(251) - Spinal cord stimulator trial outcomes related to increased steps and improved sleep as predictors of success

Abstract

Spinal Cord Stimulators have been shown to be effective in treating neuropathic and sympathetically mediated chronic pain. After screening for comorbidities and contraindications, a 7–10 day SCS trial is undertaken. A successful trial results in a greater than 50 percent reduction in pain with improved activity. There are several validated, subjective tools to determine the effectiveness of the trial, but we hypothesized that objective mobility and sleep data from a Fitbit could better determine when a permanent spinal cord stimulator would be beneficial. During the standard screening process, patients meeting the inclusion criteria and consenting to participate were given a Fitbit Flex. Each patient underwent 7 days of data collection prior to the SCS trial. The day following the SCS trial, data was again collected on the Fitbit for 7–10 days (the length of the trial). Parameters including distance walked, total steps, and steps per hour as well as duration of sleep and frequency of awakenings were monitored. We determined if these functional measures correlated well with other measurements of pain such as mood, anxiety, somatization, PROMIS Sleep Disturbance, pain catastrophizing, and the opioid risk tool. Patient data was collected before and during the trial and analyzed using SPSS statistical methods. Preliminary data have shown significant differences in sleep awakenings and improved sleep during the SCS trial. Tracking of steps and sleep provides objective measures in addition to the subjective measures reported by patients and may improve patient selection for permanent placement of a spinal cord stimulator.