Wearable health technology finds improvements in daily physical activity levels following total knee arthroplasty: A prospective study

IF 5 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-04-13 DOI:10.1002/ksa.12675

Kevin A. Wu, David N. Kugelman, Rahul K. Goel, Eric S. Dilbone, Devika Shenoy, Sean P. Ryan, Samuel S. Wellman, Michael P. Bolognesi, Thorsten M. Seyler

{"title":"Wearable health technology finds improvements in daily physical activity levels following total knee arthroplasty: A prospective study","authors":"Kevin A. Wu, David N. Kugelman, Rahul K. Goel, Eric S. Dilbone, Devika Shenoy, Sean P. Ryan, Samuel S. Wellman, Michael P. Bolognesi, Thorsten M. Seyler","doi":"10.1002/ksa.12675","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Wearable technologies, like the Apple Watch, offer new possibilities for collecting objective data on physical activity post-operatively following total knee arthroplasty (TKA). This study aims to describe changes in daily physical activity levels using objective metrics over different time points following TKA.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This study analyzed data from a prospective cohort of 152 patients undergoing a unilateral TKA. Patients wore an Apple Watch and used a digital care management application for data collection. Step count, steadiness, standing duration, gait speed and performance on a 6-min walk test were collected from Apple HealthKit at multiple time points: pre-operative, 6 weeks post-operatively, 6 months post-operatively and 12 months post-operatively. Statistical analyses were performed using R software, including descriptive statistics and paired <i>t</i> tests to compare outcomes at different time points post-operatively.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Participants demonstrated significant improvements in daily physical activity levels over the course of 12 months post-operative. At 6 months post-operative, participants showed the highest average daily step count (mean ± SD: 5293 ± 236 steps; <i>p</i> < 0.001), with improvements persisting at 12 months post-operative (5180 ± 260 steps; <i>p</i> < 0.001) compared to preoperative values. Gait speed increased from 0.88 ± 0.01 m/s preoperatively to 1.01 ± 0.01 m/s (<i>p</i> = 0.006) at 12 months post-operative. Standing hours increased from 9.99 ± 0.30 to 11.47 ± 0.31 h at 6 months post-operative and persisted. Steadiness and the estimated 6-minute walk test showed recovery trends, though variability remained at 12 months post-operative, suggesting the need for additional longitudinal assessment</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This study provides one of the first longitudinal analyses of post-operative functional recovery using Apple HealthKit, offering continuous real-world gait and activity tracking beyond traditional patient-reported measures. These findings highlight the value of wearable technology in monitoring post-operative activity and offering insights into TKA recovery patterns. The study suggests a critical recovery window at 6 months post-operative and emphasizes the need for ongoing support to maintain improvements. The integration of wearable technology in post-operative monitoring offers a promising approach to tracking patient progress and optimizing functional outcomes following TKA.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level II.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 9","pages":"3218-3227"},"PeriodicalIF":5.0000,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12675","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Wearable technologies, like the Apple Watch, offer new possibilities for collecting objective data on physical activity post-operatively following total knee arthroplasty (TKA). This study aims to describe changes in daily physical activity levels using objective metrics over different time points following TKA.

Methods

This study analyzed data from a prospective cohort of 152 patients undergoing a unilateral TKA. Patients wore an Apple Watch and used a digital care management application for data collection. Step count, steadiness, standing duration, gait speed and performance on a 6-min walk test were collected from Apple HealthKit at multiple time points: pre-operative, 6 weeks post-operatively, 6 months post-operatively and 12 months post-operatively. Statistical analyses were performed using R software, including descriptive statistics and paired t tests to compare outcomes at different time points post-operatively.

Results

Participants demonstrated significant improvements in daily physical activity levels over the course of 12 months post-operative. At 6 months post-operative, participants showed the highest average daily step count (mean ± SD: 5293 ± 236 steps; p < 0.001), with improvements persisting at 12 months post-operative (5180 ± 260 steps; p < 0.001) compared to preoperative values. Gait speed increased from 0.88 ± 0.01 m/s preoperatively to 1.01 ± 0.01 m/s (p = 0.006) at 12 months post-operative. Standing hours increased from 9.99 ± 0.30 to 11.47 ± 0.31 h at 6 months post-operative and persisted. Steadiness and the estimated 6-minute walk test showed recovery trends, though variability remained at 12 months post-operative, suggesting the need for additional longitudinal assessment

Conclusion

This study provides one of the first longitudinal analyses of post-operative functional recovery using Apple HealthKit, offering continuous real-world gait and activity tracking beyond traditional patient-reported measures. These findings highlight the value of wearable technology in monitoring post-operative activity and offering insights into TKA recovery patterns. The study suggests a critical recovery window at 6 months post-operative and emphasizes the need for ongoing support to maintain improvements. The integration of wearable technology in post-operative monitoring offers a promising approach to tracking patient progress and optimizing functional outcomes following TKA.

Level of Evidence

Level II.

Abstract Image

查看原文本刊更多论文

可穿戴健康技术发现全膝关节置换术后日常身体活动水平的改善：一项前瞻性研究。

目的：可穿戴技术，如Apple Watch，为全膝关节置换术（TKA）术后身体活动的客观数据收集提供了新的可能性。本研究旨在描述在TKA后不同时间点使用客观指标的日常身体活动水平的变化。方法：本研究分析了152例单侧TKA患者的前瞻性队列数据。患者佩戴苹果手表，并使用数字护理管理应用程序收集数据。在多个时间点（术前、术后6周、术后6个月和术后12个月）通过Apple HealthKit收集步数、稳定性、站立时间、步态速度和6分钟步行测试的表现。采用R软件进行统计学分析，包括描述性统计和配对t检验，比较术后不同时间点的结果。结果：在术后12个月的过程中，参与者的日常体力活动水平有了显著改善。术后6个月，参与者平均每日步数最高(mean±SD: 5293±236步；p证据等级：二级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).