Physical activity among hospitalised older people: insights from upper and lower limb accelerometry

Abstract

BackgroundFew studies have explored the activity levels of hospitalised older people and the intra-daily activity patterns in this group have not been described.AimsTo describe the quantity and daily pattern of physical activity among hospitalised older people using two accelerometers: the ankle-worn StepWatch Activity Monitor (SAM), and the wrist-worn GENEActiv.MethodsThis cross-sectional observational study was conducted on the acute medical wards for older people in one UK hospital. Inclusion criteria: participants aged ≥ 70 years, and able to mobilise prior to admission. Participants wore both devices for up to seven consecutive days, or until hospital discharge, whichever was sooner. Intra-daily activity levels were analysed hourly over each 24 h period.Results38 participants (mean age 87.8 years, SD 4.8) had their activity levels measured using both devices. The SAM median daily step count was 600 (IQR 240–1427). Intra-daily activity analysis showed two peak periods of ambulatory activity between 9 am–11 am and 6 pm–7 pm. With physical activity defined as ≥ 12 milli-g (GENEActiv), the median time spent above this cut-off point was 4.2 h. 62% of this activity time was only sustained for 1–5 min. Acceptability of both devices was high overall, but the wrist-worn device (96%) was more acceptable to patients than the ankle-worn device (83%).ConclusionActivity levels of these hospitalised older people were very low. Most physical activity was sustained over short periods. The intra-daily pattern of activity is an interesting finding which can help clinicians implement time-specific interventions to address the important issue of sedentary behaviour.

Accelerometry Assessed Physical Activity of Older Adults Hospitalized with Acute Medical Illness - an Observational Study

“…Patients spent a median of approximately 1 hour/day on PA, a value lower than the 4.2 hours/day reported by Lim et al's study (12), who analyzed locomotion in 38 acutely hospitalized older patients (median age of 87.8 years). Conversely, another study reported only 43 min per day spent standing or walking (32) in a sample of 45 hospitalized older patients (median age 74.2 years) capable of walking independently pre-admission.…”

“…The strengths of this study are its large sample size, its broad inclusion criteria, the use of accelerometers to assess PA and the large number of PA hours recorded. Regarding sample size, this study is the largest when compared to other studies in Europe (12,13,(16)(17)(18)41), the USA (20,21,32) and Australia (14,19).…”

“…Regarding inclusion criteria, and contrary to previous studies (12,32,47,48), we included patients with cognitive impairment/confusion as they are at increased risk of post-hospitalization functional decline (28,39). Finally, PA was assessed using accelerometers, which are considered superior to pedometers (49) and allow data analysis using different algorithms.…”

Fitbit data show poor correlation with measures of activity and sleep among hospitalized general medicine patients

“…Bedfast (con ned to bed) 2. Chairfast (ability to walk severely limited or non-existent) 3. Walks occasionally (walks occasionally during day, but for very short distances, and spends majority of each shift in bed or chair) 4.…”

“…Inpatients have been found to have very low physical activity with a median of 478-1,158 daily steps, compared to a normal of 5,000-6,000 steps for most individuals over 65. [3][4][5][6][7] Affordable consumer wearable devices that continuously measure activity, sleep and vital signs may provide valuable information that could improve the care of inpatients. These devices could provide more frequent monitoring to detect deterioration earlier and avoid failures to rescue.…”