Physical Activity & The Rise of Technology in the 21st Century

As technology develops and is integrated into our lives, it transforms our lives.  Mostly, the integration is a positive such as the development of early detection procedures for health issues, biomedical research, and surgical procedures.  However, the technology can also be detrimental to health.  Many manual jobs have been, or are being (consider the future role of AI), replaced with technology.  This leads to an increase in leisure time and, cocomittantly, an increase in generally sedentary behaviour.  A global trend which will only continue to develop in significance, is the importance of physical activity as a preventative health-care measure.  How can technology be used to address an issue it is partially responsible for?  It is part of the problem.  Can it be part of the solution?

Kohl, Kohl, Lambert et al (2012) note that physical inactivity is the fourth largest leading cause of preventable death worldwide and accounts directly for some 3 million deaths per year (Pratt, Sarmiento, Montes et al, 2012).    Secondary to this, Durstine, Gordon, Wang & Luo (2013) report that chronic diseases which are physical activity related such as cardiovascular heart disease, Type II diabetes, and obesity cause more than 36 million deaths a year.  The economic cost of this in terms of lost productivity and associated costs to the community equates to trillions of dollars per year (Pelotas, Pelotas, Hallal et al, 2012).  While the causal factors for such lifestyle (non-communicable) diseases is complex, the integration and assimilation of technology into our lives has only recently become a causal factor of further study in the literature.

Pratt, Sarmiento, Montes et al (2012) write that the growth of the internet and mobile technology from 2000-2012 has been marked and will, “be a major force in societal development in the next 10-15 years” (p.282).  It stands to reason that this will be both a negative and positive force.  Echoing this, Pelatos, Pelatos, Hallal et al (2012, p.247) point out that, “although the technological revolution has been of great benefit to many populations…it has come at a major cost in terms of its contribution to physical inactivity.”  While urbanisation and mechanisation has been significant contributors to increasing levels of physical inactivity, the growth of ICT and its ubiquitous nature in terms of promotion, decreasing cost, and access, has become a major force with respect to this issue.  Coupled to the speed of development, one can only expect levels of inactivity to continue unless deliberate interventions are put in place.  Nigg (2003, p.57) notes that, “technology has contributed to a secular decline in physical activity”.  In using the term “secular”, they refer to the economic definition in that it has taken place over a long period of time and is not a recent manifestation.  Kohl, Kohl, Lambert et al (2012) go so far as to suggest that the link between ICT growth and physical inactivity levels should be considered a “pandemic” (p.295) and as such should occupy a high position in public health policies of all countries.  One only need look at the drive towards BYOD and increasing use of ICT in schools to see how widespread this issue could potentially be.

The extent of the issue is difficult to quantify as a standardised definition of appropriate levels of physical activity is not in place.  Different countries and organisations within those countries collect data and quantify physical activity in different ways.  However, Pelotas, Pelotas, Hallal et al (2012) in their meta-analysis of this issue concluded that some 33% of adults and 80% of adolescents world-wide did not meet recommended levels of physical activity.  Further, inactivity levels were highest in in higher income countries (among which New Zealand was included), and lowest in lower income countries.  Running parallel to this was the ease of access to ICT – most significantly – mobile technology.  At the same time, the authors posit if this technology could be harnessed for the betterment of populations with respect to engagement in meaningful, purposeful health-related physical activity.

The benefits of physical activity to well-being are well established.  It is now argued that physical activity and its associated health benefits should be viewed as a medication.  The benefit of physical activity is that it changes the underlying physiology of the body (for the better), rather than altering functioning in an unnatural fashion which is the case with prescribed medication in the traditional sense.  In effect, physical activity as prophylaxis rather than treatment.

In recent years there has been an increasing awareness among technology and clothing companies of the benefit to the community (and their bottom line) of investing in physical activity.  We have seen this in the clothing industry with the rise of active wear as every day wear.  This is known as the lululemon effect or enclothed cognition.  Simply put, the wearing of such clothing imparts an improved sense of wellbeing on the owner as they take on the attributes ascribed to the clothing.  In the case of active wear, being fit, healthy, and somehow virtuous (whether they are or not does not matter).  It is the same effect when we place increased trust in someone wearing a lab coat if they are talking about science, or a doctor who has a stethoscope around their neck – we ascribe “powers” or status to them as a result.

Rotich (2016, p.15) notes that the, “proliferation of technology has not always been viewed positively by those interested in the promotion of physical activity”.  Yet many technology companies has seized on the untapped potential of the physical activity sector as advanced have been made in accelerometer technology, heart rate monitoring, GPS technology and the portability and affordability of mobile technology.  However, there has always been the issue of how we engage people with physical activity if they are not necessarily intrinsically motivated to do it in the first place.

The solution seems to lie in the gaming industry, and most importantly, the “habit-inducing features” (Rotich, 2016, p.16) of the video gaming industry.  Hence we have seen the rise of the gamification of physical activity via mobile technology.  Competition between friends, social posting of times and distances that are available to the wider community, incentives and rewards for milestones reached, badges for achievements, detailed mapping and statistical breakdown of a workout are all standard features of many fitness apps and fitness wear.  Witness the aggressive marketing of Fit Bit, Wii, Android Wear, Strava, Nike Plus, Map My Run, Samsung Gear Fit, Garman etc.

Yet, despite this, we must exercise a note of caution.  It is well established in the literature that in order for people to maintain adherence to physical activity, there needs to be an increasing degree of intrinsic motivation, rather than the extrinsic motivation that fitness technology offers.  The novelty of the device will only be a small part of a physically active lifestyle.  Kostkova, Coventry, Sullivan & Lachman (2017) in analysing current research point out that while fitness technology leverages goal setting, feedback, rewards and social factors to bring about behavioural change, it does not address the underlying negative attitudes, environmental conditions and other behaviours towards physical activity.  We see this if we consider the profile of people who use such fitness technology. Many are already intrinsically motivated to be physically active, and the technology merely serves as an extrinsic affirmation of their intrinsic motivation. The real challenge lies if the technology can bring about intrinsic attitudinal changes towards physical activity. Indeed, Kerner & Goodyear (2017) found wearable technology was initially highly motivational with respect to physical activity engagement but became increasingly amotivational in their adolescent research subjects after 8 weeks of using them. The novelty of the device began to wear off and they experienced feelings of resentment, guilt, and heightened internal pressure to conform. Furthermore, the competitive component inherent in the social aspect of sharing results created feelings of isolation and distance from peers. This was found in an earlier study by Depper & Howe (2016) who found fitness apps removed social and interactive elements that were valued as part of physical activity and accounted for the gradual loss of adherence to physical activity as determined by the app.

However, wearable technology with respect to engaging people in physical activity is in its relative infancy. At present it seems the technology serves as a short term motivational aide but does not necessarily translate to longer term exercise adherence. The use of fitness trackers should be seen as part of a holistic approach to physical activity including individualisation, personalisation, education, and mentoring support.

References:

Depper, A., & Howe, P. D. (2016). Are we fit yet? English adolescent girls’ experiences of health and fitness apps. Health Sociology Review, 26(1), 98–112. https://doi.org/10.1080/14461242.2016.1196599

Durstine, L. J., Gordon, B., Wang, Z., & Luo, X. (2013). Chronic disease and the link to physical activity. Journal of Sport and Health Science, 2(1), 3–11. https://doi.org/10.1016/J.JSHS.2012.07.009


Kerner, C., & Goodyear, V. A. (2017). The Motivational Impact of Wearable Healthy Lifestyle Technologies: A Self-determination Perspective on Fitbits with Adolescents. American Journal of Health Education, 48(5), 287–297. https://doi.org/10.1080/19325037.2017.1343161

Kohl, H. W., Kohl, H. W., Craig, C. L., Lambert, E. V., Inoue, S., & Kahlmeier, S. (2012). The pandemic of physical inactivity: global action for public health for the Lancet Physical Activity Series Working Group. The pandemic of physical inactivity should be a public health priority. The Lancet, 380(380), 294–305. https://doi.org/10.1016/S0140-6736(12)60898-8

Kostkova, P., Coventry, L. M., Sullivan, A. N., & Lachman, M. E. (2017). Behavior Change with Fitness Technology in Sedentary Adults: A Review of the evidence for increasing Physical Activity. Front. Public Health, 4(4), 2893389–289. https://doi.org/10.3389/fpubh.2016.00289

Nier, B.M. (2018).  Examining the Relationship Between Fitness Technology Use and Self Determination Theory Constructs. (2018). AngelList. Retrieved 5 March 2018, from https://angel.co/projects/270285-examining-the-relationship-between-fitness-technology-use-and-self-determination-theory-constructs

Nigg, C. R. (2003). Technology’s influence on physical activity and exercise science: the present and the future. Psychology of Sport and Exercise, 4(1), 57–65. https://doi.org/10.1016/S1469-0292(02)00017-1

Parra, D. C., Brownson, R. C., Heath, G. W., Parra, D. C., Sarmiento, O. L., Bo Andersen, L., & Brownson, R. C. (2012). Physical Activity 3 Evidence-based intervention in physical activity: lessons from around the world for the Lancet Physical Activity Series Working Group* Importance of physical activity promotion. The Lancet, 380(380), 272–281. https://doi.org/10.1016/S0140-6736(12)60816-2

Pratt, M., Sarmiento, O. L., Montes, F., Ogilvie, D., Marcus, B. H., Perez, L. G., & Brownson, R. C. (2012). Physical Activity 4: The implications of megatrends in information and communication technology and transportation for changes in global physical activity for the Lancet Physical Activity Series Working Group*. The Lancet, 380(380), 282–293. https://doi.org/10.1016/S0140-6736(12)60736-3

Rotich, W. K. (2016). Leveraging the Habit-forming Aspects of Technology to Increase Levels of Physical Activity. Strategies, 29(6), 15–19.