Effects of physical activity interventions using wearables to improve objectively-measured and patient-reported outcomes in adults following orthopaedic surgical procedures: A systematic review

• Published in: PloS one Vol. 17; no. 2; p. e0263562
• Main Authors: Master, Hiral, Bley, Jordan A, Coronado, Rogelio A, Robinette, Payton E, White, Daniel K, Pennings, Jacquelyn S, Archer, Kristin R
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 15-02-2022; Public Library of Science (PLoS)
• Subjects: Adults; Arthritis; Arthroplasty (hip); Arthroplasty (knee); Biology and Life Sciences; Chronic illnesses; Clinical outcomes; Clinical trials; Exercise; Exercise - physiology; Health aspects; Humans; Incentives; Intervention; Intervertebral discs; Joint surgery; Knee; Medicine and Health Sciences; Orthopaedic implants; Orthopedic Procedures - classification; Orthopedic Procedures - rehabilitation; Orthopedic surgery; Orthopedics; Pain; Patient outcomes; Patient Reported Outcome Measures; Patients; Physical activity; Physical therapy; Psychological stress; Quality of life; Randomized Controlled Trials as Topic; Rehabilitation; Research and Analysis Methods; Surgery; Systematic review; Wearable Electronic Devices; Wearable technology; United States; United States > US; Tennessee; Nashville Tennessee
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0263562

To synthesize evidence on physical activity interventions that used wearables, either alone or in combination with education or rehabilitation, in adults following orthopaedic surgical procedures.
PubMed, CINAHL, PsycINFO and EMBASE were searched for randomized controlled trials of wearable-based interventions from each database's inception to August 2021 in patients undergoing orthopaedic surgery. Relevant outcomes included physical activity, physical function, pain, psychological distress, or general health. PEDro scale scoring ranges from 0 to 10 and was used to appraise studies as high (≥7), moderate (5-6), or poor (<5) quality.
Of 335 articles identified, 6 articles met eligibility criteria. PEDro scores ranged from 2 to 6, with 3 studies of moderate quality and 3 of poor quality. Studies included patients undergoing total knee (number; n = 4) or total knee or hip (n = 1) arthroplasty and lumbar disc herniation surgery (n = 1). In addition to wearables, intervention components included step diary (n = 2), motivational interviewing (n = 1), goal setting (n = 2), tailored exercise program (n = 2), or financial incentives (n = 1). Interventions were delivered in-person (n = 2), remotely (n = 3) or in a hybrid format (n = 1). Intervention duration ranged from 6 weeks to 6 months. Compared to controls, 3 moderate quality studies reported greater improvement in steps/day; however, 1 moderate and 2 poor quality studies showed no between-group difference in physical function, pain, or quality of life. No serious adverse events related to the use of wearable were reported.
The effects of physical activity interventions using wearables, either delivered in-person or remotely, appear promising for increasing steps per day after joint arthroplasty; however, this finding should be viewed with caution since it is based on 3 moderate quality studies. Further research is needed to determine the therapeutic effects of using wearables as an intervention component in patients undergoing other orthopaedic surgical procedures.
PROSPERO Registration Number: CRD42020186103.