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单中心手术脊柱病变患者远程治疗监测的初步研究。

Single-center pilot study of remote therapeutic monitoring in patients with operative spinal pathologies.

机构信息

Georgetown University School of Medicine, 3900 Reservoir Road NW, Washington, DC, USA.

Georgetown University School of Medicine, 3900 Reservoir Road NW, Washington, DC, USA.

出版信息

Clin Neurol Neurosurg. 2024 Jul;242:108346. doi: 10.1016/j.clineuro.2024.108346. Epub 2024 May 20.

Abstract

OBJECTIVES

Spine pathology affects a significant portion of the population, leading to neck and back pain, impacting quality of life, and potentially requiring surgical intervention. Current pre- and postoperative monitoring methods rely on patient reported outcome (PRO) measures and lack continuous objective data on patients' recoveries. Remote therapeutic monitoring (RTM) using wearable devices offers a promising solution to bridge this gap, providing real-time physical function data. This study aims to assess the feasibility and correlation between changes in physical function and daily activity levels using RTM for individuals with operative spinal pathologies.

METHODS

A single-center pilot study involving 21 participants with operative spinal pathologies was conducted at an academic hospital. Participants were provided Bluetooth-enabled Fitbit Inspire 2 activity trackers and asked to wear them daily for 100 days. The Healthcare Recovery Solutions (HRS) mobile application facilitated remote administration of the PROMIS - Physical Function Short Form 6b PROs questionnaire at days 1, 30, and 90. Linear regression, Students' paired T tests, and one-way ANOVA were used to analyze collected data.

RESULTS

Average compliance with RTM was found to be 82.4% compared to only 48% for PROMs. Changes in daily steps were moderately positively correlated with changes in PROs at both 30 and 90 days. Participant satisfaction with RTM was high, and responses indicated greater satisfaction with RTM compared to PROMs.

CONCLUSIONS

RTM offers continuous and objective data collection, presenting a potential solution to the limitations of intermittent clinical assessments and self-reported outcomes. The study demonstrated a moderate correlation between changes in activity levels and changes in PROs, suggesting that RTM data could serve as a surrogate for PROs. Participants' high compliance and satisfaction with RTM underscore its feasibility and potential clinical utility. This study lays the groundwork for larger future investigations into the clinical benefits and broader application of RTM in spine care.

摘要

目的

脊柱病理学影响着相当一部分人群,导致颈背部疼痛,降低生活质量,并可能需要手术干预。目前的术前和术后监测方法依赖于患者报告的结果(PRO)测量,缺乏患者康复的连续客观数据。使用可穿戴设备的远程治疗监测(RTM)提供了一个有前途的解决方案,可以提供实时的身体功能数据。本研究旨在评估使用 RTM 对手术脊柱病变患者的身体功能变化与日常活动水平之间的相关性和可行性。

方法

在一家学术医院进行了一项涉及 21 名手术脊柱病变患者的单中心试点研究。为患者提供了带蓝牙功能的 Fitbit Inspire 2 活动追踪器,并要求他们每天佩戴 100 天。Healthcare Recovery Solutions(HRS)移动应用程序便于在第 1、30 和 90 天远程管理 PROMIS-Physical Function Short Form 6b PROs 问卷。线性回归、学生配对 T 检验和单向方差分析用于分析收集的数据。

结果

与仅 48%的 PROs 相比,RTM 的平均依从率为 82.4%。在第 30 和 90 天,每日步数的变化与 PROs 的变化呈中度正相关。患者对 RTM 的满意度很高,并且反馈表明 RTM 的满意度高于 PROs。

结论

RTM 提供了连续和客观的数据收集,为间歇性临床评估和自我报告结果的局限性提供了潜在的解决方案。研究表明,活动水平的变化与 PROs 的变化之间存在中度相关性,这表明 RTM 数据可以作为 PROs 的替代指标。患者对 RTM 的高依从性和满意度突出了其可行性和潜在的临床应用价值。本研究为未来更大规模的研究奠定了基础,以探讨 RTM 在脊柱护理中的临床效益和更广泛的应用。

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