Yamate Satoshi, Hamai Satoshi, Konishi Toshiki, Nakao Yuki, Inoue Takahiro, Motomura Goro, Nakashima Yasuharu
Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Orthopaedic Surgery and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
PLoS One. 2025 Jun 27;20(6):e0326338. doi: 10.1371/journal.pone.0326338. eCollection 2025.
Smartphone step counts may capture real-world activities in patients' daily lives, and the self-monitoring of step counts may introduce healthier behavioral changes. We investigated the association between living arrangements (solitude/cohabiting) and residential location (urban/suburban) of patients and their preoperative and postoperative smartphone step counts following total hip arthroplasty (THA).
Patients scheduled for THA at a university hospital from September 10, 2021, to December 5, 2023 were enrolled into the study from August 4, 2021, to November 10, 2023. We remotely monitored the patients' daily step counts from smartphone application until up to 365 days after THA. We used the moving average method and latent growth curve modeling to analyze the time-series data of the step count.
Overall, 85 patients were included in this study. Comparing the 37 solitary and 48 cohabiting patients, the percentage of men was higher in the solitary group (27% vs. 8%, P = 0.037). There were no notable differences in the demographics between the 44 urban and 41 suburban patients. Urban patients experienced a 483-step per 2-week greater preoperative increase than suburban patients (P = 0.027) after adjusting for confounding factors. From postoperative 2 weeks to preoperative 12 weeks, the intercept was larger for urban patients than for suburban patients by 893 steps (P = 0.040). From postoperative 20 weeks to preoperative 50 weeks, the intercept was larger for solitary patients than for cohabiting patients by a difference of 1,360 steps (P = 0.027).
Living arrangements and residential locations were associated with daily step counts before and after THA. Patients in urban areas had higher step counts after the initiation of step-count monitoring and during the early postoperative period. Solitary patients walked more than cohabiting patients. Our findings underscore the utility of smartphone step counts as objective outcome measures for patient assessment and encouraging healthier behavioral changes.
智能手机计步功能可以记录患者日常生活中的实际活动，自我监测步数可能会带来更健康的行为改变。我们研究了患者的居住安排（独居/同居）和居住地点（城市/郊区）与全髋关节置换术（THA）前后智能手机计步数量之间的关联。
2021年9月10日至2023年12月5日在某大学医院计划接受THA的患者于2021年8月4日至2023年11月10日纳入本研究。我们通过智能手机应用程序远程监测患者的每日步数，直至THA后长达365天。我们使用移动平均法和潜在增长曲线模型来分析步数的时间序列数据。
本研究共纳入85例患者。比较37例独居患者和48例同居患者，独居组男性比例更高（27%对8%，P = 0.037）。44例城市患者和41例郊区患者在人口统计学方面无显著差异。调整混杂因素后，城市患者术前每2周的步数增加比郊区患者多483步（P = 0.027）。从术后2周到术前12周，城市患者的截距比郊区患者大893步（P = 0.040）。从术后20周到术前50周，独居患者的截距比同居患者大1360步（P = 0.027）。
居住安排和居住地点与THA前后的每日步数有关。城市地区的患者在开始计步监测后和术后早期步数更高。独居患者比同居患者走得更多。我们的研究结果强调了智能手机计步作为患者评估的客观结果指标以及鼓励更健康行为改变的实用性。
