title: Initial Experience With Real-Time Continuous Physical Activity Monitoring in Patients Undergoing Spine Surgery.
abstract: METHODS
  Multicenter prospective pilot study.
  
  
  OBJECTIVE
  To evaluate if continuous physical activity monitoring by a personal electronic 3-dimensional accelerometer device is feasible and can provide objective data that correlates with patient-reported outcomes following spine surgery.
  
  
  BACKGROUND
  Self-reported health-related quality-of-life (HRQOL) metrics are inherently limited by being very subjective, having a low frequency of data collection, and inconsistent follow-up.
  
  
  METHODS
  Inclusion criteria: adults (18+), thoracolumbar deformity or degenerative disease, and regular access to a computer with internet connection. Physical activity parameters included: number of daily steps, maximum hourly steps, and activity intensity. Patients completed the Oswestry Disability Index (ODI), the Short-Form Health Survey 36 (SF-36), and the Scoliosis Research Society-22r (SRS22) preoperatively and postoperatively at 6 weeks, 3 months, and 6 months.
  
  
  RESULTS
  Thirty-two patients were enrolled, 8 (25%) withdrew, 1 (3.1%) died, and 1 (3.1%) did not end up undergoing surgery resulting in 22 (68.8%) available patients. Mean preoperative and postoperative step ranges were 1278±767 to 17,800±6464 and 891±587 to 12,655±7038, respectively. Eleven patients improved in mean total daily steps at the final postoperative month with 2 having significant improvements (P<0.05). Five patients did not significantly change (P>0.05) and 6 patients had significantly lower mean total daily steps at 6 months (P<0.05). The entire cohort significantly improved in ODI, SF-36 Physical Component Summary, SRS Activity, SRS Appearance, SRS Mental, SRS Satisfaction, and SRS Total score at 6 months postoperative (P<0.05 for all). Both ODI and Physical Component Summary were significantly correlated with preoperative average total daily steps (r=-0.61, P=0.0058 and r=0.60, P=0.0114, respectively). No other HRQOL metrics were significantly correlated at baseline or at 6 months postoperative (P>0.05).
  
  
  CONCLUSIONS
  A prospective pilot study for continuous real-time physical activity monitoring was successfully completed. This is the first study of its kind and demonstrates a foundation to continuous physical activity monitoring following spine surgery. A larger and longer prospective study is needed to confirm long-term results and its relationship with HRQOL scores.
authors.affiliation: School of Medicine, University of California, San Diego, La Jolla.
authors.forename: Justin K
authors.initials: JK
authors.lastname: Scheer
authors.affiliation: Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles.
authors.forename: Joshua
authors.initials: J
authors.lastname: Bakhsheshian
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA.
authors.forename: Malla K
authors.initials: MK
authors.lastname: Keefe
authors.affiliation: Spine Service, Hospital for Special Surgery.
authors.forename: Virginie
authors.initials: V
authors.lastname: Lafage
authors.affiliation: Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
authors.forename: Shay
authors.initials: S
authors.lastname: Bess
authors.affiliation: Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
authors.forename: Themistocles S
authors.initials: TS
authors.lastname: Protopsaltis
authors.affiliation: Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, KS.
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Burton
authors.affiliation: Department of Orthopaedic Surgery, Oregon Health & Science University, Portland, OR.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hart
authors.affiliation: Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA.
authors.forename: Christopher I
authors.initials: CI
authors.lastname: Shaffrey
authors.affiliation: Spine Service, Hospital for Special Surgery.
authors.forename: Frank
authors.initials: F
authors.lastname: Schwab
authors.affiliation: Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA.
authors.forename: Justin S
authors.initials: JS
authors.lastname: Smith
authors.affiliation: Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL.
authors.forename: Zachary A
authors.initials: ZA
authors.lastname: Smith
authors.affiliation: Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL.
authors.forename: Tyler R
authors.initials: TR
authors.lastname: Koski
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Ames
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D017558:Elective Surgical Procedures / Q000379:methods*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D013122:Spinal Diseases / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D013997:Time Factors; D055815:Young Adult