Physical activity monitors can be successfully implemented to assess perioperative activity in urologic surgery

Abstract

Background: Mobile health and physical activity monitors (PAMs) are emerging technologies allowing patients to track multiple health parameters. These parameters could be useful in monitoring and modifying the perioperative health of urology patients. We performed a pilot study and describe a model for which to implement mHealth applications in a urology population. Methods: Patients undergoing robotic assisted retropubic prostatectomy were screened for inclusion and provided with Fitbit® Charge HR TM (Boston, MA, USA) devices. Patients were fitted with the device during the preoperative visit and instructed to wear before and after surgery. Biophysical data was collected and patient acceptance was assessed with a Mobile Physical Activity Monitor Questionnaire (MPAMQ). Results: Forty-six patients met inclusion criteria. Median duration of PAM usage was one and seven days preoperatively and postoperatively. Postoperatively, there was a reduction in median daily steps compared to preoperatively (2,782 vs. 3,907, P=0.024), but no statistically significant difference in minutes slept or nighttime awakenings. Obese (BMI ≥30) and older men (≥65 years) had a greater reduction in steps after surgery (P<0.001 and P=0.055), whereas there was no difference in non-obese and men age <65. Patients with BMI ≥30 took 35% fewer steps postoperatively than BMI <30 (P=0.017). The majority of patients (82%) reported a medical benefit and 95% were satisfied with using PAM technology in the perioperative period. Conclusions: PAM effectively captures perioperative biophysical parameters and is associated with high patient satisfaction. Clinically, obese and elderly men appear to have significantly reduced activity following prostatectomy.

Catheter Removal on the Same Day of Holmium Laser Enucleation of the Prostate: Outcomes of a Pilot Study

“…Additionally, less indwelling catheter time should theoretically decrease rate of postoperative urinary tract infections. Patients also ambulate less with a catheter in place, 16 , 17 which has the potential to increase the risk for postoperative deep venous thrombosis. Catheter dysfunction is also a postoperative issue, causing for patient concern and unintended emergency room visits for clogging and/or poor drainage.…”

Wearable devices for patient monitoring in the early postoperative period: a literature review

“…However, these patients may also present unique challenges regarding informed consent, patient education and compliance, thereby necessitating a well-planned and multidisciplinary approach to ensure adequate implementation. The data provided by wearable devices may also aid the recovery process (50,51,54,64). Patients may find quantitative and graphical evidence of their improvements motivating, thereby potentially creating a positive feedback loop.…”

“…Further, raw data, such as acceleration, may still violate patient privacy given that unknown diseases or personal habits may be detected. Robust protections, such as data encryption, password protection and access restrictions, must be employed to provide safety and patients must also be educated in order to alleviate their concerns (50,55). Some patients may also find quantitative and graphical evidence of slow recovery, plateauing or regression demotivating, thereby potentially creating a negative feedback loop.…”

Digitale Innovation in der Medizin – die COVID-19-Pandemie als Akzelerator von „digital health“

“…Daneben wurden an der Schnittstelle zur Urogynäkologie in der Inkontinenzbehandlung der Frau zahlreiche digitale Behandlungsformen von Beckenbodentraining erprobt [ 25 ], wobei in hochmotivierten Probanden bessere Behandlungserfolge erzielt werden [ 26 ]. Perioperativ kann Aktivitätstracking eingesetzt werden, um Aktivitätsniveaus beispielsweise für Patienten zu erfassen, die sich einer Prostatektomie unterziehen [ 27 ]. Viele dieser Lösungen stellen aktuell Insellösungen dar und lassen sich noch nicht optimal in das Gesundheitssystem integrieren.…”