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Smartphone GPS signatures of patients undergoing spine surgery correlate with mobility and current gold standard outcome measures

Alessandro Boaro, Jeffrey Leung, Harrison T. Reeder, Francesca Siddi, Elisabetta Mezzalira, Gang Liu, Rania A. Mekary, Yi Lu, Michael W. Groff, Jukka-Pekka Onnela, and Timothy R. Smith

objective patient monitoring. 7–9 There is a need for more objective, patient centered and less invasive tools to assess patients’ ability to return to activity after surgery. Recently, there has been increasing interest in the use of smartphone and wearable devices to collect this type of information. 10–13 The data generated by these devices can be used to study social, behavioral, and cognitive phenotypes in naturalistic settings. This approach, now known as digital phenotyping, has been defined as moment-by-moment quantification of the individual-level human

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Reliability of the 6-minute walking test smartphone application

Martin N. Stienen, Oliver P. Gautschi, Victor E. Staartjes, Nicolai Maldaner, Marketa Sosnova, Allen L. Ho, Anand Veeravagu, Atman Desai, Corinna C. Zygourakis, Jon Park, Luca Regli, and John K. Ratliff

-minute walking distance (6WD; in m) is documented by recording complete laps and walkway marks on the floor for incomplete laps. Without specialized in-hospital infrastructure and personnel, the traditional 6WT is cumbersome to apply. Therefore, we designed a free smartphone application (app) that uses global positioning system (GPS) coordinates to allow patients to independently perform 6WD measurements. This study reports reliability measures of the 6WT smartphone app. Methods App Development This spine-specific 6WT smartphone app was conceptualized by O.P.G. and M

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Defining the minimal clinically important difference in smartphone-based mobility after spine surgery: correlation of survey questionnaire to mobility data

Presented at the 2023 AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves

Daksh Chauhan, Hasan S. Ahmad, Robert Subtirelu, Sai Mannam, Ryan Turlip, Kevin Bryan, Shreya Bathula, Yohannes Ghenbot, Andrew I. Yang, Michael Y. Wang, Gregory Basil, Zarina S. Ali, and Jang W. Yoon

disability across a lengthy time course. 8 , 9 While PROMs represent an adequate assessment of surgical outcome, there is a growing interest in the development and validation of more objective and data-driven outcome measurements. Objective measurements of activity, obtained from smartphones, smartwatches, and other wearable devices, can provide clinicians with reliable, unbiased objective determinations of functional outcome. 10 Apple iPhones (Apple Inc.) in particular have demonstrated high fidelity for human activity measurement, achieving uniformly low error rates

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Normative data of a smartphone app–based 6-minute walking test, test-retest reliability, and content validity with patient-reported outcome measures

Lazar Tosic, Elior Goldberger, Nicolai Maldaner, Marketa Sosnova, Anna M. Zeitlberger, Victor E. Staartjes, Pravesh S. Gadjradj, Hubert A. J. Eversdijk, Ayesha Quddusi, Maria L. Gandía-González, Jamasb Joshua Sayadi, Atman Desai, Luca Regli, Oliver P. Gautschi, and Martin N. Stienen

resource-intensive manner by trained physiotherapy personal. New smartphone technology allows for Global Positioning System (GPS)–based determination of the 6WD using a spine-specific, free, and accurate smartphone app ( Fig. 1 ). 13 FIG. 1. Screenshot of the user interfaces of the 6WT smartphone app. A: In this example, the measurement is at 3:59 minutes and 248 meters and ongoing. Patients can push the “flash” button (lightning bolt) when they experience clinically relevant symptoms (e.g., back pain, neurogenic claudication, sciatica). The app will register the time

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Evaluation of the 6-minute walking test as a smartphone app-based self-measurement of objective functional impairment in patients with lumbar degenerative disc disease

Nicolai Maldaner, Marketa Sosnova, Anna M. Zeitlberger, Michal Ziga, Oliver P. Gautschi, Luca Regli, Astrid Weyerbrock, Martin N. Stienen, and for the International 6WT Study Group

equipment and are associated with a high responder burden. 7 To overcome these challenges and to make objective patient evaluation more feasible, we recently developed a free smartphone app that allows patients to self-determine their walking capacity. The 6-minute walking test (6WT) accurately assesses the maximum distance (in meters) a patient can walk in 6 minutes by triangulating global positioning system (GPS) coordinates. 11 In order for the 6WT to gain broad acceptance, we need to scrutinize its psychometric properties and correlate the test to established PROMs

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Letter to the Editor. Expanding the scope of mHealth in spine surgery: beyond smartphones

Yuudai Kobayashi, Tadatsugu Morimoto, Tomohito Yoshihara, Takaomi Kobayashi, and Masaaki Mawatari

TO THE EDITOR: We were intrigued by the article by Greenberg et al., 1 which presents a comprehensive review of the technology, analytical considerations, and applications of mobile health (mHealth) tools for evaluating patients undergoing spine surgery ( Greenberg JK, Javeed S, Zhang JK, et al. Current and future applications of mobile health technology for evaluating spine surgery patients: a review. J Neurosurg Spine . 2023;38[5]:617-626 ). Their paper highlights the importance of smartphones as a commonly available form of mHealth technology that can

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Remote patient monitoring following full endoscopic spine surgery: feasibility and patient satisfaction

Tobias Prasse, Natalie Yap, Sananthan Sivakanthan, James Pan, John Ogunlade, Jan Bredow, Peer Eysel, Richard G. Ellenbogen, and Christoph P. Hofstetter

patient health status has been used for numerous medical conditions such as diabetes, hypertension, infectious diseases, and many more. 10 – 12 Of those who own a smartphone, 62% reported using some form of an app-based health tracker to manage various health factors and to share health information with others via the internet. 13 , 14 In spine surgery, several studies have introduced smartphone apps for patient education, scheduling, and appointment reminders, as well as for the collection of feedback and patient-reported outcome (PROM) questionnaires. 15 , 16

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Current and future applications of mobile health technology for evaluating spine surgery patients: a review

Jacob K. Greenberg, Saad Javeed, Justin K. Zhang, Braeden Benedict, Madelyn R. Frumkin, Ziqi Xu, Jingwen Zhang, Thomas L. Rodebaugh, Chenyang Lu, Jay F. Piccirillo, Michael Steinmetz, Zoher Ghogawala, Mohamad Bydon, and Wilson Z. Ray

M obile health (mHealth) technology has permeated nearly every aspect of society. It is estimated that there are currently approximately 4 billion smartphone users, representing nearly half the world’s population. 1 In the United States, smartphone users represent approximately 85% of the population. With this expansive growth, mHealth technology has assumed an increasingly important role in healthcare. Innovations in the use of mHealth technology in medicine have included mobile sensors and algorithms for monitoring heart rate, falls, skin cancers, and

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Responsiveness of the self-measured 6-minute walking test and the Timed Up and Go test in patients with degenerative lumbar disorders

Nicolai Maldaner, Marketa Sosnova, Anna M. Zeitlberger, Michal Ziga, Oliver P. Gautschi, Luca Regli, Oliver Bozinov, Astrid Weyerbrock, and Martin N. Stienen

various areas like walking ability, balance, and various activities of daily life. 3 However, PROMs may be subject to multiple potential inaccuracies and do not reflect a direct and objective measurement of functional impairment. 1 , 4 , 5 Several objective functional tests have thus recently been developed to complement the standardized assessment of patients with DLDs. 6 The Timed Up and Go (TUG) test and the 6-minute walking test (6WT) are two of the currently best-explored smartphone-app–based instruments to evaluate objective functional impairment in patients

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Responsiveness of the self-measured 6-minute walking test and the Timed Up and Go test in patients with degenerative lumbar disorders

Nicolai Maldaner, Marketa Sosnova, Anna M. Zeitlberger, Michal Ziga, Oliver P. Gautschi, Luca Regli, Oliver Bozinov, Astrid Weyerbrock, and Martin N. Stienen

various areas like walking ability, balance, and various activities of daily life. 3 However, PROMs may be subject to multiple potential inaccuracies and do not reflect a direct and objective measurement of functional impairment. 1 , 4 , 5 Several objective functional tests have thus recently been developed to complement the standardized assessment of patients with DLDs. 6 The Timed Up and Go (TUG) test and the 6-minute walking test (6WT) are two of the currently best-explored smartphone-app–based instruments to evaluate objective functional impairment in patients