Initial Experience With Real-Time Continuous Physical Activity Monitoring in Patients Undergoing Spine Surgery. Issue 10 (December 2017)

• Record Type: Journal Article
• Authors: Scheer, Justin K.; Bakhsheshian, Joshua; Keefe, Malla K.; Lafage, Virginie; Bess, Shay; Protopsaltis, Themistocles S.; Burton, Douglas C.; Hart, Robert A.; Shaffrey, Christopher I.; Schwab, Frank; Smith, Justin S.; Smith, Zachary A.; Koski, Tyler R.; Ames, Christopher P.
• Is Part Of: Clinical spine surgery. Volume 30:Issue 10(2017)
• Publication Date: 2017-12
• Subjects: continuous physical monitoring -- accelerometer -- activity monitoring -- Fitbit -- physical activity -- adult spinal deformity -- degenerative -- spine surgery -- spine -- outcomes; Spinal cord -- Diseases -- Periodicals; Spinal cord -- Surgery -- Periodicals; 617.56059
• DOI: 10.1097/BSD.0000000000000521
• Languages: English
• ISSNs: 2380-0186

Abstract

Abstract : Study Design: Multicenter prospective pilot study. Objective: To evaluate if continuous physical activity monitoring by a personal electronic 3-dimensional accelerometer device is feasible and can provide objective data that correlates with patient-reported outcomes following spine surgery. Summary of Background Data: Self-reported health-related quality-of-life (HRQOL) metrics are inherently limited by being very subjective, having a low frequency of data collection, and inconsistent follow-up. Methods: Inclusion criteria: adults (18+), thoracolumbar deformity or degenerative disease, and regular access to a computer with internet connection. Physical activity parameters included: number of daily steps, maximum hourly steps, and activity intensity. Patients completed the Oswestry Disability Index (ODI), the Short-Form Health Survey 36 (SF-36), and the Scoliosis Research Society-22r (SRS22) preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. Results: Thirty-two patients were enrolled, 8 (25%) withdrew, 1 (3.1%) died, and 1 (3.1%) did not end up undergoing surgery resulting in 22 (68.8%) available patients. Mean preoperative and postoperative step ranges were 1278±767 to 17, 800±6464 and 891±587 to 12, 655±7038, respectively. Eleven patients improved in mean total daily steps at the final postoperative month with 2 having significant improvements ( P <0.05). Five patients did not significantly change ( P >0.05) and 6 patients had significantly lower mean total daily steps at 6 months ( P <0.05). The entire cohort significantly improved in ODI, SF-36 Physical Component Summary, SRS Activity, SRS Appearance, SRS Mental, SRS Satisfaction, and SRS Total score at 6 months postoperative ( P <0.05 for all). Both ODI and Physical Component Summary were significantly correlated with preoperative average total daily steps ( r =−0.61, P =0.0058 and r =0.60, P =0.0114, respectively). No other HRQOL metrics were significantly correlated at baseline or at 6 months postoperative ( P >0.05). Conclusions: A prospective pilot study for continuous real-time physical activity monitoring was successfully completed. This is the first study of its kind and demonstrates a foundation to continuous physical activity monitoring following spine surgery. A larger and longer prospective study is needed to confirm long-term results and its relationship with HRQOL scores.