Thoraxcentrum Twente, Medisch Spectrum Twente, P.O. Box 50 000, 7500 KA Enschede, The Netherlands.
Department of Biomechanical Engineering, TechMed Centre, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
Sensors (Basel). 2021 Mar 11;21(6):1979. doi: 10.3390/s21061979.
Cardiac surgery patients infrequently mobilize during their hospital stay. It is unclear for patients why mobilization is important, and exact progress of mobilization activities is not available. The aim of this study was to select and evaluate accelerometers for objective qualification of in-hospital mobilization after cardiac surgery. Six static and dynamic patient activities were defined to measure patient mobilization during the postoperative hospital stay. Device requirements were formulated, and the available devices reviewed. A triaxial accelerometer (AX3, Axivity) was selected for a clinical pilot in a heart surgery ward and placed on both the upper arm and upper leg. An artificial neural network algorithm was applied to classify lying in bed, sitting in a chair, standing, walking, cycling on an exercise bike, and walking the stairs. The primary endpoint was the daily amount of each activity performed between 7 a.m. and 11 p.m. The secondary endpoints were length of intensive care unit stay and surgical ward stay. A subgroup analysis for male and female patients was planned. In total, 29 patients were classified after cardiac surgery with an intensive care unit stay of 1 (1 to 2) night and surgical ward stay of 5 (3 to 6) nights. Patients spent 41 (20 to 62) min less time in bed for each consecutive hospital day, as determined by a mixed-model analysis ( < 0.001). Standing, walking, and walking the stairs increased during the hospital stay. No differences between men ( = 22) and women ( = 7) were observed for all endpoints in this study. The approach presented in this study is applicable for measuring all six activities and for monitoring postoperative recovery of cardiac surgery patients. A next step is to provide feedback to patients and healthcare professionals, to speed up recovery.
心脏外科手术后患者在住院期间很少活动。患者不清楚活动的重要性，也无法得知确切的活动进展情况。本研究的目的是选择和评估加速度计，以客观评估心脏手术后住院期间的活动能力。定义了 6 种静态和动态患者活动，以测量术后住院期间患者的活动能力。制定了设备要求，并对现有设备进行了审查。选择三轴加速度计（AX3，Axivity）用于心脏外科病房的临床试点，并分别放置在上臂和大腿上。应用人工神经网络算法对卧床、坐在椅子上、站立、行走、在健身车上骑自行车和走楼梯等活动进行分类。主要终点是 7 点至 11 点之间每天进行的每种活动的数量。次要终点是重症监护病房住院时间和外科病房住院时间。计划进行男性和女性患者的亚组分析。共有 29 例心脏手术后患者被分类，重症监护病房住院时间为 1 晚（1 至 2 晚），外科病房住院时间为 5 晚（3 至 6 晚）。通过混合模型分析，每位患者连续住院天数减少 41 分钟（20 至 62 分钟）（ < 0.001）。站立、行走和走楼梯的次数在住院期间增加。在本研究中，男性（ = 22）和女性（ = 7）患者的所有终点均无差异。本研究中提出的方法适用于测量所有 6 种活动，并监测心脏手术患者的术后恢复情况。下一步是为患者和医疗保健专业人员提供反馈，以加快康复速度。
