Vanderbilt Institute of Clinical & Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Phys Ther. 2024 Feb 1;104(2). doi: 10.1093/ptj/pzad096.
The purpose of this study was to examine the feasibility and acceptability of a wearable device and telehealth counseling physical activity intervention early after lumbar spine surgery.
Sixteen patients were randomized to an 8-session physical activity intervention or to usual postoperative care after surgery. The intervention included a wearable device (ie, Fitbit) and telehealth counseling by a licensed physical therapist. The feasibility of study procedures was assessed through recruitment, randomization, retention, and participation rates. Acceptability was assessed through a satisfaction survey and median within-participant change in objective physical activity (steps per day and time spent in moderate-to-vigorous physical activity [MVPA]) and patient-reported outcomes.
Of 64 participants who were eligible, recruitment and randomization rates were 41 and 62%, respectively. Retention for objective physical activity and patient-reported outcomes was 94 and 100%, respectively, at 6-month follow-up. Seven (88%) participants in the intervention group completed all telehealth sessions, and 6 (75%) met step goals over the 8 sessions. All participants in the intervention group found the wearable device and telehealth counseling to be helpful and reported it much or somewhat more important than other postoperative services. Median within-participant change for steps per day improved from baseline (preoperative) to 6 months after surgery for both the intervention (1070) and usual care (679) groups, while MVPA only improved for the intervention group (2.2. minutes per day). Improvements in back and leg pain and disability were noted for both groups. No adverse events were reported in the study.
Combining wearable technology and telehealth counseling is a feasible approach to promote the physical activity during the early postoperative period after spine surgery. Future randomized controlled trials are needed to investigate the efficacy of leveraging wearables and telehealth during postoperative rehabilitation.
This study has implications for the clinical dissemination of physical activity strategies in the rehabilitation setting.
本研究旨在探讨可穿戴设备和远程健康咨询体力活动干预措施在腰椎术后早期的可行性和可接受性。
16 名患者随机分为 8 节体力活动干预组或术后常规护理组。干预措施包括可穿戴设备（即 Fitbit）和由持照物理治疗师提供的远程健康咨询。通过招募、随机化、保留和参与率评估研究程序的可行性。通过满意度调查和客观体力活动（每天步数和中高强度体力活动[MVPA]时间）和患者报告结果的参与者内中位数变化评估可接受性。
在 64 名符合条件的参与者中，招募和随机化率分别为 41%和 62%。在 6 个月的随访中，客观体力活动和患者报告结果的保留率分别为 94%和 100%。干预组的 7 名（88%）参与者完成了所有远程健康会议，有 6 名（75%）在 8 次会议中达到了步数目标。干预组的所有参与者都认为可穿戴设备和远程健康咨询很有帮助，并表示它比其他术后服务更重要或更重要。与基线（术前）相比，两组（干预组 1070 步/天，常规护理组 679 步/天）术后 6 个月每天的步数中位数均有所改善，而 MVPA 仅在干预组有所改善（每天 2.2 分钟）。两组患者的腰背疼痛和残疾均有所改善。研究中未报告不良事件。
将可穿戴技术与远程健康咨询相结合，是促进脊柱手术后早期康复期间体力活动的一种可行方法。需要进一步开展随机对照试验，以研究在术后康复中利用可穿戴设备和远程健康的疗效。
本研究对康复环境中体力活动策略的临床推广具有重要意义。
