Gadangi Pranav V, Lambert Bradley S, Goble Haley, Harris Joshua D, McCulloch Patrick C
Texas A&M Health Science Center, College Station, Texas, U.S.A.
Texas A&M College of Engineering, College Station, Texas, U.S.A.
Arthrosc Sports Med Rehabil. 2023 Aug 14;5(5):100783. doi: 10.1016/j.asmr.2023.100783. eCollection 2023 Oct.
To assess the utility of a validated wearable device (VWD) in examining preoperative and postoperative sleep patterns and how these data compare to patient-reported outcomes (PROs) after rotator cuff repair (RCR) or total shoulder arthroplasty (TSA).
Male and female adult patients undergoing either RCR or TSA were followed up from 34 days preoperatively to 6 weeks postoperatively. Sleep metrics were collected using a VWD in an unsupervised setting. PROs were assessed using the following validated outcome measures: Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function questionnaire; American Shoulder and Elbow Surgeons self-evaluation questionnaire; visual analog scale assessing pain; and Disabilities of the Arm, Shoulder and Hand questionnaire. Data were analyzed preoperatively and at 2-week intervals postoperatively with χ analysis to evaluate device compliance. Sleep metrics and PROs were evaluated at each interval relative to preoperative values within each surgery type with an analysis of variance repeated on time point. The relation between sleep metrics and PROs was assessed with correlation analysis.
A total of 57 patients were included, 37 in the RCR group and 20 in the TSA group. The rate of device compliance in the RCR group decreased from 84% at surgery to 46% by 6 weeks postoperatively ( < .001). Similarly, the rate of device compliance in the TSA group decreased from 81% to 52% ( < .001). Deep sleep decreased in RCR patients at 2 to 4 weeks (decrease by 10.99 ± 3.96 minutes, = .021) and 4 to 6 weeks postoperatively (decrease by 13.37 ± 4.08 minutes, = .008). TSA patients showed decreased deep sleep at 0 to 2 weeks postoperatively (decrease by 12.91 ± 5.62 minutes, = .045) and increased rapid eye movement sleep at 2 to 4 weeks postoperatively (increase by 26.91 ± 10.70 minutes, = .031). Rapid eye movement sleep in the RCR group and total sleep in the TSA group were positively correlated with more favorable PROs ( < .05).
VWDs allow for monitoring components of sleep that offer insight into potential targets for improving postoperative fatigue, pain, and overall recovery after shoulder surgery. However, population demographic factors and ease of device use are barriers to optimized patient compliance during data collection.
Level IV, diagnostic case series.
评估一种经过验证的可穿戴设备（VWD）在检查肩袖修复术（RCR）或全肩关节置换术（TSA）术前和术后睡眠模式方面的效用，以及这些数据与患者报告结局（PROs）的比较情况。
对接受RCR或TSA的成年男性和女性患者进行术前34天至术后6周的随访。在无监督环境下使用VWD收集睡眠指标。使用以下经过验证的结局指标评估PROs：患者报告结局测量信息系统（PROMIS）身体功能问卷；美国肩肘外科医生自我评估问卷；评估疼痛的视觉模拟量表；以及手臂、肩部和手部功能障碍问卷。术前和术后每隔2周进行χ分析以评估设备依从性。在每种手术类型中，相对于术前值，在每个时间间隔评估睡眠指标和PROs，并对时间点进行重复方差分析。通过相关性分析评估睡眠指标与PROs之间的关系。
共纳入57例患者，其中RCR组37例，TSA组20例。RCR组的设备依从率从手术时的84%降至术后6周的46%（P <.001）。同样，TSA组的设备依从率从81%降至52%（P <.001）。RCR患者在术后2至4周（减少10.99±3.96分钟，P =.021）和4至6周（减少13.37±4.08分钟，P =.008）时深度睡眠减少。TSA患者在术后0至2周深度睡眠减少（减少12.91±5.62分钟，P =.045），在术后2至4周快速眼动睡眠增加（增加26.91±10.70分钟，P =.031）。RCR组的快速眼动睡眠和TSA组的总睡眠时间与更有利的PROs呈正相关（P <.05）。
VWDs能够监测睡眠成分，有助于深入了解改善肩部手术后疲劳、疼痛和整体恢复的潜在目标。然而，人群人口统计学因素和设备使用的便利性是数据收集过程中优化患者依从性的障碍。
IV级，诊断性病例系列。
