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Die postoperative Mobilisation nach Hüfttotalendoprothesenimplantation

Messung mittels Fitbit-Tracker

Postoperative mobilization after total hip arthroplasty

Measured by Fitbit activity trackers

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Zusammenfassung

Hintergrund

Patienten werden immer autonomer und selbstbestimmter, zusätzlich wird die postoperative Hospitalisation immer kürzer. Deshalb ist es umso wichtiger, die Patienten aktiv in die Nachbehandlung einzubeziehen. Es stellt sich die Frage, ob man die postoperative Rehabilitation mit modernen Devices unterstützen oder verbessern kann.

Methodik

Im Rahmen einer prospektiven Studie wurden zwischen Mai 2016 und August 2017 bei 100 Patienten, welche eine elektive Hüfttotalprothese erhalten haben, die postoperative Mobilisation mittels Activitiy-Tracker (Fitbit Charge HR™) aufgezeichnet und analysiert. Eingeschlossen wurden 50 Männer (Ø 70,6 Jahre) und 50 Frauen (Ø 71,1 Jahre). Sämtliche Patienten wurden mittels Röttinger-Zugang versorgt. Des Weiteren wurden die Patienten bei Abgabe des Armbandes über dessen Akzeptanz befragt.

Ergebnisse

Die durchschnittliche Hospitalisationsdauer war 7,98 (SD ± 1,76) Tage. Die Schrittanzahl betrug am ersten postoperativen Tag 712 (SD ± 617). Im Durchschnitt wurden täglich 1528 (SD ± 1076) absolviert. Vor dem Austrittstag betrug die mittlere Schrittzahl 2165 (SD ± 1570). Bezüglich Alter (m 70,6 Jahre vs. w 71,1 Jahre) und präoperativem „Harris Hip Score“ (m 55,3 vs. w 53,9) zeigten sich keine geschlechtsspezifischen Unterschiede. Ein statistisch signifikantes Ergebnis findet sich jedoch bei der Anzahl der Schritte vor dem Austrittstag, hier legten die Männer 2483 Schritte und die Frauen 1864 Schritte zurück (p = 0,04). Mit einem p-Wert von 0,06 war der Unterschied der durchschnittlichen Schrittanzahl pro Tag zwischen den Geschlechtern (m 1734 vs. w 1322) knapp nicht signifikant. 42 % der Patienten besitzen ein Smartphone, 52 % haben den Activity-Tracker als Motivation empfunden. 14 % haben die Daten am Armband nie oder nur ein Mal pro Tag abgefragt, 65 % zwischen 2‑ und 4‑mal pro Tag und 21 % haben >5-mal pro Tag die Daten abgerufen.

Schlussfolgerung

Durchschnittlich wurden täglich 1528 Schritte durchgeführt. Im Vergleich Männer und Frauen, legten die Männer nur am Tag vor dem Austritt signifikant mehr Schritte zurück. Männer waren signifikant kürzer im Krankenhaus als Frauen. Je jünger die Patienten waren, desto mehr haben sie sich fortbewegt. Ein Großteil der Patienten steht neuen Technologien/Devices offen gegenüber. Dieses Interesse sollte in Zukunft bewusst für die Nachbehandlung genutzt werden.

Abstract

Background

Patients are becoming increasingly more independent and self-determined, in addition to having shorter post-operative hospitalization. This is why it is more important than ever to actively involve patients in the follow-up treatment. The question arises as to whether post-operative rehabilitation can be improved with modern devices.

Methods

As part of a prospective study, the post-operative mobilization was recorded and analyzed by Fitbit®-activity-trackers between 05/2016 and 08/2017 in 100 patients who received a THA. 50 men (Ø 70.6y) and 50 women (Ø 71.1y) were included. Furthermore, the patients were interviewed about their acceptance of the Fitbit®-wristband.

Results

The average hospital stay was 7.98 days (SD ± 1.76). The number of steps on the first post-operative day was 712 (SD ± 617). On average (during total hospitalization), 1528 (SD ± 1076) steps were completed daily. One day before discharge, the average number of steps was 2165 (SD ± 1570) on that particular day. There were no gender differences in age and pre-operative Harris hip scores (♂55.3 vs. ♀53.9). Also, there were no statistically significant differences in the number of steps on the first postoperative day (♂745 vs. ♀678). A statistically significant result can be found in the number of steps prior to discharge: on this day, the men took 2483 and the women 1846 steps (p = 0.04). 42% of our patients own a modern smartphone and are able to operate software applications. 52% of the patients found the activity tracker to be motivating, 65% were open to new technologies (e.g. activity trackers) in the hospital. 14% did not check at all or only queried their wristband data once a day, 65% queried 2–4 times/day, and 21% retrieved the data >5 times/day.

Discussion

On average, 1528 steps were completed daily. In a comparison of the men and women, the men were only able to demonstrate significantly more steps than the women on the day prior to discharge. The men had significantly shorter hospital stays than the women. The younger the patients, the more mobile they were. A majority of patients are familiar with and/or interested in new technologies. This interest and curiosity should be consciously used for integration in the post-operative treatment.

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Abbreviations

ANOVA:

„Analysis of variance“

ASA :

American Society of Anaesthesiologists

HHS :

„Harris Hip Score“

HTEP :

Hüftgelenkstotalendoprothese

SD :

Standardabweichung

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Authors and Affiliations

  1. Orthopädie und Traumatologie, Kantonsspital Münsterlingen, Münsterlingen, Schweiz

    Michael Doppelbauer, Michael Schüler & Daniel Sauter

  2. Beckenmoosstraße 6, 8586, Riedt bei Erlen, Schweiz

    Michael Doppelbauer

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  1. Michael Doppelbauer
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Correspondence to Michael Doppelbauer.

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Interessenkonflikt

M. Doppelbauer, M. Schüler und D. Sauter geben an, dass kein Interessenkonflikt besteht.

Die Studie mit den genannten Rahmenbedingungen wurde der Ethikkommission vorgelegt. Eine Bewilligung war nicht notwendig.

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Doppelbauer, M., Schüler, M. & Sauter, D. Die postoperative Mobilisation nach Hüfttotalendoprothesenimplantation. Orthopäde 49, 230–237 (2020). https://doi.org/10.1007/s00132-019-03768-9

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