Li Zhi, Feng Weiyan, Zhou Lili, Gong Shu
Department of Cardiovascular Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China.
Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China.
Digit Health. 2024 Nov 4;10:20552076241297036. doi: 10.1177/20552076241297036. eCollection 2024 Jan-Dec.
Wearable activity trackers provide a simple and objective measurement of postoperative mobilization. However, few have validated the accuracy of trackers in patients after major abdominal surgery.
To examine the accuracy of wrist-worn activity trackers to measure steps of patients in early mobilization after major abdominal surgery, and to explore the influence of clinical variables and gait parameters on the accuracy of trackers.
Forty-five patients after major abdominal surgery were recruited to participate in modified six-minute walk tests wearing three trackers simultaneously, the Fitbit Inspire HR, Xiaomi MI 4, and HONOR 5. The differences in displayed steps before and after the walking test were considered as the step counts measured by the trackers; the actual steps taken were determined as the average of the values manually counted by two researchers. The intraclass correlation coefficient, Bland-Altman method, mean percentage error, and mean absolute percentage error were used to assess the accuracy of trackers with reference to manual step counts.
The three trackers undercounted postoperative steps by -65.5% to -23.5%. Analysis showed low-to-good agreement between step counts recorded by trackers and actual steps (ICC = 0.35-0.75); the mean absolute percentage errors ranged from 24.5% to 65.7%. For all trackers, mean absolute percentage errors correlated negatively with postoperative days ( = -0.626 to -0.744), walking speed ( = -0.714 to -0.854), step length ( = -0.466 to -0.615), and cadence ( = -0.681 to -0.790), while there were positive correlations between mean absolute percentage errors and the number of abdominal drains ( = 0.450-0.514).
The specific activity trackers used in this study might not be reliable tools for measuring steps counts during the walking test in the early postoperative period for patients undergoing major abdominal surgery.
可穿戴活动追踪器为术后活动提供了一种简单且客观的测量方法。然而，很少有研究验证追踪器在腹部大手术后患者中的准确性。
探讨腕戴式活动追踪器测量腹部大手术后早期活动患者步数的准确性，并探究临床变量和步态参数对追踪器准确性的影响。
招募45例腹部大手术后的患者，同时佩戴三款追踪器（Fitbit Inspire HR、小米MI 4和荣耀5）参与改良六分钟步行测试。步行测试前后追踪器显示的步数差异被视为追踪器测量的步数；实际步数通过两名研究人员手动计数的平均值确定。采用组内相关系数、Bland-Altman方法、平均百分比误差和平均绝对百分比误差，参照手动计数步数评估追踪器的准确性。
三款追踪器对术后步数的计数少了65.5%至23.5%。分析表明，追踪器记录的步数与实际步数之间的一致性为低到良好（ICC = 0.35 - 0.75）；平均绝对百分比误差在24.5%至65.7%之间。对于所有追踪器，平均绝对百分比误差与术后天数（r = -0.626至-0.744）、步行速度（r = -0.714至-0.854）、步长（r = -0.466至-0.615）和步频（r = -0.681至-0.790）呈负相关，而与腹腔引流管数量呈正相关（r = 0.450 - 0.514）。
本研究中使用的特定活动追踪器可能不是测量腹部大手术患者术后早期步行测试中步数的可靠工具。
