Background: Wearable devices with real-time feedback (WRF) provide increasing opportunities to enhance adherence and improve performance in rehabilitation through collecting and processing health-related data. Real-time feedback from the device is expected to result in a more dynamic, coordinated and synchronous rhythmic activity. However, age-specific characteristics of WRF integrating real-time audio or sound feedback during rhythmic activity have largely remained unexplored. Objective: The study investigates the use of a wearable device with real-time feedback (WRF) for rhythmic activity among older adults aged 65 and above from the perspective of age heterogeneity. The study explores older adults’ previous use of wearables to track their physical activity, adherence with WRF during rhythmic activity, and the interactive features of WRF enhancing the synchronisation during rhythmic activity. Methods: The study was conducted as a qualitative interview study with 18 older adults who used a WRF for rhythmic activity during a 3-week period at home in Sweden. The wearable used in the study is a chest-band sensor device that helps users to synchronise their steps with their heartbeat through the provision of real-time audio feedback. The material consists of a pre-interview before using the device, and post-interview after using the device. Material from the semi-structured interviews was analysed with an inductive content analysis method. Device-generated data on the usage of WRF for rhythmic activity were used to contextualise the qualitative interview data. Results: The study identified three themes in the emergence of age heterogeneity in the use of wearables: (1) Limited or non-use of wearables in physical activity, (2) synchronisation of step and heart rate in device-guided rhythmic activity, and (3) adherence to interaction modalities and audio feedback with a WRF. The contradiction between personal goals and device-related features might hinder the use of wearables, whereas enjoyment, sense of accomplishment and social motivations can drive the uptake of wearables. Device-guided synchronisation required participants to change their natural walking rhythm, which resulted in a sense of disruption during rhythmic activity. Real-time audio feedback was considered convenient in finding the right walking rhythm, which resulted in perceived improvement in synchronisation over time. Conclusions: Age heterogeneity in the use of wearables with real-time feedback is pronounced at three interconnected levels: previous use of wearables, efficiency in device-guided synchronisation and adherence to interaction modalities. The study concludes that real-time feedback can enhance the user experience in synchronisation during rhythmic activity, but the heterogeneity in responding to these modalities require adaptive solutions to ensure long-term engagement with wearables.
Lu et al. (Mon,) studied this question.