Patient‐centred measurement of recovery from day‐case surgery using wrist worn accelerometers: a pilot and feasibility study*

Abstract

This pilot and feasibility study evaluated wrist-worn accelerometers to measure recovery from day-case surgery in comparison with daily quality of recovery-15 scores. The protocol was designed with extensive patient and public involvement and engagement, and delivered by a research network of anaesthesia trainees. Forty-eight patients recruited through pre-operative assessment clinics wore wrist accelerometers for 7 days before (pre-operative) and immediately after elective surgery (early postoperative), and again at 3 months (late postoperative). Validated activity and quality of recovery questionnaires were administered. Raw accelerometry data were archived and analysed using open source software. The mean (SD) number of valid days of accelerometer wear per participant in the pre-operative, early and late postoperative periods were 5.4 (1.7), 6.6 (1.1) and 6.6 (1.0) days, respectively. On the day after surgery, Euclidian norm minus one (a summary measure of raw accelerations), step count, light physical activity and moderate/vigorous physical activity decreased to 57%, 47%, 59% and 35% of baseline values, respectively. Activity increased progressively on a daily basis but had not returned to baseline values by 7 days. Patient questionnaires suggested subjective recovery by postoperative day 3 to 4; however, accelerometry data showed that activity levels had not returned to baseline at this point. All activity measures had returned to baseline by 3 months. Wrist-worn accelerometery is acceptable to patients and feasible as a surrogate measure for monitoring postoperative recovery from day-case surgery. Our results suggest that patients may overestimate their rate of recovery from day-case surgery, which has important implications for future research.

Financial and Clinical Impact of Virtual Care During the COVID-19 Pandemic: Difference-in-Differences Analysis

“…Adherence to wearables has typically been reported as the total number of days patients wore a device, rather than the consistency of wear during those days. In both postoperative and clinical trial contexts, median length of engagement has been reported at around 5 days [ 23 , 24 ]. It was notable that patients less adherent to the wearable were more likely to require escalation to physical care.…”

Designing compact features for remote stroke rehabilitation monitoring using wearable accelerometers

“…which are normally subjective and expensive, the automated systems may provide an objective, low-cost alternative, which can also be used for continuous monitoring/assessment. Some automated systems are developed to assess the behaviours of diseases such as Parkinson's disease (zia ur et al 2019;Hammerla et al 2015), autism (Ploetz et al 2012), depression (Little et al 2020); or to monitor the health status such as sleep (Zhai et al 2020;Supratak et al 2017), fatigue (Bai et al 2020;Ibrahim et al 2020), or recover-level from surgery (Ratcliffe et al 2020;Gurchiek et al 2019), etc. After collecting behaviour or physiological signals (e.g., accelerometers, ECG, audio, etc.…”

How to plan, do and report patient and public involvement in research

“…A recent example of this approach was reported in the study by Ratcliffe et al. of recovery from surgery, where data were obtained using wrist‐worn accelerometers [12]. A PPI group was surveyed to determine the preferred type of accelerometer device, as well as the acceptability of study contacts and likely familiarity with similar technologies.…”

“…This is arguably of particular importance for clinical research in anaesthesia, critical care and perioperative medicine which all take place around the time of major life events for patients. A recent example of this approach was reported in the study by Ratcliffe et al of recovery from surgery, where data were obtained using wrist-worn accelerometers [12]. A PPI group was surveyed to determine the preferred type of accelerometer device, as well as the acceptability of study contacts and likely familiarity with similar technologies.…”