Postoperative physical activity in orthogeriatric patients – new insights with continuous monitoring

Keppler, Alexander Martin; Holzschuh, Jenny; Pfeufer, Daniel; Neuerburg, Carl; Kammerlander, Christian; Böcker, Wolfgang; Fürmetz, Julian

doi:10.1016/j.injury.2020.01.041

Cited by 17 publications

(23 citation statements)

References 30 publications

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“…(continued) review provide evidence to support the notion that wearable devices are useful, cost-effective and objective tools to reliably, remotely and regularly monitor postoperative function and recovery(50,(53)(54)(55)(56)(59)(60)(61)(63)(64)(65)(66)(67)(68)71). A number of studies also reported high levels of patient compliance and satisfaction(50,61,65,67,68,71,73).…”

mentioning

confidence: 89%

“…Further, Mobbs et al (80) reported a case demonstrating the utility of wearable device data, in conjunction with clinical and radiologic assessment, in detecting a postoperative complication and so allowing for timely intervention. Specific at-risk populations identified in our review which may especially benefit from postoperative wearable device monitoring include obese patients (50), disabled patients (51) and orthogeriatric patients (61). Patient groups which may be particularly suited to wearable device monitoring include those who are difficult to adequately monitor using traditional methods.…”

Section: The Potential Impact Of Wearable Devices In Postoperative Monitoringmentioning

confidence: 99%

“…Mobbs et al and Sun et al both noted the discordance in scores between traditional subjective and recent objective measures, such as wearable device data, of function and recovery (65,68). As such, the objective data collected by wearable devices may replace or serve as an important adjunct to static and subjective traditional monitoring tools, such as clinical assessments or patient reported questionnaires (61,62,(65)(66)(67)(68)71).…”

Section: The Potential Impact Of Wearable Devices In Postoperative Monitoringmentioning

confidence: 99%

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

Amin¹,

Mobbs²,

Mostafa³

et al. 2021

mHealth

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The early postoperative period is a crucial stage in a patient's recovery as they are susceptible to a range of complications, with detection and management the key to avoiding long term consequences.Wearable devices are an innovative way of monitoring patient's post-intervention and may translate into improved patient outcomes, and reduced strain on healthcare resources, as they may facilitate safer and earlier discharge from the hospital setting. Several recent studies have investigated the use of wearable devices in postoperative monitoring. This review outlines the current literature including the range of wearable devices used for postoperative monitoring, the variety of surgeries investigated, and the outcomes assessed.A search of five electronic databases was performed. Data on the range of wearable devices, outcomes and surgeries investigated were extracted and synoptically analysed. Twenty-four articles were retrieved. Data on several different types of surgery were available and discussed. Most studies used wrist-mounted wearable devices and accelerometers or pedometers to assess physical activity metrics, including step counts and physical activity intensity (PAI), as markers of recovery. Wearable devices can provide objective data capture in the early postoperative phase to remotely monitor patients using various metrics including temperature, cardiac monitoring and physical activity. The majority of current research is focussed on wrist-mounted accelerometers and pedometers used to assess physical activity as a marker of postoperative function. Further research is required to demonstrate improved safety and cost-effectiveness of this technology.

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mentioning

confidence: 89%

Section: The Potential Impact Of Wearable Devices In Postoperative Monitoringmentioning

confidence: 99%

Section: The Potential Impact Of Wearable Devices In Postoperative Monitoringmentioning

confidence: 99%

See 1 more Smart Citation

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

Amin¹,

Mobbs²,

Mostafa³

et al. 2021

mHealth

View full text Add to dashboard Cite

show abstract

“…However, previous data on immediate postoperative mobility in orthogeriatric patients often refer to self-or third-party assessment or short walking tests [8,9]. Continuous monitoring or real-world walking assessment is rare in this patient population, but with modern sensor technologies (wearables), this is easy to implement and provides important information [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, reduced gait speed and step length are risk factors for future falls. [16] Thus, accelerometry appears to be a valuable tool for assessing mobility in elderly patients continuously [10,11,17].…”

Section: Introductionmentioning

confidence: 99%

Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients

Keppler

Holzschuh

Pfeufer

et al. 2021

Eur J Trauma Emerg Surg

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Background Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns. Methods Thirty-one orthogeriatric fracture patients [pertrochanteric femur fractures (PFF), femoral neck (FN), and proximal humerus fractures (PHF)] were consecutively enrolled in a maximum care hospital in a prospective study design. All patients wore an accelerometer placed at the waist during the postoperative stay (24 h/d) and at 6-week follow-up, to measure real gait speed and step length. In addition, self-assessment of mobility (Parker mobility score) and activities of daily living (Barthel index) were collected at baseline, during the inpatient stay, and at 6-week follow-up. Results During postoperative hospitalization, significantly higher gait speed (m/s) was observed in the PHF group (0.52 ± 0.27) compared with the FN group (0.36 ± 0.28) and PFF group (0.19 ± 0.28) (p < 0.05). Six weeks postoperatively, gait speed improved significantly in all groups (PHF 0.90 ± 0.41; FN 0.72 ± 0.13; PFF 0.60 ± 0.23). Similarly, step length (m) differed between groups postoperatively [FN 0.16 ± 0.13; PFF 0.12 ± 0.15; PHF 0.31 ± 0.05 (p < 0.005)] and improved over time significantly (FN 0.47 ± 0.01; 0.39 ± 0.19; 0.50 ± 0.18). Self-assessment scores indicate that the majority of the patients had minor restrictions in mobility before the fracture. These values decreased immediately postoperatively and improved in the first 6 weeks, but did not reach the initial level. Conclusions Gait speed, step length, and self-assessment in terms of mobility and activities of daily living improve significantly in the first 6 postoperative weeks in orthogeriatric fracture patients. As very low postoperative mobility during hospitalization was observed, this collective shows great potential in postoperative rehabilitation regardless of their fracture pattern. For this reason, specific aftercare concepts similar to the “fast track” concepts in primary arthroplasty are crucial for orthogeriatric patients in clinical practice. Level of evidence Prospective cohort study, 2.

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Challenges in Geriatric Patients with Fractures Around the Knee

Keppler¹,

Fleischhacker²,

Fürmetz³

et al. 2021

Knee Fractures

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Postoperative physical activity in orthogeriatric patients – new insights with continuous monitoring

Cited by 17 publications

References 30 publications

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

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

Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients

Challenges in Geriatric Patients with Fractures Around the Knee

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