Smartwatches could help prepare patients for major surgery, improving their recovery, researchers at The Christie NHS Foundation Trust in Manchester have found in a study sppnsored by The Univesity of Manchester.
Preliminary results, from what’s believed to be the first monitored remote pre-habilitation programme in the UK, are promising and could improve recovery by a third.
The surgical research team at the leading cancer centre has just completed the fourth phase of the study to discover if, by using a Fitbit smartwatch, it can improve a patients’ fitness pre-surgery enabling better recovery and a shorter stay in hospital post-op.
The trial initially started in May 2019, and recruited 22 patients who were scheduled to have major abdominal surgery at The Christie for appendix cancer. Half the patients were given an exercise programme to suit their abilities and half were told to continue to just do their normal level of activity.
The cohort was constantly monitored remotely to ensure they were completing the daily activities they’d been set, and the research team also called them weekly over their 4-6 week pre-habilitation period. Having the FitBit increased compliance and reduced hospital visits, which benefited patients, particularly those that didn’t live locally.
Feedback from the participants found the Fitbit wearable devices encouraged them to complete their exercises as they could easily see their progress towards their activity goals.
Mr Omer Aziz, consultant surgeon at The Christie and Honorary Lecturer at The University of Manchester who is leading the study, said: “To the best of our knowledge this is the first research into using smartwatch technology to benefit patients’ outcomes post-surgery. This novel approach could mean more patients are fitter for surgery resulting in a shorter recovery time and therefore less days in hospital, which not only benefits the patient but saves the NHS money. Using this method is also more convenient and safer for patients as they can do their pre-habilitation at home, avoiding a trip to hospital. During the pandemic this has, of course, been even more beneficial.”
Julie Gray, 61, from Bacup in Rossendale, Lancashire, one of the patients on the trial, who had major abdominal surgery, said: “The Fitbit certainly made me go and do more exercise. I’m a convert and I’ve now bought my own Fitbit and given one to my husband and daughter. It keeps track of your general health and sleep patterns which is also really helpful. In 2019 I had an 11 hour operation but came out of it feeling better than before. I think it did help me with the recovery and I was up and about not long after the operation. I even joined a gym and did spin and step classes.”
Julie left hospital nine days after her operation which is three days earlier than the average length of stay, 12 days, for this kind of operation.
Seema Rahman, Senior Physiotherapist at The Christie who was involved with this trial, said: “We see patients as little as 12 hours after their operation. We noticed the patients that had used the Fitbits felt fitter and were more than happy to get out of bed and start rehab. They were in the right mindset as they had put in all the hard work beforehand and were keen to get back to fitness. They were more mentally prepared for the next part of their journey to recovery and it wasn’t a shock for them.
“We know exercise helps reduce the recurrence of cancer, so changing their mindset to exercise is extremely important for their long term health. It’s still too early to determine if the Fitbits are key to shorter post-op stays, as we need to study this further but anecdotally we observed that the patients using the Fitbits generally left hospital sooner than those that didn’t.”
Previously, prehabilition before major abdominal cancer surgery has ranged from unsupervised home-based techniques such as providing the patient with exercise booklets, CDs and computer programmes, to supervised hospital-based face-to-face sessions using cycle ergometers and exercise equipment.