Feasibility of Using a Commercially Available Smartwatch to Advance Outcomes for Patient with Post-acute Sequelae of COVID-19 (PASC): Case Report

Research Objectives: To explore if smartwatch usage can augment rehabilitation of patient with PASC.

Design: Retrospective case report.

Setting: Outpatient physical rehabilitation hospital.

Participants: Adult with PASC including fatigue, post-exertional malaise (PEM), brain fog, weakness, and limited ability to complete IADLs and work/life roles.

Interventions: Patient completed 15-week post-COVID outpatient program (11 visits each for physical, occupational, and speech therapies). Garmin Venu SQ2 watch provided (second visit) to monitor daily steps, heart rate, sleep, and stress. Treatment included pacing, graded endurance and strength training, cognitive therapy, and diaphragmatic breathing. Smartwatch data integrated across therapies to guide exercise intensity, stress management, and sleep hygiene. Clinicians and patient discussed smartwatch data to identify salient factors impacting day-to-day stress and sleep patterns.

Main Outcome Measures: Qualitative patient feedback, smartwatch data (first vs. last week), and clinical measures (baseline vs. discharge).

Results: Patient reported maintaining employment and re-engaging in hobbies across therapy weeks. Patient stated the smartwatch “confirmed my perception of my symptoms…”, “showed me stress triggers I never would've known about…", allowed identification of stressful cognitive tasks “so much easier”, particularly at work, and "helped me understand how managing my stress helped me sleep." Patient sustained high average daily Steps (8,667 vs. 7,419) between first and last therapy weeks. Average daily Stress remained steady (32.1 vs. 32.3), Sleep Duration increased (6.6 vs. 7.2 hours) and Resting Heart Rate decreased (60.2 vs. 57.7 bpm). Between admission and discharge, patient increased 6 Minute Walk Test (6MWT) distance (401 vs. 571 m), 30-Second Sit-to-Stand (STS) repetitions (10 vs. 16), and dominant arm Grip Strength (36 vs. 56 lbs). Decreases recorded for each test’s Ratings of Perceived Exertion (6MWT 7 vs. 2; STS 5 vs. 3) and Dyspnea (5 vs 2; STS 5 vs. 3), and DePaul Symptom Questionnaire PEM frequency (2.0 vs. 0.4) and severity (2.2 vs. 0.6)

Conclusions: Patient with PASC’s physical function and PEM improved following participation in multidisciplinary rehabilitation. Patient benefited from smartwatch usage, including biomarker feedback, to determine symptom-titrated exercise threshold and reinforce pacing, stress management, and sleep hygiene strategies. Findings highlight benefits of integrating smartwatches into PASC rehabilitation for improving carryover of exercise, recovery, and pacing strategies.

Author(s) Disclosures: This project is being supported, in whole or in part, by federal award numbers SLFRP1965 (PI: Burnfield) awarded to Douglas County and SLFRP1615 (PI: Burnfield) awarded to the Nebraska Department of Health and Human Services by the U.S. Department of the Treasury. The co-authors’ work on this abstract was supported, in part, by these grants.