Implementation of wearable activity trackers in hospital rehabilitation: a feasibility study tailored to local settings.

backgroundPhysical inactivity during and after hospitalisation is associated with poorer outcomes. Wearable activity trackers (WATs) are effective in promoting physical activity in healthcare settings, however, their successful implementation remains a challenge, and evidence for how this can be achieved is so far limited.

objectiveThis feasibility study evaluated WAT implementation in inpatient and outpatient rehabilitation by assessing: (1) feasibility metrics including uptake and retention rates; (2) patient and clinician perceptions; (3) challenges and factors contributing to success; and (4) changes in PA.

methodsA single-arm, feasibility study was conducted in two rehabilitation settings at a major teaching hospital. Patients were provided with a WAT (Fitbit Inspire 3) to wear throughout their admission, which was used to set step goals with clinicians, monitor daily step counts and support efforts and encouragement to meet step goals. Feasibility was assessed based on recruitment, retention, and data completeness rates. Patient and clinician experiences, satisfaction and perceptions were evaluated through surveys. Effect sizes for change in physical activity from baseline to follow-up were assessed for daily step counts, light physical activity, moderate-vigorous physical activity, and sedentary behaviour, were calculated using Cohen’s d and matched-pairs rank-biserial correlation (r).

resultsOf 36 invited patients, 26 participated, (mean age 72 years; SD: 13; range 33–93; 72% uptake rate). Data completeness was high (92%), with no devices lost or broken. Most patients perceived WATs helped increase walking (68%) and achieve rehabilitation goals (64%), with 84% willing to use WATs again in rehabilitation. All clinicians (n = 6) found WATs easy to use, though perspectives on therapy enhancement varied. Large effect sizes were observed for increased daily steps in both the inpatient (1050 to 1366 steps/day, (r) = 0.595) and outpatient (4749 to 5986 steps/day, (r) = 0.532) rehabilitation settings. The simplicity of the approach and patient and clinician resources were identified as factors contributing to the success of implementation, though the recruitment approach revealed challenges related to inviting individual patients to participate.

conclusionWAT implementation was feasible in both rehabilitation settings. Future research should evaluate larger scale implementation and effectiveness of such approaches through service-level enrolment and larger controlled trials, and exploring applications across diverse clinical settings.

trial registrationThis trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (Trial ID: ACTRN12624000447550; registration date: 11 April 2024).