Initial Experience with Real-Time Continuous Physical Activity Monitoring in Patients Undergoing Spine Surgery

Justin K. Scheer*, Joshua Bakhsheshian, Malla K. Keefe, Virginie Lafage, Shay Bess, Themistocles S. Protopsaltis, Douglas C. Burton, Robert A. Hart, Christopher I. Shaffrey, Frank Schwab, Justin S. Smith, Zachary A. Smith, Tyler R. Koski, Christopher P. Ames

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Study Design: Multicenter prospective pilot study. Objective: To evaluate if continuous physical activity monitoring by a personal electronic 3-dimensional accelerometer device is feasible and can provide objective data that correlates with patient-reported outcomes following spine surgery. Summary of Background Data: Self-reported health-related quality-of-life (HRQOL) metrics are inherently limited by being very subjective, having a low frequency of data collection, and inconsistent follow-up. Methods: Inclusion criteria: adults (18+), thoracolumbar deformity or degenerative disease, and regular access to a computer with internet connection. Physical activity parameters included: number of daily steps, maximum hourly steps, and activity intensity. Patients completed the Oswestry Disability Index (ODI), the Short-Form Health Survey 36 (SF-36), and the Scoliosis Research Society-22r (SRS22) preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. Results: Thirty-two patients were enrolled, 8 (25%) withdrew, 1 (3.1%) died, and 1 (3.1%) did not end up undergoing surgery resulting in 22 (68.8%) available patients. Mean preoperative and postoperative step ranges were 1278±767 to 17,800±6464 and 891±587 to 12,655±7038, respectively. Eleven patients improved in mean total daily steps at the final postoperative month with 2 having significant improvements (P<0.05). Five patients did not significantly change (P>0.05) and 6 patients had significantly lower mean total daily steps at 6 months (P<0.05). The entire cohort significantly improved in ODI, SF-36 Physical Component Summary, SRS Activity, SRS Appearance, SRS Mental, SRS Satisfaction, and SRS Total score at 6 months postoperative (P<0.05 for all). Both ODI and Physical Component Summary were significantly correlated with preoperative average total daily steps (r=-0.61, P=0.0058 and r=0.60, P=0.0114, respectively). No other HRQOL metrics were significantly correlated at baseline or at 6 months postoperative (P>0.05). Conclusions: A prospective pilot study for continuous real-time physical activity monitoring was successfully completed. This is the first study of its kind and demonstrates a foundation to continuous physical activity monitoring following spine surgery. A larger and longer prospective study is needed to confirm long-term results and its relationship with HRQOL scores.

Original languageEnglish (US)
Pages (from-to)E1434-E1443
JournalClinical spine surgery
Issue number10
StatePublished - 2017


  • Fitbit
  • accelerometer
  • activity monitoring
  • adult spinal deformity
  • continuous physical monitoring
  • degenerative
  • outcomes
  • physical activity
  • spine
  • spine surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Orthopedics and Sports Medicine


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