Iandoli J
CCOM, Woodridge, Illinois, United states
The use of wearable devices to give real-time, objective patient data is an increasing area of interest in the medical field. The Actigraph is a premier patient worn sensor used to track activity in biomechanical testing. Likewise, the Delsys wireless EMG system can be used to provide accurate kinetic and electromyographic data in the extremities of subjects. The purpose of this study was to utilize Actigraph and Delsys technology as an adjunct to patient reported outcomes to provide objective post operative data on activity, and range of motion following shoulder arthroplasty.
Patients undergoing anatomic or reverse total shoulder arthroplasty were prospectively enrolled. At preoperative, 6-, 12-, and 24-week appointments, they were asked to complete SANE scores, UCLA, WOSI, and ASES. At each visit the examiner also took the patient through a number of shoulder range of motion tasks utilizing the Delsys EMG system at each visit. These tasks were shoulder Forward Flexion with Resistance, Passive Forward Flexion, Active and Passive Abduction, Active and Passive Internal Rotation at both 90 degrees and 0 degrees of Abduction, and Active and Passive External Rotation at both 90 degrees and 0 degrees of Abduction. Each patient was also instructed to wear the Actigraph sensor on his/her arm (mid-bicep) or forearm for the next 24 hours, except while sleeping and showering, after each session to measure limb activity.
A total of 66 patients (37 anatomic, 29 reverse) were included, average age was 68.3 years. Significant improvement occurred across all patient reported outcomes at each follow up visit (p<0.05). There were no significant differences noted in Actigraph activity levels at any time point. Preliminary Delsys EMG analysis provided objective data identifying true range of motion, muscle recruitment patterns, acceleration and velocity in the operative extremity, with preliminary correlation to Patient Recorded Outcome Measures.
Delsys technology can provide objective clinical data in addition to patient reported outcomes to aid in the post operative evaluation of patients following anatomic and reverse total shoulder arthroplasty. Early data also suggests it may be used to identify muscle recruitment patterns and other objective biomechanical data that may help direct patient specific rehab, and predict operation success. Longer duration of time periods may need to be utilized to fully capture patient activities at each time point using Actigraph technology.
