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Combining wearable technology and telehealth counseling for rehabilitation after lumbar spine surgery: feasibility and acceptability of a physical activity intervention [with consumer summary]
Master H, Coronado RA, Whitaker S, Block S, Vanston SW, Pennings JS, Gupta R, Robinette P, Stephens B, Abtahi A, Schwarz J, Archer KR
PTJ: Physical Therapy & Rehabilitation Journal 2024 Feb;104(2):pzad096
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The purpose of this study was to examine the feasibility and acceptability of a wearable device and telehealth counseling physical activity intervention early after lumbar spine surgery. METHODS: Sixteen patients were randomized to an 8-session physical activity intervention or to usual postoperative care after surgery. The intervention included a wearable device (ie, Fitbit) and telehealth counseling by a licensed physical therapist. Feasibility of study procedures was assessed through recruitment, randomization, retention, and participation rates. Acceptability was assessed through a satisfaction survey and median within-participant change in objective physical activity (steps per day and time spent in moderate-to-vigorous physical activity) and patient-reported outcomes. RESULTS: Of 64 participants who were eligible, recruitment and randomization rates were 41% and 62%, respectively. Retention for objective physical activity and patient-reported outcomes was 94% and 100%, respectively, at 6-month follow-up. Seven (88%) participants in the intervention group completed all telehealth sessions and 6 (75%) met step goals over the 8 sessions. All participants in the intervention group found the wearable device and telehealth counseling to be helpful and reported it much or somewhat more important than other postoperative services. Median within-participant change for steps per day improved from baseline (preoperative) to 6 months after surgery for both the intervention (1070) and usual care (679) groups, while moderate-to-vigorous physical activity only improved for the intervention group (2.2. minutes per day). Improvements in back and leg pain and disability were noted for both groups. No adverse events were reported in the study. CONCLUSIONS: Combining wearable technology and telehealth counseling is a feasible approach to promote physical activity during the early postoperative period after spine surgery. Future randomized controlled trials are needed to investigate the efficacy of leveraging wearables and telehealth during postoperative rehabilitation. TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT04591249.

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