The feasibility of using wearable activity trackers during rehabilitation

Participants in an inpatient Virtual Rehabilitation Ward (VRW) and an outpatient Falls, Fracture, Frailty Intervention Team (FIT) program will be provided with wearable activity trackers (WATs) and will receive information and guidance on goal setting, activity feedback, and self-monitoring by trained clinicians. This will be conducted within patients’ usual clinical appointments. • Physical activity monitoring will last for the duration of the participants’ admission. We anticipate this will be 2-4 weeks in the VRW, and approx. 6 weeks in the FIT program, the typical admission duration for each service. • The WATs will be used for two main purposes : promoting patient activity during rehabilitation, and measuring patient activity for data collection. Activity promotion will target walking, which will involve goal setting based on daily step counts, patient self-monitoring via the device interface and application, and feedback on progress based on daily step counts. • Exercise Physiologists (EPs) and Physiotherapists (PTs) working in each service will lead protocol delivery, including initial assessments and goal-setting based on WAT metrics. Goals will include a daily step goal that is gradually progressed over the course of the admission. • Participating patients will track their daily steps, and EPs/PTs will adjust goals, provide encouragement and support for patients, and troubleshoot as needed. • Setting and reviewing goals will occur during every therapy session with the EPs/PTs (approx. 3x weekly). Activity feedback and self-monitoring will occur daily and throughout the day as the patient's use WATs to track and work toward their daily step goals. • Patients will be asked to wear WATs during waking and sleep hours. The WATs are water resistant and can be worn during bathing. Patients will be able to remove WATs while sleeping or bathing for comfort if they prefer, or if required for any other necessary purpose (i.e. if it needs to be removed to take another health measure). Patients will be asked to wear WATs for a minimum of 12 waking hours, but encouraged to wear for more to capture more step counts. • When participating patients complete their final assessment with EPs/PTs, their activity progress as measured by the WAT over the course of their admission will be reviewed. • When participants are discharged, VRW patients will return their WATs to the hospital in the VRW home monitoring kits, and FIT patients will return their WAT to the hospital during their final assessment. Returned WATs will be cleaned, and patient physical activity data will be exported from devices by the researcher. • If WAT devices are not returned when participating patients are discharged, the participant will be phoned by the researchers or an allied health assistant to arrange return (e.g. patient to bring to hospital, or arrange reply-paid postage). • The lead researcher will set up and manage accounts for participants required for monitoring, and will also be available to meet with clinicians throughout the implementation period to provide additional support and troubleshooting of any issues that may arise. • While patients will receive exercise programs as part of their standard rehabilitation, this intervention is additional to exercise programs prescribed as part of standard rehabilitation and the intervention will not involve additional exercise prescription other than walking. The exercise programs that patients are prescribed as part of usual rehabilitation will vary depending on their presentation, but will typically include exercises such as sit to stands, ankle dorsiflexion and plantarflexion, bicep curls, seated row, lateral raises.