Very Low Levels of Physical Activity in Older Patients During Hospitalization at an Acute Geriatric Ward: A Prospective Cohort Study

Abstract

Lack of activity during hospitalization may contribute to functional decline. The purpose of this study was to investigate (1) the time spent walking during hospitalization by geriatric patients referred to physical and/or occupational therapy and (2) the development in time spent walking during hospitalization. In this observational study, 24-hr accelerometer data (ActivPal) were collected from inclusion to discharge in 124 patients at an acute geriatric ward. The median time spent walking was 7 min per day. During the first quartile of hospitalization, the patients spent 4 (IQR:1;11) min per day walking, increasing to 10 (IQR:1;29) min during the last quartile. Improvement in time spent walking was primarily observed in the group able to perform the Timed Up & Go task at admission. When walking only 7 min per day, patients could be classified as inactive and at risk for functional decline; nonetheless, the physical activity level increased significantly during hospitalization.

Promoting Activity in Geriatric Rehabilitation: A Randomized Controlled Trial of Accelerometry

“…Comparability of walking times achieved in our study with those in previous studies monitoring activity in geriatric rehabilitation using wearable devices [28–33] are problematic because of differences in population characteristics (including primary diagnosis and acuity), setting (acute, sub-acute or post-acute rehabilitation), period of monitoring and activity measured (eg step count, walking, or ‘uptime’ which includes standing and walking). For example, compared with a baseline median daily walking time of 10 minutes in the current study, daily walking activity varied from 4 minutes in a study of a comparable population referred for rehabilitation therapy [33], to 7 minutes in a study of patients rehabilitated following hip fracture [28] and 23 minutes in moderately impaired elderly stroke patients [31].…”

“…For example, compared with a baseline median daily walking time of 10 minutes in the current study, daily walking activity varied from 4 minutes in a study of a comparable population referred for rehabilitation therapy [33], to 7 minutes in a study of patients rehabilitated following hip fracture [28] and 23 minutes in moderately impaired elderly stroke patients [31]. Increase in walking time over the duration of rehabilitation shows similar wide variation, depending on diagnostic group and period of monitoring.…”

Physical activity, muscle strength, and exercise capacity 3 months after severe sepsis and septic shock

“…Our results show that patients remained largely inactive (sitting and lying = 89.2 %) during hospitalization. The physical inactivity observed in hospitalized patients has previously been described in the elderly [42] and patients with chronic lung disease [18,19]. Villumsen et al [42] demonstrated that elderly patients nearing hospital discharge spent approximately 10 min/day walking.…”

“…The physical inactivity observed in hospitalized patients has previously been described in the elderly [42] and patients with chronic lung disease [18,19]. Villumsen et al [42] demonstrated that elderly patients nearing hospital discharge spent approximately 10 min/day walking. In COPD patients, the average daily walking time during hospitalization was less than 10 min/day [18,19].…”

Functional training and timed nutrition intervention in infectious medical patients

“…3,13,16,26,27 In hospitals, the ambulation and training of medical patients, however, seem to have an even lower priority in practice than patient nutrition intake. 7,28,29 Many barriers seem to be present regarding training and ambulation, as well as to providing nutrition for patients, even though nurses are present, and may be the relevant partner, closest to the patient. 28,30,31 The aim of our study was to assess whether it was possible to improve muscle function in acutely ill patients by an active approach based on evidence-based nutritional support and early physiotherapy, in an intervention closely integrated in the daily activities of the ward.…”