Prevalence and Outcomes of Low Mobility in Hospitalized Older Patients

Brown, Cynthia J.; Friedkin, Rebecca J.; Inouye, Sharon K.

doi:10.1111/j.1532-5415.2004.52354.x

Cited by 539 publications

(525 citation statements)

References 29 publications

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“…Overall functional status and timely discharge may be affected if bedside chairs are uncomfortable or do not offer support features needed to encourage use. Because early mobility and general activity are critical in avoiding functional decline, 48 lessons learned about the comfort of chairs (and other furniture) could help determine if furniture choices facilitate mobility.…”

Section: Discussionmentioning

confidence: 99%

Patients and Their Families Weigh in on Evidence-Based Hospital Design

Trochelman

Albert

Spence

et al. 2012

Critical Care Nurse

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to design and build health care facilities founded on research or the best available information, ensuring that the relatively permanent physical environment facilitates the delivery of quality care, thereby improving patients' outcomes and safety. 2 Review of the Literature on EBD in Critical and Acute CareSubstantial support exists for the view that a health care structure itself affects quality of care, patients' safety and satisfaction, as well as staff satisfaction and service efficacy. 3 In a report to the Center for Health Design funded by the Robert Wood Johnson Foundation, Ulrich and associates 4 identified more than 600 studies that link hospital design with clinical outcomes. In recent years, evidence-based design (EBD) has become a more pronounced guiding principle in health care. The concept of EBD is BACKGROUND In 2 landmark publications, the Institute of Medicine reported on significant deficiencies in our current health care system. In response, an area of research examining the role of the physical environment in influencing outcomes for patients and staff gained momentum. The concept of evidence-based design has evolved, and the development of structural guidelines for new hospital construction was instituted by the American Institute of Architects in 2006.OBJECTIVE To determine perceptions of patients and their families of evidence-based design features in a new heart center.METHODS Hospitalized patients and their families, most of whom were in intensive care and step-down units, were surveyed and data from the Hospital Consumer Assessment of Healthcare Providers and Systems were reviewed to determine perceptions of evidence-based design features incorporated into a new heart center and to assess patients' satisfaction with the environment. RESULTS Responses were reviewed and categorized descriptively. Five general environment topics of focus emerged: privacy, space, noise, light, and overall atmosphere. Characteristics perceived as being dissatisfying and satisfying are discussed.CONCLUSIONS Critical care nurses must be aware of the current need to recognize how much the physical environment influences care delivery and take steps to maximize patients' safety, satisfaction, and quality of care. This article has been designated for CE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:1. Discuss the concept of evidence-based design in health care environments 2. Identify evidence-based design features associated with improved patient care 3. Recognize the role of physical environment in influencing patient outcomes

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Section: Discussionmentioning

confidence: 99%

Patients and Their Families Weigh in on Evidence-Based Hospital Design

Trochelman

Albert

Spence

et al. 2012

Critical Care Nurse

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“…For older patients, hospitalization has been associated with a variety of adverse outcomes, including high rates of functional decline, increased risk of medical and iatrogenic events, and increased likelihood of nursing home placement upon discharge [1][2][3][4][5][6][7][8][9][10]. Low mobility, defined as activity that is limited to a bed or chair, is also a common event during hospitalization.…”

Section: Introductionmentioning

confidence: 99%

“…Low mobility, defined as activity that is limited to a bed or chair, is also a common event during hospitalization. An estimated 23 to 33 percent of older patients are limited to a bed or chair during hospitalization for acute illness [1,[10][11]. Ambulation during hospitalization occurs infrequently, with only 27 percent of patients walking in the hallways during hospitalization [12].…”

Section: Introductionmentioning

confidence: 99%

Validation of use of wireless monitors to measure levels of mobility during hospitalization

Brown

Roth

Allman

2008

JRRD

Self Cite

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Abstract-Accurate methods of measuring levels of mobility during hospitalization are lacking. We validated the use of wireless monitors to measure three levels of mobility during hospitalization: (1) lying, (2) sitting, and (3) standing or walking. Hospitalized medical patients 65 years or older who did not have delirium or dementia and could walk in the 2 weeks before admission were eligible. Wireless monitors, which recorded average position every 20 seconds, were attached to the thigh and ankle of consented patients. Direct behavioral observation by trained observers who recorded mobility level was used as the gold standard. Forty-seven male patients (mean age 73.9 years), with a mean length of stay of 5.3 days, generated 187 two-hour direct behavioral observation periods. Wireless monitors were highly correlated with direct behavioral observations. The median kappa was 0.92 and the kappa across all observations was 0.88, indicating excellent agreement. This study demonstrates that wireless monitors validly measure mobility levels among older hospitalized patients.

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“…Studies have shown that when adverse changes of inactivity are superimposed on age-induced sarcopenia there is further physiological deconditioning (Brown et al, 2004;Morris, 2007). To date, there is little information or evidence regarding the effectiveness of treadmill exercise as an intervention during periods of non-weight bearing to reduce skeletal muscle atrophy and preserve contractile function, especially in the older animal.…”

Section: Introductionmentioning

confidence: 99%

Age-dependent effects of treadmill exercise during a period of inactivity

Arora

Husom

Ferrington

et al. 2008

Experimental Gerontology

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The objective of this study was to investigate the effect of a treadmill exercise protocol to prevent muscle weakness, atrophy and alterations in calcium regulation in adult, old and very old rats. Adult (7-12 months), old (29-30 months) and very old (34-36 months) F344BNF 1 rats were randomly assigned to weight bearing (WB), weight bearing exercise (WBX), non-weight bearing (NWB) and non-weight bearing exercise (NWBX) groups. The WB group was considered the sedentary-control animals. NWB rats were hindlimb unweighted for 14 days. WBX and NWBX groups were exercised on a treadmill for approximately fifteen minutes four times daily. The contractile properties [diameter, peak active force (P 0 ), specific tension (P 0 /CSA)] of single myosin heavy chain type II fibers and Ca regulation [Ca +2 dependent ATPase activity] were determined. Fiber diameter reduced by 24% in the very old rats with NWB. P 0 and P 0 /CSA declined in the young adult and very old rats with NWB. NWBX attenuated these changes in the young and very old rats. Ca +2 dependent ATPase activity increased with treadmill exercise during non-weight bearing in the young animals. In conclusion, the treadmill exercise is beneficial in attenuating the non-weight bearing induced changes in the individual MHC type II muscle fibers of the gastrocnemius muscle.

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Prevalence and Outcomes of Low Mobility in Hospitalized Older Patients

Cited by 539 publications

References 29 publications

Patients and Their Families Weigh in on Evidence-Based Hospital Design

Patients and Their Families Weigh in on Evidence-Based Hospital Design

Validation of use of wireless monitors to measure levels of mobility during hospitalization

Age-dependent effects of treadmill exercise during a period of inactivity

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