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Continuous monitoring of functional recovery of frail elderly people after treatment of a hip fracture, making use of the data of the monitor devices 'Fitbit Charge HR and MOX, in order to optimize the rehabilitation process

Lambregts, M.C.P. and Raijmakers, F.D. and Ramselaar, M.S. and Toering, T.F. (2019) Continuous monitoring of functional recovery of frail elderly people after treatment of a hip fracture, making use of the data of the monitor devices 'Fitbit Charge HR and MOX, in order to optimize the rehabilitation process.

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Abstract:Background In the Netherlands, each year, 17,000 people are hospitalised after a hip fracture. Almost one out of three hip fracture patients deceases within the first year after surgery. This mortality rate could be decreased by improving the rehabilitation process. Nowadays, the rehabilitation process of elderly hip fracture patients is monitored by clinimetric tests, but continuous monitoring could be a valuable addition. The purpose of this study is to determine how the monitor devices Fitbit Charge HR and MOX can be used to continuously monitor functional recovery of frail elderly hip patients to optimise the rehabilitation process. Methods Qualitative research is set up to determine the definition of functional recovery and to compose parameters that are useful for continuous monitoring of functional recovery of elderly hip patients. This qualitative research consists of literature research and conducted interviews on healthcare specialists and patients. Additionally, a quantitative research was set up. This consisted of an experiment, in order to determine whether the formulated parameters can actually be measured by the monitor devices. A GERonTologic simulator (GERT), an age simulation suit, was used in order to evaluate whether progress in rehabilitation of functional recovery can be monitored. Results The parameters that can be measured by the monitor devices Fitbit Charge HR and MOX, are: number of steps, heart rate, classification and intensity of activities. When the subject was walking with a walker, the Fitbit attached to the wrist showed a very low correlation and the Fitbit attached to the ankle a high correlation between the counted steps of the observer and the counted steps by the Fitbit. Within most subjects, when wearing GERT, the heart rate increased while the intensity of the performed activity maintained approximately the same value. The increased heart rate was higher in 15 of the 24 cases for ‘with GERT’ than ‘without GERT’ during walking, with a mean rank of 13.17. When a patient was doing activities of daily living, the increased heart rate was higher ‘with GERT’ than ‘without GERT’, in 11 of the 15 cases, with a mean rank of 7.95. Discussion Safety and independence, mobility, balance and resilience are important parameters which were not evaluated in this study, due to the restrictions of technology specifications of the monitor devices. For this reason the definition of functional recovery formulated in this study, does not cover the entire content. As young healthy subjects were included, GERT was used in order to simulate a not functionally recovered elderly patient, by increasing the fatigue. However, the included subjects obviously differed from frail elderly patients with a hip fracture, due to the fact that the included parameters can be affected by aging. Besides this, the study population was very small. Results showed a difference between ‘with GERT’ in comparison to ‘without GERT’ in heart rate increase for relatively equal intensities. Despite this, further research needs to be done to apply this for continuously monitoring of elderly people. Conclusion Functional recovery is returning to the premorbid living situation by achieving a safe and independent performance of their personal targets of physical functioning, with a low fatigability. The parameter heart rate increase is promising in continuously monitoring functional recovery of elderly hip fracture patients, and is therefore a useful parameter for further research. Also, the measured number of steps and intensities can give an indication of functional recovery, by gaining more insight into the active minutes of a patient. To conclude, a combination of the Fitbit Charge HR and the MOX is recommended to continuously monitor functional recovery of a hip fracture patient during the rehabilitation process.
Item Type:Essay (Bachelor)
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine BSc (50033)
Link to this item:http://purl.utwente.nl/essays/78809
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