Web, Apps and Wearables: Tools For Joint Health

The eROAR webinar on Saturday is an annual event presented by the Patient Advisory Board of The Arthritis Research Centre. The broadcast went by so fast it was hard to absorb all of the facts, so I hope that looking at it again is useful.

Dr. Linda Li was one of the speakers. She spoke about apps and wearables and their possible use in improving joint health. Sam Bradd did a wonderful job of using his skills to turn the speaker's presentations into art and below is what Sam drew based on Dr. Li's talk.

Picture by Sam Bradd, graphic recorder.

Wearables and apps used in healthcare are a very hot topic, and I saw them in evidence at MedX in Stanford among both attendees and exhibitors. I thought that the Lumo looked interesting. It's a small device that vibrates when your posture needs adjustment, Mostly though, when I measure any aspect of my health, it's an issue of whether or not my favourite jeans are too tight, just as Susannah Fox has been quoted as saying in the past.

Dr Li takes a more scientific approach, starting by telling us that the future is here. In 2014 'wearables' are expected to generate $3 billion in sales as they move from technology enthusiasts to everyday users. With this ability to collect minute to minute information and pair it with a mobile device there is great potential to help people be active.

Not many people use them yet. Dr Li suggests use of exercise to help in osteoarthritis (OA) to improve pain and function, weight loss to decrease symptoms, and acetaminophen as the first line pain medication.

Studies like the Canadian Community Health Survey have shown that large percentages of people with OA do not meet guidelines for physical activity, which call for only 150 minutes per week.

Why is this the case? Lack of motivation is number one. When you are in pain it takes more effort to remain active. Other reasons for inactivity which people give are doubts that it will work and lack of professional advice.

Dr Linda Li and partners in the Arthritis Research Centre and other funders, are in the process of recruiting for six different studies, some in osteoarthritis and some in rheumatoid arthritis, lupus and in indigenous communities. You'll be seeing more results coming from her as this data is analyzed.

Activity trackers are looking more attractive to me as time passes. It seems there is more attention being paid to them as a way for people with chronic health problems to improve activity levels. The call for 10,000 steps a day is being modified as usage moves from the very healthy to the not so healthy.

Here is the text from one of Dr. Li's slides that describes a physical activity counselling model. This is what is happening when people join one of her current studies.

1.Physiotherapist provides information on physical activity

•A brief education session

•Goal-setting

2.Fitbit Flex – an activity tracker

3.Physiotherapist reviews physical activity with participants

•10-minute weekly phone counseling

•Progressively modify the participant’s activity

•Patients may email if they have questions

A tweet about Dr Li from #eROAR Nov. 22

Dr Linda Li @LLi_1 2014 recipient Outstanding Inclusion Patients in Research award @Arthritis_ARC patient advisory board 2time win!



Exercise is necessary. Raise a little sweat.

What do you want researchers to find out for you?

I've heard a lot of talk this past year about patients being more involved in research and in decision making. People in high places are talking about including the patient voice, from Ontario's Health Minister Eric Hoskins on Thursday at Health Quality Transformation 2014, to the Canadian Foundation for Healthcare Improvement (CFHI).

Minister Eric Hoskins said the first priority is to create and grow a patient centered health system. CFHI (Canadian Foundation for Health Improvement) says they are "Putting Patients at the Centre of Care" and they are behind the Strategy for Patient-Oriented Research (SPOR) which has big research projects coming up. These indicators sound as though the patient rallying cry of "Nothing about me without me" has been heard.

This does not guarantee success - there are many forces that want to see their own vision of participatory medicine, some because of profit, some who like the status quo, and others who resist change.

I was involved in a tweet chat this weekend with The Arthritis Research Centre and their Patient Advisory Board. This organization and their researchers have found ways to include patients and their views throughout the research process. ROAR stands for Reaching Out with Arthritis Research.

The event featured researchers speaking about their new projects to an audience that included anyone who wanted to listen to the live webinar or be in the in-person audience. That's a big change from the usual way we hear about and use research in our own lives.

They want to know what the audience wants to see and hear at the next eROAR event. So I take that to be an open question. Let them know what you want to hear about.

Let them hear what you want to see studied.

They'll have to use those ideas to get grants to do the research so it may be a long shot but I'm betting you all have at least two questions that you want answered.

What questions do you have that you think are being missed and neglected in your health area?
Do you ever look at research papers and wonder who on earth would have picked ____ as a research topic? I have been saving some doozies that I just won't post and let them see the light of day.

I'll forward all responses from comments to the Arthritis Research Centre, or you can send them direct at their website. It doesn't matter what country you're in. You know researchers - they all share. Your ideas won't go to waste.

ARC researchers, bloggers, and Arthritis Society representative

If you are interested in a definition of Patient Centered Healthcare I have linked to a paper by Donald Berwick that has a good discussion of the concept.