Effect of Digital Step Counter Feedback on Mobility After Cesarean Delivery: A Randomized Controlled Trial

OBJECTIVE:To assess the effect of a personalized repeated feedback approach using digital step counters (pedometers) on mobility after cesarean delivery in high-risk patients. METHODS:This was a randomized controlled trial at a tertiary university hospital. Patients who underwent cesarean delivery and were defined as high risk for thromboembolic events were asked to wear a pedometer around their wrists postpartum for 48 hours. Patients were randomized to the feedback group, which received personalized feedback by the research staff regarding their mobility at three set timepoints, or the control group, which received standard care. The number of steps taken by patients was compared between the groups and served as the primary outcome. Secondary outcomes included patient reported pain, physical and mental recovery, and overall satisfaction. Sample size was predetermined to detect a 25% between-group difference in the primary outcome. RESULTS:From December 2018 to July 2019, 215 patients were recruited, randomized and completed follow-up—108 in the feedback group and 107 in the control group. Patientsʼ demographics and intrapartum course were similar between the groups. The number of steps taken was significantly higher in the feedback group compared with the control group5,918±3,116 vs 4,161±2,532 steps, P