The Hospital to Home study (H2H): smartwatch technology-enabled rehabilitation following hip fracture in older adults, a feasibility non-randomised trial

Abstract

Hip fractures are associated with significant morbidity and mortality. This study assessed the feasibility of smartwatches supporting rehabilitation post-surgical fixation. MethodsThis UK-based non-randomised intervention study recruited patients who had sustained a hip fracture (age ≥65 and Abbreviated Mental Test Score ≥8/10), following surgical fixation, at one hospital to the intervention group, and at a second hospital to a usual care group. The intervention group received a smartwatch (Fitbit Charge 4) and app (CUSH Health © ). Feasibility measures included retention and completion of outcome measures. ResultsBetween November 2020 and November 21, 66 participants were recruited (median age 78 (IQR 74-84)). The intervention cohort were younger, with no significant differences in frailty or multi-morbidity between the cohorts. Hospital stay was shorter in the intervention cohort (10 days (7-16) versus 12 (10-18), p=0.05). There were 15 falls-related readmissions in the control cohort, including 11 fractures, with none in the intervention cohort (p=0.016). In the intervention group, median daily step counts increased from 477 (320-697) in hospital, to 931 (505-1238) 1 week post-discharge, to 5,352 (3,552-7,944) at 12-weeks (p=0.001). Of the intervention cohort, 12 withdrew.

Smartwatches in healthcare medicine: assistance and monitoring; a scoping review

“…Disease detection using wearable devices offers many advantages over traditional testing methods, such as no testing infrastructure, materials or personnel, passive testing and high-resolution continuous screening to allow follow-up testing and self-isolation. Although smartwatches are increasing and digital technology was widespread during the COVID-19 pandemic, few studies have used smartwatches for rehabilitation, empowerment or patient engagement in rehabilitation [ 57 , 77 ]. Moreover, the smartwatch can track heart rate and identify any abnormalities, which could serve as an initial indication of potential cardiovascular issues [ 10 , 66 ].…”