Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Oct 14, 2022
Date Accepted: Feb 23, 2023
Using Wearable Technology to Quantify Physical Activity Recovery: A Secondary Report from the App-Facilitated Tele-Rehabilitation (AFTER) Program for COVID-19 Survivors Randomized Study
ABSTRACT
Background:
Knowledge on physical activity recovery after COVID-19 survival is limited. The App-Facilitated Tele-Rehabilitation (AFTER) program for COVID-19 survivors randomized participants following hospital discharge to education and unstructured physical activity versus a tele-rehabilitation program. Step count data were collected as a secondary outcome.
Objective:
The purpose of this analysis was to examine physical activity trajectories and correlates among participants across the 12-week study period.
Methods:
Linear mixed models with a random intercept were used to model daily steps over the number of study days. Models with zero, one, and two inflection points were considered with the final model selection based on the highest log-likelihood value.
Results:
Participants included 44 adults (41 with available Fitbit data). Initially, step counts increased by an average of 935 steps ([95% CI: 725, 1150] p<0.001) per week, culminating in an average daily step count at the beginning of week four of 7630 ([95% CI: 6500, 8815], p<0.001). During the remaining nine weeks of the study, weekly step counts increased by an average of 90 steps ([95% CI: 40, 145], p<0.001) per week resulting in a final estimate of 8455 ([95% CI: 7260, 9650], p<0.001).
Conclusions:
Participants showed a marked improvement in daily step counts during the first three weeks of the study, followed by more gradual improvement in the remaining nine weeks. Physical activity data and step count recovery trajectories may be considered a surrogate for physiological recovery, although further research is needed to examine this relationship. Clinical Trial: The study is registered at clinicaltrials.gov: NCT04663945
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