BACKGROUND Lumbar spinal disease causes disabilities in performing daily activities. Operative treatments are aimed at pain relief and rapid return to routine activity. Patient-based outcome measures are used to evaluate pathologies and therapeutic effects associated with lumbar spinal disease. Nevertheless, it remains unknown as to how much such treatment improves activity levels. The purpose of the current study was to measure changes in activity levels before and after lumbar spinal surgery using a wearable activity tracker and to analyze the differences between results and patient-based outcomes. METHODS Sixty patients who underwent lumbar surgery were studied. The physical activity of participants was objectively evaluated using a wearable Micro-Motion logger system (Actigraph). We measured the amount of activity before and at 1, 3, 6, and 12 months after the surgery to evaluate postoperative changes. The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, Oswestry Disability Index, Roland-Morris Disability Questionnaire and visual analog scale were used to assess patient-based outcomes of pain and activities of daily living-related scores; we analyzed the relationships between scores and actual activity levels. RESULTS The amount of actual activity decreased significantly 1 month after the surgery compared to that during the preoperative period, which then improved after 3 months postoperatively (p < 0.01). Furthermore, there was a significant improvement 6 months after the surgery compared to that during the preoperative period (p < 0.05). The changes in activity for each period were strongly correlated, regardless of the period. In contrast, a significant improvement was observed at 1 month after the surgery in almost all items of the patient-based questionnaires (p < 0.05). CONCLUSIONS The objective activity tracker demonstrated that lumbar surgery results in the amount of activity decreasing 1 month just after surgery followed by gradual postoperative recovery within 3 months. By contrast, patient-based outcomes showed improvement in 1 month that was significantly different from the change in actual activity, indicating a gap between patient-oriented clinical scores and their actual activities.

中文翻译：

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使用可穿戴式追踪器客观评估腰椎手术术后患者实际活动水平的变化。

背景技术腰椎疾病导致进行日常活动的残疾。手术治疗旨在缓解疼痛并迅速恢复日常活动。基于患者的结局指标用于评估与腰椎疾病相关的病理和治疗效果。然而，关于这种治疗在多大程度上提高活动水平仍是未知的。本研究的目的是使用可穿戴活动追踪器测量腰椎手术前后的活动水平变化，并分析结果与基于患者的结果之间的差异。方法对60例腰椎手术患者进行研究。使用可穿戴的Micro-Motion记录器系统（Actigraph）客观地评估了参与者的身体活动。我们测量了1、3、6之前和之后的活动量 并在手术后12个月评估术后变化。日本骨科协会腰痛评估问卷，Oswestry残疾指数，Roland-Morris残疾问卷和视觉模拟量表用于评估基于患者的疼痛结局和日常生活活动相关评分。我们分析了分数与实际活动水平之间的关系。结果术后1个月的实际活动量较术前明显减少，术后3个月后有所改善（p <0.01）。此外，与术前相比，术后6个月有显着改善（p <0.05）。不论哪个时期，每个时期的活动变化都密切相关。相反，术后1个月，几乎所有基于患者的问卷调查表均出现了显着改善（p <0.05）。结论客观活动追踪器表明，腰椎手术导致术后1个月活动量减少，随后3个月内逐渐恢复。相比之下，基于患者的结果显示1个月的改善与实际活动的变化显着不同，这表明以患者为中心的临床评分与其实际活动之间存在差距。结论客观活动追踪器表明，腰椎手术导致术后1个月活动量减少，随后3个月内逐渐恢复。相比之下，基于患者的结果显示1个月的改善与实际活动的变化显着不同，这表明以患者为中心的临床评分与其实际活动之间存在差距。结论客观活动追踪器表明，腰椎手术导致术后1个月活动量减少，随后3个月内逐渐恢复。相比之下，基于患者的结果显示1个月的改善与实际活动的变化显着不同，这表明以患者为导向的临床评分与其实际活动之间存在差距。