Improving spinal care with activity monitors

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By Matthew Smuck

What mobile technologies are available for the management of spinal disorders?

You can, as some spinal specialists do, now use commercially available activity monitors to give patients feedback about their activity levels. My research lab at Stanford University is devoted to understanding the role of these monitors and is focused on maximising their ability to help patients with spinal and other musculoskeletal problems.

By investigating the many variables related to physical activity, we have already discovered important connections. For instance, using activity monitors, we were able to uncover the role of physical activity in the relationship between obesity and low back pain—we now know that physical activity is more important for preventing back pain in overweight people than it is in normal weight people. Therefore by harnessing the power of this mobile technology, we were able to gain insights that were not previously apparent. Because of this, and in recognition of the importance of developing more objective methods of researching spinal problems, our study was selected for The Spine Journal’s 2013 “Outstanding Paper Award in medical/interventional science” to be presented at NASS.


What data are available for these devices?

The data depends on the device. Activity monitors provide information about the amount and intensity of a person’s movement. Based on this information, we can make projections about what kinds of activity people are up to and we can monitor them for characteristic changes that appear as a result of spinal conditions. We are also beginning to apply them to monitor a person’s recovery after treatment (such as spinal surgery).

These same monitors can be used to gain insights into a person’s quality of sleep. Other new devices that track motion are being used to test spinal range of motion and posture. We already know that exercise, sleep, movement and posture can affect back pain. These new mobile devices will allow spinal specialists to uncover more of the important variables that influence how their patients can best recover from back pain and, eventually, better understand how to prevent back pain in the first place.


What are the benefits and disadvantages of such devices?

The primary benefits of these devices are that they can be used passively. Patients only need to wear them. They are much easier to use and they are less of a burden to patients than the long questionnaires that we have typically used to evaluate a patient’s condition and track response to treatment. Just as important, these monitors more accurately record how a patient is doing in daily life compared to questionnaires that are limited to information provided in the questions asked.

That patients have to wear these devices for them to work is also a disadvantage, but this problem will disappear as these technologies transition from being separate devices to programmes that can be downloaded to a smartphone or “smartwatch” (they are coming!).

Another disadvantage has to do with privacy. Some people may not want their doctors to know so many details about their good or bad habits—although I think it is in their best interest to allow their doctors to have full insight! That said, it will be important to ensure that such personal information remains under the control of the patient and that access to this private information is restricted and prevented from getting into the wrong hands.


What future mobile technologies do you think might become available?

Currently, no mobile technologies are routinely used in spinal care. However, I predict that in the near future, patients will be able to download information from activity monitors and from their smartphones or smartwatches, and this information will give their doctors important insights into simple behaviour changes and solutions to improve spine health.

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