Leveraging Wearables to Transform Patient Recovery after Tibial Fracture Surgery

每年有超过49万美国人胫骨骨折，需要手术治疗。然而，患者恢复1 手术后1年的情况较差，与2/3的患者报告无法进行伤前休闲活动不一致 1/2的人还没有恢复到足以重返工作岗位的水平。临床医生在胫骨干术后的关键作用 骨折手术是规定一个康复锻炼计划，使每个病人的胫骨暴露在增加的 逐渐恢复伤前活动的能力。然而，主要的局限性阻碍了 该领域的进展是缺乏关于患者在日常活动中经历多少胫骨力的知识， 活动，在整个恢复过程中的康复计划，以及恢复早期胫骨力如何影响 长期功能恢复。这项工作的首要目标是生成知识库和工具 这将使我们能够重新设想和提高对胫骨干骨折后个人的护理标准， 手术，通过监测和管理日常生活中的胫骨力。我们建议实现 通过以下目标。目的1：表征患者在家时的胫骨力， 手术后一年。目标2：创建第一个临床参考指南，对通常情况下的胫骨力进行排序- 规定的康复训练。目标3：评估早期恢复期间较高的胫骨力是否与 6个月和12个月随访时功能结局更好。如果我们的假设得到支持，那么这些结果 将告知新的临床指南（目标骨力阈值）和生物反馈干预，以监测 并在恢复过程中促进健康的骨骼力量。这种可穿戴监测模式具有无与伦比的潜力， 适用于提高对许多肌肉骨骼疾病的康复护理。

Over 490K Americans fracture their tibia (shinbone) yearly, and require surgery. However, patient recovery 1 year following surgery is poor and inconsistent with 2/3 of patients reporting an inability to do pre-injury leisure activities and 1/2 still not having recovered enough to return to work. A key role of clinicians after tibial shaft fracture surgery is to prescribe a rehabilitation exercise program that exposes each patient's tibia to increasing forces to gradually recover the ability to do pre-injury activities. However, major limitations holding back progress in the field are the lack of knowledge on how much tibial force patients experience during daily activities, in their rehabilitation program throughout recovery, and how tibial force early in recovery affects longer-term functional recovery. The overarching goal of this work is to generate the knowledgebase and tools that will enable us to reimagine and elevate the standard of care for individuals after tibial shaft fracture surgery, by monitoring and managing tibial bone forces in daily life. We propose to accomplish the overarching objective through the following aims. Aim 1: Characterize tibial bone force in patients at home over the first year following surgery. Aim 2: Create the first clinical reference guide that ranks tibial forces during commonly- prescribed rehabilitation exercises. Aim 3: Assess if higher tibial forces during early recovery correspond with better functional outcomes at 6- and 12-month follow up. If our hypothesis is supported then these results would inform new clinical guidelines (target bone force thresholds) and biofeedback interventions to monitor and promote healthy bone forces in recovery. This wearable monitoring paradigm has unparalleled potential to be adapted to elevate care for recovery from numerous musculoskeletal disorders.