Department of Neurosurgery, Stanford University Hospital and Clinics, Stanford, CA.
Department of Neurosurgery, University Hospital Zurich & Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland.
Spine (Phila Pa 1976). 2024 Aug 15;49(16):1145-1153. doi: 10.1097/BRS.0000000000004940. Epub 2024 Jan 30.
STUDY DESIGN/SETTING: Prospective cohort study.
To use a commercial wearable device to measure real-life, continuous physical activity in patients with CS and to establish age-adjusted and sex-adjusted standardized scores.
Patients with cervical spondylosis (CS) often present with pain or neurologic deficits that result in functional limitations and inactivity. However, little is known regarding the influence of CS on the patient's real-life physical activity.
This study included 100 English-speaking adult patients with cervical degenerative diseases undergoing elective spine surgery at Stanford University who owned iPhones. Patients undergoing surgery for spine infections, trauma, tumors, or lumbar degenerative disease were excluded. Activity two weeks before surgery was expressed as raw daily step counts. Standardized z-scores were calculated based on age-specific and sex-specific values of a control population. Responses to patient-reported outcome measures (PROMs) surveys assessed convergent validity. Functional impairment was categorized based on predetermined z-score cut-off values.
Thirty CS with a mean (±SD) age of 56.0 (±13.4) y wore an Apple Watch for ≥8 hours/day in 87.1% of the days. The mean watch wear time was 15.7 (±4.2) hours/day, and the mean daily step count was 6400 (±3792). There was no significant difference in activity between 13 patients (43%) with myelopathy and 17 (57%) without myelopathy. Test-retest reliability between wearable step count measurements was excellent (ICC β=0.95). Physical activity showed a moderate positive correlation with 36-Item Short Form Survey Physical Component Summary, EuroQol-5-dimension visual analog scale, and Patient-Reported Outcomes Measurement Information System Physical Function Subscale. Activity performance was classified into categories of "no impairment" [step count=9640 (±2,412)], "mild impairment" [6054(±816)], "moderate impairment" [3,481 (±752)], and "severe impairment" [1,619 (±240)].
CS patients' physical activity is significantly lower than the general population or the frequently stated goals of 7000 to 10,000 steps/day. Standardized, continuous wearable physical activity monitoring in CS is a reliable, valid, and normalized outcome tool that may help characterize functional impairment before and after spinal interventions.
研究设计/设置：前瞻性队列研究。
使用商业可穿戴设备测量 CS 患者的真实、连续的身体活动，并建立年龄和性别调整的标准化评分。
患有颈椎病 (CS) 的患者常因疼痛或神经功能缺损而出现功能受限和活动减少。然而，对于 CS 对患者日常生活中的身体活动的影响知之甚少。
这项研究纳入了 100 名在斯坦福大学接受择期脊柱手术的患有颈椎退行性疾病的讲英语的成年患者，他们都拥有 iPhone。排除因脊柱感染、创伤、肿瘤或腰椎退行性疾病而接受手术的患者。手术前两周的活动量表示为每日原始步数。根据对照人群的年龄特异性和性别特异性值计算标准化 z 分数。通过患者报告的结果测量 (PROM) 调查评估收敛效度。根据预定的 z 分数截断值对功能障碍进行分类。
30 例 CS 患者的平均（±SD）年龄为 56.0（±13.4）岁，其中 87.1%的天数佩戴 Apple Watch 时间≥8 小时/天。手表佩戴时间的平均值为 15.7（±4.2）小时/天，每日平均步数为 6400（±3792）步。有 13 名（43%）有脊髓病的患者和 17 名（57%）没有脊髓病的患者之间的活动量没有显著差异。可穿戴步数测量的重测信度极好（ICC β=0.95）。身体活动与 36 项简短形式调查身体成分摘要、EuroQol-5 维度视觉模拟量表和患者报告的结果测量信息系统身体功能子量表之间呈中度正相关。活动表现分为“无损伤”[步数=9640（±2412）]、“轻度损伤”[6054（±816）]、“中度损伤”[3481（±752）]和“重度损伤”[1619（±240）]。
CS 患者的身体活动明显低于一般人群或 7000 到 10000 步/天的常规定量。CS 患者的标准化、连续的可穿戴身体活动监测是一种可靠、有效的、规范化的结果工具，可帮助在脊柱干预前后描述功能障碍。
