Assessing Physical Activity In Rehabilitation After Cardiac Surgery Using Wearable Technology
Isabeau Thijs, Libera Fresiello, Wouter Oosterlinck, Peter Sinnaeve, Filip Rega.
University Hospitals Leuven, Leuven, Belgium.
Objective: Wearable technology is finding its way in clinical practice. Physical Activity (PA) describes patient's functional status after cardiac surgery and in remote monitoring by use of PA trackers. The aim of this work is to assess the usability of a wearable fitness tracker, to monitor patients who underwent coronary artery bypass surgery, by either the conventional Off-Pump procedure (OPCAB) or robotically assisted CABG (RA-MIDCAB). We hypothesized a faster recovery of functional status after RA-MIDCAB in the first weeks after discharge. Methods: Patients undergoing RA-MIDCAB or OPCAB were included. Each patient received a Fitbit Charge Heart Rate PA tracker (Fitbit Inc., San Francisco, CA, USA) following discharge. Rehabilitation progress was assessed by measuring the number of steps and physical activity level (PAL) daily. PAL was calculated as energy expenditure divided by basic metabolic rate. Results: 10 RA-MIDCAB patients with a median age of 68 (IQR: [60;76]) and 12 OPCAB patients with a median age of 69 (IQR: [65;76]) were included. Baseline characteristics were comparable except for BMI (RA-MIDCAB: 26 Kg/mē [24;27] versus OPCAB: 29 Kg/mē [27;31]; P<0.001). Intubation time was significantly lower in the RA-MIDCAB group (P<0.05). A clear trend, although not statistically significant, was observed towards a higher number of steps in RA-MIDCAB patients in the first week following discharge, as depicted in Figure. Conclusion: RA-MIDCAB and OPCAB patients were comparable except for BMI. Intubation time was significantly lower in RA-MIDCAB. Wearable PA trackers can describe functional status in a cardiac rehabilitation setting after surgery. RA-MIDCAB patients have an advantage in recovery in the first weeks of revalidation reflected by the number of steps and PAL, measured by the Fitbit Charge HR. Acknowledgements: None of the authors have any conflict of interest to declare, related to the design or the execution of this study. The Fitbit trackers were purchased by the department of cardiac surgery of the University Hospitals Leuven. LEGEND Weekly average number of steps are plotted as medians; RA-MIDCAB: Robotically Assisted Minimally Invasive Direct Coronary Artery Bypass; OPCAB: Off-Pump Coronary Artery Bypass; n indicates the number of patients included in the cohort; P-value of the Mann Whitney U test for difference between both groups at the specific time point. 
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