@Article{info:doi/10.2196/43436,
author="Churchill, Laura
and Morrow, Mary
and Capin, Jacob J
and Jolley, Sarah E
and Hare, Kristine
and MaWhinney, Samantha
and Stevens-Lapsley, Jennifer E
and Erlandson, Kristine M",
title="Using Wearable Technology to Quantify Physical Activity Recovery: Secondary Report From the AFTER (App-Facilitated Tele-Rehabilitation) Program for COVID-19 Survivors Randomized Study",
journal="JMIR Rehabil Assist Technol",
year="2023",
month="Mar",
day="20",
volume="10",
pages="e43436",
keywords="Fitbit; steps; COVID-19; hospitalization; rehabilitation; digital health intervention; physical activity; step count; mHealth application; tele-rehabilitation",
abstract="Background: Knowledge on physical activity recovery after COVID-19 survival is limited. The AFTER (App-Facilitated Tele-Rehabilitation) program for COVID-19 survivors randomized participants, following hospital discharge, to either education and unstructured physical activity or a telerehabilitation program. Step count data were collected as a secondary outcome, and we found no significant differences in total step count trajectories between groups at 6 weeks. Further step count data were not analyzed. Objective: The purpose of this analysis was to examine step count trajectories and correlates among all participants (combined into a single group) across the 12-week study period. Methods: Linear mixed models with random effects were used to model daily steps over the number of study days. Models with 0, 1, and 2 inflection points were considered, and the final model was selected based on the highest log-likelihood value. Results: Participants included 44 adults (41 with available Fitbit [Fitbit LLC] data). Initially, step counts increased by an average of 930 (95{\%} CI 547-1312; P<.001) steps per week, culminating in an average daily step count of 7658 (95{\%} CI 6257-9059; P<.001) at the end of week 3. During the remaining 9 weeks of the study, weekly step counts increased by an average of 67 (95{\%} CI −30 to 163; P<.001) steps per week, resulting in a final estimate of 8258 (95{\%} CI 6933-9584; P<.001) steps. Conclusions: Participants showed a marked improvement in daily step counts during the first 3 weeks of the study, followed by more gradual improvement in the remaining 9 weeks. Physical activity data and step count recovery trajectories may be considered surrogates for physiological recovery, although further research is needed to examine this relationship. Trial Registration: ClinicalTrials.gov NCT04663945; https://tinyurl.com/2p969ced ",
issn="2369-2529",
doi="10.2196/43436",
url="https://rehab.jmir.org/2023/1/e43436",
url="https://doi.org/10.2196/43436",
url="http://www.ncbi.nlm.nih.gov/pubmed/36939818"
}