Feasibility of A Digital Health Intervention to Assess and Encourage Physical Activity in Total Hip Arthroplasty Patients

Abstract

Value-based medicine invites physicians to objectively measure the outcomes of their interventions, but the cost, complexity and bulkiness of research-grade activity monitors is prohibitive for doing this on a large scale. Moreover, these devices are generally not designed to provide feedback to patients. PURPOSE: To investigate the feasibility of using consumer activity monitors to objectively assess physical activity during recovery from total hip arthroplasty (THA) in the early post-operative period and to engage this older population in their rehab. METHODS: 131 patients electively undergoing a primary anterolateral THA by a single surgeon at a single institution were invited to participate in this study. Patients were asked to wear the Misfit™ Shine physical activity monitor, which has been shown to accurately measure steps compared to a research-grade actigraph, for 1 week pre-operatively and 6 weeks post-operatively. Medical staff and patients were surveyed about their experiences. RESULTS: 92% of patients agreed to participate in this study. Complete physical activity data were collected for 76% of participants. 100% of staff endorsed that they were better able to provide personalized care through objective data about their patients’ activity; and that the device helped engage participants in their rehabilitation. Factors identified by staff contributing to the study feasibility included device ease of use and cost, and patient eagerness to use new technology. Factors identified by patients that aided their compliance included device comfort and simplicity, and no need to remove the device for charging or showering. Data loss occured from lost devices and syncing malfunctions. CONCLUSION: Wirelessly monitoring patient mobility with consumer physical activity monitors is feasible and provides an opportunity to objectively track patients’ recovery on a scale not previously possible with dedicated research devices, while engaging patients in their rehabilitation. This type of information can help us better understand the role of pre and post operative physical activity, and changes in technique or protocol, on patients’ return to function. Device features aided compliance. Device loss and syncing malfunction contributed to data loss.