(UoM-Melb) Patterns of physical activity pre- and post-total knee replacement, assessed through the linkage of NHS and consumer health and fitness tracker data

The uptake of consumer technology has been significant in the last ten years. Mobile devices collect digital traces from our everyday lives - for example, tracking patterns of activity. Such data may be successfully reused for health research.

One disease area where mobility is notably impacted by symptoms is arthritis, making this an interesting case to understand how we might make use of retrospectively collected consumer data for health insights.

Total knee replacements (TKRs) are a common surgical procedure for knee osteoarthritis. Prior to surgery, clinicians and patients need to make shared informed decisions about the likely benefits and potential harms of surgery. Benefits commonly cited include improvements in pain and discomfort, and improvement in mobility. Improvements in pain are supported by strong evidence; however, changes in mobility and activity levels are less clear.

Understanding the patterns of physical activity pre- and post-op have historically been limited to physical activity questionnaires. Some studies are starting to use more objective measures including accelerometry – although this typically requires provision of devices and prospective data collection. To date, the numbers of such studies are limited, outcome measures vary, and assessment is at fixed intervals such as six or 12 months post-op.

In the population of 80k total knee replacement patients per year in the UK, a subset will have been tracking their physical activity data via consumer devices (Fitbit, Google Fit, Strava etc). This provides a major opportunity to learn about changes in activity from real-world data. It is important to understand, though, whether this subset are representative of the whole population of interest, and how the findings can (or cannot) be extrapolated. We also need to know what aspects of activity are of interest to stakeholders, especially patients, so that the analysis can be usefully translated into meaningful information to guide shared, informed decision making in the future.

Aims:

• To conduct a systematic literature review to summarise what is known about physical activity pre- and post-TKR
• To conduct a qualitative study in pre-operative and post-operative TKR patients to explore physical activity behaviours and determine what digital health information should be used to summarise patterns of activity pre- and post-TKR
• In partnership with Fitbit and Janeiro Digital, to identify patients who have undergone TKR, collect consent, and link their Fitbit data with their NHS data
• Analyse the linked data to:
• Understand the representativeness of Fitbit-owning TKR patients
• Generate descriptive statistics of activity levels pre- and post-TKR
• Examine patterns of activity in those with good and bad outcomes according to self-reported status (if able to link to data on patient-reported outcomes).

Supervisory team:

• Prof Will Dixon, Dr Dave Wong (The University of Manchester)
• Dr Stephanie Filbay, Prof Kim Bennell, Dr Mark Merolli (The University of Melbourne)

Eligibility 

Applicants must have obtained or be about to obtain a First or Upper Second class UK honours degree, or the equivalent qualifications gained outside the UK, in a relevant discipline.  

Before you Apply 

Applicants must make direct contact with preferred supervisors before applying. It is your responsibility to make arrangements to meet with potential supervisors, prior to submitting a formal online application.  

How to Apply 

For information on how to apply for this project, please visit the Faculty of Biology, Medicine and Health Doctoral Academy website (https://www.bmh.manchester.ac.uk/study/research/apply/). Informal enquiries may be made directly to the primary supervisor. On the online application form select the appropriate subject title.

For international students, we also offer a unique 4 year PhD programme that gives you the opportunity to undertake an accredited Teaching Certificate whilst carrying out an independent research project across a range of biological, medical and health sciences.  

Your application form must be accompanied by a number of supporting documents by the advertised deadlines. Without all the required documents submitted at the time of application, your application will not be processed and we cannot accept responsibility for late or missed deadlines. Incomplete applications will not be considered. If you have any queries regarding making an application please contact our admissions team [Email Address Removed]  

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