Postoperative mobility monitoring effective in elderly patients

Tools

Wireless monitoring of mobility after major surgery "creates an opportunity for early identification and intervention in individual patients and could serve as a tool to evaluate and improve the process of care and to affect post-discharge outcomes," concludes an article in The Annals of Thoracic Surgery. The study results demonstrate that the technology can be a cost-effective tool to monitor activity levels of elderly cardiac patients recovering from surgery.

"Hospitalization and surgery in older patients often leads to a loss of strength, mobility, and functional capacity," the article authors write. "We tested the hypothesis that wireless accelerometry could be used to measure mobility during hospital recovery after cardiac surgery."

The Mayo Clinic study of 149 elderly patients evaluated the Fitbit activity tracking monitor to measure daily mobility in patients after surgery. There was a direct correlation between the level of post-discharge health and patient levels of mobility after surgery. In order to assess their performance, data were transmitted wirelessly, aggregated, and configured onto a provider-viewable dashboard.

Fitbit monitors were placed on ankles of each patient following discharge from the intensive care unit and monitored the total number of steps taken each day by patients following elective heart surgery (coronary artery bypass grafting, valve repair or replacement, or both). Study patients were older than age 50, lived at home, were ambulatory prior to surgery, and were expected to be hospitalized for 5-7 days following surgery.

"Wireless monitoring of mobility after major surgery was easy and practical," according to the article. "There was a significant relationship between the number of steps taken in the early recovery period, length of stay, and dismissal disposition."

The study's lead author, David J. Cook, MD, from the Mayo Clinic, noted in an announcement that while the results were not unexpected, they are unique because they represent the first demonstration that remote monitoring of mobility is effective in assessing hospital surgical recovery, and such data have implications for resource utilization and outcomes.

In an accompanying commentary in the same issue of The Annals of Thoracic Surgey, physicians from the University of Pennsylvania Perelman School of Medicine in Philadelphia discussed the benefits of wireless monitoring and its impact on resource utilization and heath care costs.

"The application of wireless accelerometry to quantify physical activity has the potential to extend the capabilities of the physical therapy team, measure the effectiveness of rehabilitation regimens, quantify progress and improve the ability to predict operative risk," said Dr. Cheung. "The investigators have shown that creative application of sophisticated but affordable miniature electronic devices has the potential to advance the care of hospitalized patients." 

Two Wake Forest University colleagues have developed an iPad app, the Mobility Assessment Tool (MAT), that helps senior patients describe more accurately how often they move and what problems they have with mobility. The app takes about four minutes to complete, and shows seniors short videos of animated figures climbing stairs or walking while carrying an object. 

The user then touches the screen to indicate which tasks they can or can't accomplish. The product's creators say MAT works better than online videos because the patient can more easily see themselves attempting the tasks.

To learn more:
- read the article abstract
- read the announcement

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