Feasibility and usability of wearable devices for ambulatory monitoring of the rehabilitation process of older patients after hip fracture surgery

Objective: To assess the feasibility and usability of wearable devices for ambulatory monitoring of older patients during geriatric rehabilitation after hip fracture surgery. Methods: Patients (≥70 years) who were surgically treated for a hip fracture wore the Fitbit Charge 2/HR and the MOX device. Feasibility was assessed by investigating whether real world data gathering revealed sufficient high-quality data. Usability was assessed by 1) evaluating whether changes in the device parameters correlated with changes in clinimetric tests and 2) determining whether the wearable devices properly measured activity. Results: Data from 67 patients was used to assess feasibility; all patients wore the Fitbit and 33 the MOX. The mean amount of high-quality data was 88.1% for the Fitbit and 93.6% for the MOX. Data from 42 patients was used to assess usability; all patients wore the Fitbit and 14 the MOX. A positive progression in clinimetric tests was correlated with an increase in activity parameters. However, the Fitbit often miscalculated the number of steps and the MOX algorithm often misclassified slow walking as standing. Conclusions: Ambulatory monitoring using the Fitbit and MOX is feasible in older patients with a hip fracture. Concerning the usability, the Fitbit often miscalculated the number of steps. The MOX was more adequate but the activity classification algorithm often misclassified slow walking based on which it is recommended to use the raw data instead.