Background/Purpose:

The incidence of total hip and knee arthroplasties has risen over the past decade and by 2030, the demand of these arthroplasties is estimated to increase by 137% and 601%, respectively. Early ambulation is critical for timely recovery of functional independence. However, not all patients have access to rehabilitation due to lack of money, transportation, and/or time. Accelerometer has been validated in analyzing gait and physical activities among patients with arthritis. We assessed the feasibility of a wireless system that remotely monitors patient’s physical activities, functional status, and pain among patients with hip or knee arthritis. This information can then provide feedback to patients to facilitate their post-operative rehabilitation regimen.

Methods:

Patients with hip or knee arthritis who had internet access were asked to complete web-based patient-derived questionnaires and wear the SenseWear^® armband (SWA) for 14 day except during sleep and shower. SWA collects heat flux, Galvanic Skin Response (GSR), 3-axis accelerometer, and skin temperature. Data on demographics (age, sex, highest level of education, marital status, and yearly household income) and baseline functional status using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were obtained. The web-based questionnaire comprised of WOMAC, visual analog scale (VAS) for pain, and self-reported duration of daily exercise. The web-based questionnaire was developed using a HIPAA compliant commercial survey tool called SurveyGizmo (www.surveygizmo.com).

Results:

Convenient sample of 14 patients were recruited with 9 patients (64%) completing the study. The 2 most common reasons for incompletion were difficulty downloading the SWA software and inconvenience of wearing daily SWA. The majority of the completers were Caucasians (56%) and female (89%) with a mean age and body mass index (BMI) of 52.4 ± 12.3 years and 37.5 ± 9.2, respectively. Education level ranged from junior high to post-graduate levels with 77% having completed at least college. Majority (77%) had annual household income ≤ $40,000. Non-completers were older (70.0 ± 10.9 years) with lower BMI (29.5 ± 5.7). The majority of patients had significant arthritis with baseline VAS pain of 56.7 + 26.9 and WOMAC of 48.7 (out of 97). The paper- and web-based WOMAC score correlated well with intraclass coefficient (ICC) of 0.885 (p=0.0015). Patients wore SWA for mean 12hrs 25min daily with mean duration of exercise >3MET for 40min daily. The mean self-reported duration of exercise was higher than actual duration measured by SWA (94min vs 40min). There was no correlation between the level of pain and the duration of SWA-measured exercise.

Conclusion:

As patients tend to overestimate their levels of physical activity, a wireless activity-monitoring tool such as SWA serves as a valuable tool to better assess the level of physical activity. This study demonstrated the feasibility of our activity and functional status monitoring system, which can be used to facilitate earlier return to independence after joint arthroplasties by providing a means to assist patients with home-based rehabilitation program.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/feasibility-of-remote-activity-and-functional-status-monitoring-of-patients-with-hip-or-knee-pain/