. In new chapter 2.3 Data extraction it can be seen how many reviewers collected data.
- In the manuscript, several typos were found, such as the incorrect combination of Actigraph GT9X triaxial with the Fitbit Charge, which was written as "Fitbit ActiGraph GT9X triaxial wrist accelerometer Charge" in the main text and table. Other typos, such as "I(m)provement of the tolerance of..." in Table 1 on page 5, were also identified. The authors should correct these errors to improve the manuscript's quality.
Our response: Thank you so much for thoroughly reading the review and pointing out the mistakes that we made. It appears that we missed some small typos. Fitbit Charge was used as wearable device and ActiGraph GT9X triaxial was used to assess physical activity. We understood that the mentioned part was not clearly explained so we deleted it. The changes can be seen in the revised version.
We truly appreciate your careful assessment of our work and the enlightening and intriguing suggestions you made to improve it. We believe we have addressed all of your primary issues, which are further described upper, and we hope that this will minimize any worries you may have about the strategies used in our paper.
Round 2
Reviewer 2 Report
Thank you for give me a second opportunity to review this updated version, I am pleased to note that this version shows significant improvement in addressing the previous comments. However, there are several additional observations that I believe should be addressed.
Abstract and Methods
In the abstract, the authors stated that "to better understand which commercially available wearable devices are more or less successful in promoting physical activity and health, we have conducted a review that was based on a theoretical framework...". However, it is not clear from the methods section which theoretical framework was used. Therefore, the authors should provide more detail on the theoretical framework used in the methods section.
In addition, for the statement above, the manuscript should clarify how the results compare the strengths and weaknesses of each commercially available wearable device.
While the review "focuses on the impact of specific devices on physical activity promotion and health" (stated in the abstract), it does not compare the effect size of each device or other ways to indicate the manitude of the intervention (change). The authors should therefore provide more detail on how they examined the specific impact of each device.
Results, Discussion, and Conclusion
Furthermore, in the conclusion, the authors repeatedly used phrases such as "moderate impact" and "moderate positive influence" without calculating the effect size. It is inappropriate to make such statements without providing a quantitative measure of the effect size. The authors should therefore revise the language in the conclusion to avoid making unsupported claims.
The manuscript states that "the majority of the data were conflicting". This may be due to the variability of the intervention approaches, which are not clearly described in the manuscript. To address this issue, the authors should provide more detail on the intervention approaches in Table 1 and discuss the implications of this variability in the discussion section.
Author Response
June 4, 2023
MDPI Applied Sciences
Submitted to the section: Biomedical Engineering
The Role of Wearable Technology in Sports Science and Medicine
Manuscript ID applsci-2409638
Patrick Han, Managing Editor
Mr.Robin Hou, Assistant Editor
Dear Editor and Reviewer,
We are very thankful for the reviewers' patience and constructive suggestions, which we have considered while revising our manuscript, entitled “Effects of Commercially Available Wearable Devices on Physical Activity Promotion and Health in Children and Adolescents: Systematic Review”. We made the necessary modifications according to the ideas highlighted in the text. The replies to the recommendations made are presented in the text that follows.
We hope that the revisions in the manuscript and our accompanying responses will be sufficient to make our manuscript suitable for publication in Applied Sciences.
Sincerely,
Miss Romina Herodek
Thank you very much for the opportunity to submit the revised version of the paper. We are grateful that you have thoroughly read our work and helped us improve it.
Reviewer Comments:
Comments to the authors
Abstract and Methods
- In the abstract, the authors stated that "to better understand which commercially available wearable devices are more or less successful in promoting physical activity and health, we have conducted a review that was based on a theoretical framework...". However, it is not clear from the methods section which theoretical framework was used. Therefore, the authors should provide more detail on the theoretical framework used in the methods section. In addition, for the statement above, the manuscript should clarify how the results compare the strengths and weaknesses of each commercially available wearable device. While the review "focuses on the impact of specific devices on physical activity promotion and health" (stated in the abstract), it does not compare the effect size of each device or other ways to indicate the magnitude of the intervention (change). The authors should therefore provide more detail on how they examined the specific impact of each device.
Our response: We are sorry for not providing that information. Now, our review provides a more detailed explanation of the theoretical framework in question. The Self-determination Theory (SDT), a comprehensive theory on motivation and social development that has grown in importance in the field of physical education research recently, was explained in the revisions. In order to clarify ways to indicate the magnitude of the intervention of wearable devices on PA motivation, we also included a list of the questionnaires, surveys, and self-monitoring activity used in the selected research, along with a brief explanation. The questionnaires were modified for children, their parents, and teachers and were used to assess PA motivation. Although we didn’t manage to detect the effect size for pre-post studies, we have shown the importance of using wearable technologies and their feasibility The analyzed studies did not consider the effect size of each device, and everything regarding the differences in results has been recorded in the Table 1. In order to further clarify how questionnaires, surveys, and self-monitoring activity are utilized, we have added a new paragraph 3.7 Monitoring physical activity motivation.
Results, Discussion, and Conclusion
- Furthermore, in the conclusion, the authors repeatedly used phrases such as "moderate impact" and "moderate positive influence" without calculating the effect size. It is inappropriate to make such statements without providing a quantitative measure of the effect size. The authors should therefore revise the language in the conclusion to avoid making unsupported claims.
Our response: We appreciate your careful review of our work and the instructive and stimulating suggestions you made to improve it. We agree with your comment. Moreover, this whole paragraph was revised according to suggestion. This study was designed as a systematic review rather than a meta-analysis because the identified studies did not report the effect size, but you have provided us with interesting insight. Perhaps our next paper could be a meta-analysis on this topic.
- The manuscript states that "the majority of the data were conflicting". This may be due to the variability of the intervention approaches, which are not clearly described in the manuscript. To address this issue, the authors should provide more detail on the intervention approaches in Table 1 and discuss the implications of this variability in the discussion section.
Our response: Thank you so much for pointing out the mistakes that we made. It seems like we made some oversight, which we have corrected in accordance with the suggestions. While a higher number of research examined feasibility and usefulness, unfortunately only a small number actually included interventions that required wearing wearable devices for an extended length of time.
We appreciate your comments. The adjustments were made, and the updated document represents them. We made changes to the abstract by explaining the Self-Determination Theory (SDT) as a theoretical framework. We also added a new section, 3.7 Monitoring Physical Activity Motivation, and revised the results chapter, including modifications to Table 1. In the discussion chapter, we included additional text about the questionnaires used to assess PA motivation. Finally, we made corrections to the conclusion chapter based on the suggestions. We hope that we have followed all the reviewers' guidelines correctly.
Best regards.
Author Response File: 
Author Response.docx
Round 3
Reviewer 2 Report
No further comments
