SAN DIEGO, March 10, 2025 ~ Apple Health App Proves to be a Valuable Tool for Assessing Patient Recovery Following Lower Extremity Trauma Surgery

At the 2025 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), a study was presented that showcased the potential of Apple Health mobility data in assessing patient recovery following lower extremity trauma surgery. The study, titled "The Future is Mobile: Validating Apple Health as a Novel Orthopaedic Trauma Outcome Metric," was led by Dr. Dane J. Brodke, MD, MPH, assistant professor at Oregon Health & Science University in Portland.

According to Dr. Brodke, the goal of orthopaedic surgeons is to help patients regain mobility and resume their daily activities. However, assessing functional recovery in cases of traumatic leg injuries has been challenging due to a lack of objective data. This is where smartphone-based platforms like Apple Health come into play.

"Since smartphone-based platforms like Apple Health collect data passively in the background, we have a unique opportunity to measure mobility both before and after an injury, providing valuable context for patient recovery," explained Dr. Brodke. "This baseline information is vital to contextualizing a patient's recovery and is generally unavailable with other functional outcome measures."

The study included adult patients with lower extremity fractures who owned iPhones and had at least six months of post-injury follow-up. Participants shared their Apple Health data and completed Patient Reported Outcomes Measurement Information System (PROMIS) surveys to analyze physical function and pain.

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The key metrics analyzed were daily step count, walking asymmetry (the percentage of time steps are asymmetric), double support time (the portion of the gait cycle where both feet are on the ground), walking speed, and step length. Using mixed-effects models, researchers compared these parameters at three critical time points: pre-injury (28 days prior), acute post-injury (first 28 days after injury), and six months post-injury (days 152-180). They also assessed the correlations between these parameters and PROMIS physical function and pain interference.

The study found that all five Apple Health mobility parameters showed significant changes from pre-injury to post-injury. Step count decreased by 93%, walking speed decreased by 9%, step length decreased by 6%, walking asymmetry increased by 88%, and walking double support increased by 1%. However, six months following the injury, there were improvements in these parameters. The average daily step count increased by 655% from early post-injury but was still a 52% decrease from before the injury. Walking speed and step length continued to decrease during the first six months of recovery, while walking asymmetry and double support time increased. Compared to pre-injury levels, walking asymmetry remained 198% higher and speed was 15% lower.

Of all the mobility parameters, step count showed a moderate or stronger correlation with patient-reported physical function. Additionally, patients with nonunions (when the bone doesn't heal properly) demonstrated a slower recovery in daily step counts compared to those who healed normally.

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"These findings suggest that smartphone-measured step counts not only correlate with adverse clinical outcomes but may also predict them, allowing for earlier intervention and improved patient care," said Dr. Nathan O'Hara, PhD, MHA, associate professor of orthopaedics at University of Maryland Medical System in Baltimore. "Conversely, when a patient's recovery plateaus, it may indicate they have reached their maximum potential improvement."

Dr. O'Hara also noted that while the PROMIS survey offers valuable insights from a patient's perspective, it remains subjective. For the first time, the objective data from Apple Health provides a clearer and more reliable understanding of a patient's recovery.

The team is currently developing an app that patients can download during their initial visit with their orthopaedic surgeon. The goal is to enroll more participants and track their Apple Health data. By leveraging this technology, the team hopes to empower patients with personalized insights that support their recovery and help them safely return to an active lifestyle.

In conclusion, the study presented at the 2025 AAOS Annual Meeting highlights the potential of Apple Health mobility data in assessing patient recovery following lower extremity trauma surgery. With its ability to collect objective data before and after an injury, this technology can provide valuable context for patient recovery and improve overall care.

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