Wrist strap monitors physiological changes in IBD

A novel health tracker that is strapped around the wrist can detect changes in the physiology of individuals with inflammatory bowel disease (IBD) in real time, as shown in a study presented at the Advances in Inflammatory Bowel Diseases (AIBD) conference.

Called WHOOP, the wearable strap captures resting heart rate, heart rate variability, as well as sleep metrics including rapid eye movement (REM) and deep sleep—all of which are related to IBD symptoms.

Remote patient monitoring (RPM) devices are used to predict changes in disease activity and help patients with chronic conditions like IBD to have a hand in their own care, according to lead study author Dr Kara DiJoseph of the Penn State Hershey Medical Center in Hershey, Pennsylvania, US.

“To date, there is limited data on the benefit of RPM in IBD care,” DiJoseph noted.

As an RPM device, the WHOOP strap was developed based on the proposition that bowel inflammation can lead to suboptimal sleep, circadian rhythm disruption, and even additional immune system activation.

The strap also takes advantage of heart rate variability as a validated metric that has been used to predict outcomes and help manage other disease states, DiJoseph stated. “Decreases in heart rate variability correlate with adverse outcomes in chronic disease states, including heart failure and chronic obstructive pulmonary disease.”

WHOOP was initially tested in six adult patients with ulcerative colitis who agreed to wear the strap for 12 months. The strap was paired with a mobile application, which patients used to record their symptoms. DiJoseph and colleagues performed monthly “check-ins” to collect data on disease activity, mood, and stress using the Simple Clinical Colitis Activity Index (SCCAI), Hospital Anxiety and Depression Scale (HADS), and the Perceived Stress Scale (PSS4) questionnaires.

Over 12 months, two patients noticed a significant change in their WHOOP metrics in conjunction with worrying symptoms. They subsequently reached out to communicate concern for an underlying disease flare. [AIBD 2021, abstract 70]

Patient 1 underwent serologic testing after having elevated heart rate variability and resting heart rate several days prior to the onset of symptoms. The results showed a rise in C-reactive protein from 0.25 mg/dL at baseline to 2.82 mg/dL at month 12, consistent with active inflammation. Faecal calprotectin was also elevated at 566 ug/g. The patient was scheduled for colonoscopy in the near future.

Likewise, patient 2 had noticeable heart rate variability and resting heart rate changes that occurred with significant sleep disturbances. These irregularities prompted additional testing.

The preliminary data indicate that RPM “is a feasible way to give patients ownership of their medical care and involve them in the diagnostic and treatment process of their underlying IBD,” according to DiJoseph.

“Furthermore, the WHOOP device appears easy to use and may empower patients to reach out to providers even before symptoms occur, leading to an expedited evaluation for increased disease activity,” she added.

DiJoseph hopes that the current feasibility study will lead to larger prospective efforts utilizing wearable technology devices, such as the WHOOP strap, in IBD patients.