Feasibility of collecting objective data and exploring patient's experiences on physical activity in persistent spinal pain syndrome type 2 patients receiving spinal cord stimulation: A mixed feasibility study.

Abstract

Background: Patients with chronic pain due to persistent spinal pain syndrome Type 2 (PSPS Type 2) experience daily limitations in their physical activities. Physical, emotional, and social well-being changes are usually measured with standardized, validated self-reporting questionnaires. These reported data are subjective and are answered at a particular moment, which may not accurately reflect the patient's overall condition. Moreover, questionnaires could be misinterpreted, leading to potential inaccuracies in the reported data. This highlights the need for objective measurement tools that report longitudinal real-life data, which could be helpful in evaluating physical activity in spinal cord stimulation (SCS). However, objective measurement tools in SCS therapy are scarce.

Objective: We aimed to investigate the feasibility of collecting objective data from an activity tracker and a neurostimulator device to evaluate physical activity. As this is a feasibility study, we also aimed to evaluate the experiences of participating patients and healthcare professionals to explore the viability and practicality of future studies.

Methods: We performed a mixed-methods feasibility study with quantitative and qualitative data collection. Alongside the standardized questionnaires, we collected objective data on different bodily functions as measured by the activity tracker and on different body positions as measured with the neurostimulator device, starting 1 month before the trial spinal cord stimulation and with a follow-up of 3 months. Additionally, we performed face-to-face, in-depth interviews exploring patients' experiences of physical activity using the six dimensions of the diagram of positive health as a topic list. At the end of the study, patients and participating healthcare professionals were asked to evaluate their experiences on a five-point Likert scale expressing satisfaction. The study was performed in two Dutch hospitals.

Results: We included 20 patients with PSPS Type 2, of whom 17 (85%) completed the three-month follow-up with a nearly complete personalized real-time data set. Most of the missing data was due to the wear of the watch. One patient developed an allergic reaction to the watch strap. According to the interviews, patients mentioned feeling motivated to be physically active by wearing an activity tracker. The evaluation form showed that 84% of the patients and 75% of the healthcare professionals were very satisfied and would participate in a study with a similar design. The activity tracker remotely collected objective data on physical activity at baseline, trial, and three-month follow-up.

Conclusion: Collecting objective data on physical activities and health status of PSPS Type 2 patients receiving SCS appeared feasible with a neuromodulation device and an activity tracker if the watch was correctly worn on the wrist or with clear instructions. The personalized data could add value to the standardized questionnaires evaluating holistic SCS outcomes. Participating patients and healthcare professionals supported a future prospective study with objective measurement tools in a similar design.