Walking in hospital is associated with a shorter length of stay in older medical inpatients

McCullagh, Ruth; Dillon, Christina; Dahly, Darren; Horgan, N Frances; Timmons, Suzanne

doi:10.1088/0967-3334/37/10/1872

Cited by 40 publications

(29 citation statements)

References 34 publications

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“…However, the low median daily step count of 600 steps reported in this study appears to be consistent with findings from research in other countries. McCullagh et al examined the mobility levels of 150 medical inpatients (mean age 77.5, SD 7.4) in a hospital in Ireland and reported a median daily step count ranging from 299 to 661 steps per day [ 27 ]. Studies in the US report a similar range of daily step count.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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“…2). The studies that performed better in the analysis [34,[36][37][38] gave greater consideration to reporting information on non-responders (patients that were eligible for inclusion but declined to participate).…”

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

A systematic review of the physical activity levels of acutely ill older adults in Hospital At Home settings: an under-researched field

et al. 2020

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Purpose The purpose of this review was to identify, evaluate and synthesise existing evidence reporting the physical activity levels of acutely ill older patients in a ‘Hospital At Home’ setting and compare this to patients with similar characteristics treated in a traditional hospital inpatient setting. Functional changes and any adverse outcomes due to physical activity (e.g. falls) in both settings where PA was reported or recorded were also evaluated as secondary outcomes. Methods A search strategy was devised for the MEDLINE, CINAHL, AMed, PEDRO, OT Seeker and Cochrane databases. Search results were title, abstract and full-text reviewed by two independent researchers. Data were extracted from included articles using a custom form and assessed for quality and risk of bias using the Appraisal Tool for Cross-Sectional Studies. Results No studies set in the Hospital at Home environments were identified. 16 hospital inpatient studies met the criteria for inclusion. Older patients managed in inpatient settings that would be eligible for Hospital at Home services spent 6.6% of their day active and undertook only 881.8 daily steps. Functional change was reported in four studies with both improvement and decline during admission reported. Conclusion There is a lack of published research on the physical activity levels of acutely-ill older adults in Hospital at Home settings. This review has identified a baseline level of activity for older acutely ill patients that would be suitable for Hospital at Home treatment. This data could be used as a basis of comparison in future hospital at home studies, which should also include functional change outcomes to further explore the relationship between physical inactivity and functional decline.

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“…[ 15 ] Accumulation of hospital days is inversely correlated with in-hospital physical inactivity. [ 16 ] Our patients who were fully ambulatory with good PS at baseline showed slow recovery from HAPI after prolonged hospitalization (≥8 days). It is difficult to differentiate the adverse effects of chemotherapy on PA from the adverse effects of hospitalization.…”

Section: Discussionmentioning

confidence: 90%

Impact of Cancer Cachexia on Hospitalization-associated Physical Inactivity in Elderly Patients with Advanced Non-small-cell Lung Cancer

Morikawa

Naito

Sugiyama

et al. 2018

Asia-Pacific Journal of Oncology Nursing

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Objective:New or worsening disability can develop in elderly patients in just 1 week of hospitalization for acute illness. Elderly patients with cancer, particularly those with cancer cachexia, are vulnerable to disability. This study aimed to explore the impact of hospitalization and cachexia on physical activity (PA) in elderly patients during chemotherapy.Methods:We prospectively enrolled 18 patients aged ≥70 years with newly-diagnosed, advanced non-small-cell lung cancer scheduled to initiate first-line chemotherapy. PA was measured using an accelerometer (Lifecorder®, Suzuken Co., Ltd., Japan). Mean daily steps at baseline, during hospitalization, and subsequent weeks (1st, 2nd, and 3rd week after discharge) were compared.Results:A total of 30 hospitalizations for chemotherapy were evaluated in 18 patients with a median age of 74.5 years. The median number of baseline daily steps was 3756. Fifteen cases (50%) showed fewer daily steps during hospitalization and no recovery to baseline level during the 1st week after discharge. Long hospitalizations (≥8 days) and the presence of cachexia were associated with persistent physical inactivity. One patient developed disability within 30 days after hospitalization.Conclusions:Physical inactivity was frequently seen after hospitalization for chemotherapy in elderly patients with advanced lung cancer. Longer in-hospital days and the presence of cancer cachexia caused slow recovery from physical inactivity. Individualized hospitalization planning based on careful consideration of patient age and the presence of cancer cachexia may be needed to prevent physical inactivity and disability.

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Walking in hospital is associated with a shorter length of stay in older medical inpatients

Cited by 40 publications

References 34 publications

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

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

A systematic review of the physical activity levels of acutely ill older adults in Hospital At Home settings: an under-researched field

Impact of Cancer Cachexia on Hospitalization-associated Physical Inactivity in Elderly Patients with Advanced Non-small-cell Lung Cancer

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