Orthometria: Metric Fixation in Digital Health and a Framework for Responsible Use in High-Performance Sport
Sports medicine - open · 2026
A new name for wearable-data anxiety in athletes, useful language, but the framework and scale behind it are still completely untested.
The paper
Perspective/opinion piece (no primary data, no systematic review), proposing a new behavioural construct, 'orthometria', and a theory-derived implementation framework for digital health technology in high-performance sport.
What they found
There are no empirical findings to report: the abstract presents a coined term for metric-driven anxiety from wearables, and a 5-stage framework built on Kolb's Experiential Learning Theory, with no data, effect sizes, or outcomes tested.
Study design
This is a conceptual/opinion paper, not a review or empirical study: it proposes a new term and a theoretical framework with no participants, no data collection, and no population or setting to speak of. On the evidence hierarchy it sits at the bottom, below narrative reviews and case series, alongside expert commentary and position statements.
Methodology
There is no search strategy, no quality appraisal tool, and no data to be biased by selection, performance, detection, or attrition in the usual sense, because nothing was measured or tested. The main threats here are conceptual: citation bias in how Kolb's theory and prior wearable-anxiety literature were selected to build the argument, and the authors' own framing bias in defining a new construct they then use to structure the paper. There is no way for a clinician to ascertain a threshold, cutoff, or effect size from this paper because none exists; any application of the term or framework in practice would rest on face validity alone until formally tested.
The appraisal
The idea is plausible and clinically resonant, athletes and coaches obsessing over sleep or HRV scores is a real phenomenon many practitioners have seen, but this paper establishes a label and a theoretical process, not evidence that the framework changes behaviour or outcomes. The authors are explicit that orthometria is a behavioural descriptor, not a diagnosable clinical condition, so don't let the neologism drift into being treated as a formal disorder in athlete notes or MDT discussions. Nothing here is statistically or clinically significant because nothing was measured; treat it as hypothesis-generating expert opinion, the lowest rung of the evidence hierarchy, not practice-supporting.
The gap
There is no validated tool to identify or quantify orthometria and no test of whether the 5-stage framework actually reduces metric-driven anxiety or improves performance; that validation study is the necessary next step before this informs practice.
Landmark context
This closely mirrors 'orthosomnia', the term coined by Baron and colleagues in 2017 for anxiety and insomnia driven by obsessive pursuit of 'perfect' sleep-tracker data, and this paper appears to generalise that sleep-specific idea to digital health metrics broadly across high-performance sport.
What to do Monday
This doesn't change Monday's practice directly, but it gives clinicians and coaches a shared term for the athlete who seems more distressed by their wearable numbers than by how they actually feel or perform. Use it as a conversation opener, not a diagnosis, there is no validated screening tool yet, so don't build a formal 'orthometria screen' into monitoring protocols on the strength of this paper alone.
In practice
In the clinic, this fits the athlete or patient who feels and moves fine but disengages or catastrophises because last night's sleep score or HRV reading came up 'red'; ask how they're actually performing and recovering before letting the app set the agenda, and if checking behaviour looks compulsive, consider a short break from visible daily scores rather than adding more monitoring. On the S&C floor, keep decisions anchored to subjective readiness plus objective output, session RPE, bar speed, jump height, rather than a single wearable metric, and be deliberate about who sees raw daily scores and when, particularly with younger or anxious athletes who tend to fixate. There's no validated tool to screen for this yet, so treat 'orthometria' as a name for a conversation you're probably already having, not a new assessment to bolt onto intake or return-to-play paperwork.
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