心脏手术后康复期间通过可穿戴技术评估体力活动：探索性前瞻性单中心观察队列研究。

Assessment of Physical Activity by Wearable Technology During Rehabilitation After Cardiac Surgery: Explorative Prospective Monocentric Observational Cohort Study.

机构信息

Research Unit of Cardiac Surgery, Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium.

Department of Cardiac Surgery, Katholiek Universiteit Leuven, Leuven, Belgium.

出版信息

JMIR Mhealth Uhealth. 2019 Jan 31;7(1):e9865. doi: 10.2196/mhealth.9865.

DOI:10.2196/mhealth.9865

PMID:30702433

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6374731/

Abstract

BACKGROUND

Wearable technology is finding its way into clinical practice. Physical activity describes patients' functional status after cardiac surgery and can be monitored remotely by using dedicated trackers.

OBJECTIVE

The aim of this study was to compare the progress of physical activity in cardiac rehabilitation by using wearable fitness trackers in patients undergoing coronary artery bypass surgery by either the conventional off-pump coronary artery bypass (OPCAB) or the robotically assisted minimally invasive coronary artery bypass (RA-MIDCAB). We hypothesized faster recovery of physical activity after RA-MIDCAB in the first weeks after discharge as compared to OPCAB.

METHODS

Patients undergoing RA-MIDCAB or OPCAB were included in the study. Each patient received a Fitbit Charge HR (Fitbit Inc, San Francisco, CA) physical activity tracker following discharge. Rehabilitation progress was assessed by measuring the number of steps and physical activity level daily. The physical activity level was calculated as energy expenditure divided by the basic metabolic rate.

RESULTS

A total of 10 RA-MIDCAB patients with a median age of 68 (min, 55; max, 83) years and 12 OPCAB patients with a median age of 69 (min, 50; max, 82) years were included. Baseline characteristics were comparable except for body mass index (RA-MIDCAB: 26 kg/m²; min, 22; max, 28 versus OPCAB: 29 kg/m²; min, 27; max, 33; P<.001). Intubation time (P<.05) was significantly lower in the RA-MIDCAB group. A clear trend, although not statistically significant, was observed towards a higher number of steps in RA-MIDCAB patients in the first week following discharge.

CONCLUSIONS

RA-MIDCAB patients have an advantage in recovery in the first weeks of revalidation, which is reflected by the number of steps and physical activity level measured by the Fitbit Charge HR, as compared to OPCAB patients. However, unsupervised assessment of daily physical activity varied widely and could have consequences with regard to the use of these trackers as research tools.

摘要

背景

可穿戴技术正在进入临床实践。体力活动描述了心脏手术后患者的功能状态，可以通过专用追踪器远程监测。

目的

本研究旨在比较传统非体外循环冠状动脉旁路移植术（OPCAB）和机器人辅助微创冠状动脉旁路移植术（RA-MIDCAB）患者使用可穿戴健身追踪器在心脏康复过程中体力活动的进展。我们假设与 OPCAB 相比，RA-MIDCAB 患者在出院后最初几周的体力活动恢复更快。

方法

纳入接受 RA-MIDCAB 或 OPCAB 的患者。每位患者出院后都会收到一个 Fitbit Charge HR（Fitbit Inc，旧金山，加利福尼亚州）活动追踪器。通过测量每天的步数和体力活动水平来评估康复进展。体力活动水平通过能量消耗除以基础代谢率来计算。

结果

共纳入 10 例 RA-MIDCAB 患者（中位年龄 68 岁[最小 55 岁，最大 83 岁]）和 12 例 OPCAB 患者（中位年龄 69 岁[最小 50 岁，最大 82 岁]）。除了体重指数（RA-MIDCAB：26kg/m²；最小 22；最大 28 与 OPCAB：29kg/m²；最小 27；最大 33；P<.001）外，基线特征无差异。RA-MIDCAB 组的气管插管时间明显更短（P<.05）。尽管没有统计学意义，但出院后第一周 RA-MIDCAB 患者的步数明显更多，呈明显趋势。