scholarly journals Variations in Physical Activity and Sedentary Behavior During and After Hospitalization in Acutely Admitted Older Medical Patients: A Longitudinal Study

2021 ◽  
Author(s):  
Baker Nawfal Jawad ◽  
Janne Petersen ◽  
Ove Andersen ◽  
Mette Merete Pedersen
Keyword(s):  
Physical Activity ◽  
Sedentary Behavior ◽  
Older Patients ◽  
Functional Decline ◽  
Median Number ◽  
Medical Illness ◽  
Medical Patients ◽  
Small Peak ◽  
Objective Evidence ◽  
Diurnal Profile

Abstract Background: Inactivity and bedrest are frequent among older patients during hospitalization and are associated with functional decline. No longitudinal objective evidence exists on how patients' diurnal profile for physical activity changes during acute hospitalization and what happens when the patient is discharged to own home. By the use of accelerometers, this study aims to describe and compare the distribution of physical activity and sedentary behavior in acutely hospitalized older patients during hospitalization and after discharge. Methods: The study population consisted of 80 patients (+65 years) from the STAND-Cph trial, who were admitted with acute medical illness and were able to stand. Physical activity and sedentary behavior were measured as number of steps, uptime (walking/standing) and sedentary behavior (lying/sitting) per hour with an activity monitor worn on the thigh (activPAL3, PAL Technologies Ltd). The patients wore the monitor for three periods of one week: during hospitalization, after discharge, and four weeks after discharge. Results: The patients’ median age was 80 years [IQR: 75-88], 68% of the patients were female and The median DEMMI was 57 [IQR: 48-67]. The daily median uptime was 1.7 h [IQR: 1-2.8] during hospitalization, 4.0 h [IQR: 2.7-5.4] after discharge and 4.0 h [IQR: 2.8-5.8] four weeks after discharge. The median number of steps was 728 [IQR: 176-2089], 2207 [IQR: 1433-3148], and 2622 [IQR: 1714-3865], respectively. During hospitalization, a small peak was observed both for number of steps and uptime between 9-11 AM. However, the diurnal profile had no notable variation. At discharge and four weeks after discharge, the median of physical activity peaked 2-3 times and had mostly the same diurnal profile. Conclusion: Older hospitalized patients spend most of their time engaged in sedentary behavior, where their main activity peak is in the morning between 9-11 AM. The uptime doubles and the number of steps triples after discharge, where peaks of activity are seen throughout the day. This indicates that daily routines are disrupted during hospitalization and that older patients have the potential to be more physically active during hospitalization. This emphasizes the need for interventions that encourage physical activity throughout the day during hospitalization.

scholarly journals Is Promotion of Mobility in Older Patients Hospitalized for Medical Illness a Physician’s Job?—An Interview Study with Physicians in Denmark

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 74
Author(s):  
Mette Merete Pedersen ◽  
Rasmus Brødsgaard ◽  
Per Nilsen ◽  
Jeanette Wassar Kirk
Keyword(s):  
Older Patients ◽  
Social Influences ◽  
Theoretical Domains Framework ◽  
Perceived Barriers ◽  
Barriers And Facilitators ◽  
Medical Illness ◽  
Medical Patients ◽  
Face To Face ◽  
Multiple Levels ◽  
Common Barriers

The aim of this study was to identify the most common barriers and facilitators physicians perceive regarding their role in the promotion of mobility in older adults hospitalized for medical illness as part of on an intervention to promote mobility. Twelve physicians at two medical departments were interviewed face-to-face using semi-structed interviews based on the Theoretical Domains Framework. The physicians’ perceived barriers to promoting mobility were: the patients being too ill, the department’s interior does not fit with mobility, a culture of bedrest, mobility not being part their job, lack of time and resources and unwillingness to accept an extra workload. The facilitators for encouraging mobility were enhanced cross-professional cooperation focusing on mobility, physician encouragement of mobility and patient independence in e.g., picking up beverages and clothes. The identified barriers and facilitators reflected both individual and social influences on physicians’ behaviors to achieve increased mobility in hospitalized older medical patients and suggest that targeting multiple levels is necessary to influence physicians’ propensity to promote mobility.

scholarly journals PHYSICAL ACTIVITY IN HOSPITALIZED OLD MEDICAL PATIENTS; HOW ACTIVE ARE THEY, AND WHAT

2015 ◽  
pp. 1-8
Author(s):  
M. Holst ◽  
P.L. Hansen ◽  
L.A. Pedersen ◽  
S. Paulsen ◽  
C.D. Valentinsen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Quantitative Methods ◽  
Fear Of Falling ◽  
Functional Decline ◽  
Clinical Problem ◽  
Medical Patients ◽  
Structured Interviews ◽  
Old Patients ◽  
Sensewear Armband ◽  
Qualitative And Quantitative Methods

Objective: To examine how physically active Danish old medical patients are during hospitalization and to achieve knowledge of motivation and barriers to physical activity. Background: Functional decline in frail old patients during hospitalization is an important clinical problem with potential long-lasting undesirable outcomes and complications. Design: A mixed methods study including qualitative and quantitative methods. Methods: Patients >60 years of age were recruited at two medical departments during one week. Three SenseWear armband monitors were used for quantitative monitoring of physical activity. Semi Structured interviews were used for qualitative data. Results: The study comprised 13 patients, five female and eight male, mean age 73 (SD 9); BMI 19.4-32.1, mean 25.2 (SD 3.7). Only 11 patients completed 24-hours of SenseWear armband monitoring. Half of the participants walked less than 50 steps a day. The majority were bedridden 9 to 15 hours a day. Five of 11 patients had very low activity score. Four patients were moderately active for 19-38 minutes. Five patients sleep less than 6,3 hours, mean 9 (SD 3.3). Lying down was recorded for a mean of 11 hours (SD 4). Factors motivating to physical activity were: Praise and recognition from the staff, experienced boredom, continued ability to perform Activities of Daily Living. Barriers: Symptoms of illness, fear of falling, lack of meaningful activities, inadequate facilities and staff’s lack of focus. Organisational routines such as waiting for physical examinations and rounds, were barriers for patients to get out of bed. Conclusion: Old medical patients were very inactive during hospitalization. Motivation for physical activity was continued ADL abilities, boredom and staff interest, however often hindered by organizational barriers, lack of meaningful activities and focus from staff.

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

2020 ◽  
Author(s):  
Plamena Tasheva ◽  
Vanessa Kraege ◽  
Peter Vollenweider ◽  
Guillaume Roulet ◽  
Marie Méan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Observational Study ◽  
Hospital Stay ◽  
Barthel Index ◽  
Older Patients ◽  
Medical Illness ◽  
Barthel Index Score ◽  
Physically Active ◽  
Walking Aids ◽  
Active Patients

Abstract Background: In a hospital setting and among older patients, inactivity and bedrest are associated with a wide range of negative outcomes such as functional decline, increased risk of falls, longer hospitalization and institutionalization. Our aim was to assess the distribution, determinants and predictors of physical activity (PA) levels using wrist-worn accelerometers in older patients hospitalized with acute medical illness.Methods: Observational study conducted from February to November 2018 at an acute internal medicine unit in the University hospital of Lausanne, Switzerland. We enrolled 177 patients aged ≥65 years, able to walk prior to admission. PA during acute hospital stay was continuously recorded via a 3D wrist accelerometer. Clinical data was collected from medical records or by interview. Autonomy level prior to inclusion was assessed using Barthel Index score. PA levels were defined as <30 mg for inactivity, 30-99 mg for light and ≥100 for moderate PA. Physically active patients were defined as 1) being in the highest quartile of time spent in light and moderate PA or 2) spending ≥20 minutes/day in moderate PA.Results: Median [interquartile range - IQR] age was 83 [74-87] years and 60% of participants were male. The median [IQR] time spent inactive and in light PA was 613 [518-663] and 63 [30-97] minutes/day, respectively. PA peaked between 8 and 10 am, at 12 am and at 6 pm. Less than 10% of patients were considered physically active according to definition 2. For both definitions, active patients had a lower prevalence of walking aids and a lower dependency level according to Barthel Index score. For definition 1, use of medical equipment was associated with a 70% reduction in the likelihood of being active: odds ratio (OR) 0.30 [0.10-0.92] p=0.034; for definition 2, use of walking aids was associated with a 75% reduction in the likelihood of being active: OR=0.24 [0.06-0.89], p=0.032.Conclusion: Older hospitalized patients are physically active only 10% of daily time and concentrate their PA around eating periods. Whether a Barthel Index below 95 prior to admission may be used to identify patients at risk of inactivity during hospital stay remains to be proven.

scholarly journals Accelerometry assessed physical activity of older adults hospitalized with acute medical illness - an observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Plamena Tasheva ◽  
Vanessa Kraege ◽  
Peter Vollenweider ◽  
Guillaume Roulet ◽  
Marie Méan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Observational Study ◽  
Hospital Stay ◽  
Barthel Index ◽  
Older Patients ◽  
Medical Illness ◽  
Barthel Index Score ◽  
Physically Active ◽  
Walking Aids ◽  
Active Patients

Abstract Background In a hospital setting and among older patients, inactivity and bedrest are associated with a wide range of negative outcomes such as functional decline, increased risk of falls, longer hospitalization and institutionalization. Our aim was to assess the distribution, determinants and predictors of physical activity (PA) levels using wrist-worn accelerometers in older patients hospitalized with acute medical illness. Methods Observational study conducted from February to November 2018 at an acute internal medicine unit in the University hospital of Lausanne, Switzerland. We enrolled 177 patients aged ≥65 years, able to walk prior to admission. PA during acute hospital stay was continuously recorded via a 3D wrist accelerometer. Clinical data was collected from medical records or by interview. Autonomy level prior to inclusion was assessed using Barthel Index score. PA levels were defined as < 30 mg for inactivity, 30–99 mg for light and ≥ 100 for moderate PA. Physically active patients were defined as 1) being in the highest quartile of time spent in light and moderate PA or 2) spending ≥20 min/day in moderate PA. Results Median [interquartile range - IQR] age was 83 [74–87] years and 60% of participants were male. The median [IQR] time spent inactive and in light PA was 613 [518–663] and 63 [30–97] minutes/day, respectively. PA peaked between 8 and 10 am, at 12 am and at 6 pm. Less than 10% of patients were considered physically active according to definition 2. For both definitions, active patients had a lower prevalence of walking aids and a lower dependency level according to Barthel Index score. For definition 1, use of medical equipment was associated with a 70% reduction in the likelihood of being active: odds ratio (OR) 0.30 [0.10–0.92] p = 0.034; for definition 2, use of walking aids was associated with a 75% reduction in the likelihood of being active: OR = 0.24 [0.06–0.89], p = 0.032. Conclusion Older hospitalized patients are physically active only 10% of daily time and concentrate their PA around eating periods. Whether a Barthel Index below 95 prior to admission may be used to identify patients at risk of inactivity during hospital stay remains to be proven.

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

2020 ◽  
Author(s):  
Plamena Tasheva ◽  
Vanessa Kraege ◽  
Peter Vollenweider ◽  
Guillaume Roulet ◽  
Marie Méan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Observational Study ◽  
Hospital Stay ◽  
Barthel Index ◽  
Older Patients ◽  
Medical Illness ◽  
Barthel Index Score ◽  
Physically Active ◽  
Walking Aids ◽  
Active Patients

Abstract Background: In a hospital setting and among older patients, inactivity and bedrest are associated with a wide range of negative outcomes such as functional decline, increased risk of falls, longer hospitalization and institutionalization. Our aim was to assess the distribution, determinants and predictors of physical activity (PA) levels using wrist-worn accelerometers in older patients hospitalized with acute medical illness.Methods: Observational study conducted from February to November 2018 at an acute internal medicine unit in the University hospital of Lausanne, Switzerland. We enrolled 177 patients aged ≥65 years, able to walk prior to admission. PA during acute hospital stay was continuously recorded via a 3D wrist accelerometer. Clinical data was collected from medical records or by interview. Autonomy level prior to inclusion was assessed using Barthel Index score. PA levels were defined as <30 mg for inactivity, 30-99 mg for light and ≥100 for moderate PA. Physically active patients were defined as 1) being in the highest quartile of time spent in light and moderate PA or 2) spending ≥20 minutes/day in moderate PA.Results: Median [interquartile range - IQR] age was 83 [74-87] years and 60% of participants were male. The median [IQR] time spent inactive and in light PA was 613 [518-663] and 63 [30-97] minutes/day, respectively. PA peaked between 8 and 10 am, at 12 am and at 6 pm. Less than 10% of patients were considered physically active according to definition 2. For both definitions, active patients had a lower prevalence of walking aids and a lower dependency level according to Barthel Index score. For definition 1, use of medical equipment was associated with a 70% reduction in the likelihood of being active: odds ratio (OR) 0.30 [0.10-0.92] p=0.034; for definition 2, use of walking aids was associated with a 75% reduction in the likelihood of being active: OR=0.24 [0.06-0.89], p=0.032.Conclusion: Older hospitalized patients are physically active only 10% of daily time and concentrate their PA around eating periods. Whether a Barthel Index below 95 prior to admission may be used to identify patients at risk of inactivity during hospital stay remains to be proven.

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

2020 ◽  
Author(s):  
Plamena Tasheva ◽  
Vanessa Kraege ◽  
Peter Vollenweider ◽  
Guillaume Roulet ◽  
Marie Méan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Observational Study ◽  
Hospital Stay ◽  
Barthel Index ◽  
Older Patients ◽  
Medical Illness ◽  
Barthel Index Score ◽  
Physically Active ◽  
Walking Aids ◽  
Active Patients

Abstract Background: In a hospital setting and among older patients, inactivity and bedrest are associated with a wide range of negative outcomes such as functional decline, increased risk of falls, longer hospitalization and institutionalization. Our aim was to assess the distribution, determinants and predictors of physical activity (PA) levels using wrist-worn accelerometers in older patients hospitalized with acute medical illness.Methods: Observational study conducted from February to November 2018 at an acute internal medicine unit in the University hospital of Lausanne, Switzerland. We enrolled 177 patients aged ≥65 years, able to walk prior to admission. PA during acute hospital stay was continuously recorded via a 3D wrist accelerometer. Clinical data was collected from medical records or by interview. Autonomy level prior to inclusion was assessed using Barthel Index score. PA levels were defined as <30 mg for inactivity, 30-99 mg for light and ≥100 for moderate PA. Physically active patients were defined as 1) being in the highest quartile of time spent in light and moderate PA or 2) spending ≥20 minutes/day in moderate PA.Results: Median [interquartile range - IQR] age was 83 [74-87] years and 60% of participants were male. The median [IQR] time spent inactive and in light PA was 613 [518-663] and 63 [30-97] minutes/day, respectively. PA peaked between 8 and 10 am, at 12 am and at 6 pm. Less than 10% of patients were considered physically active according to definition 2. For both definitions, active patients had a lower prevalence of walking aids and a lower dependency level according to Barthel Index score. For definition 1, use of medical equipment was associated with a 70% reduction in the likelihood of being active: odds ratio (OR) 0.30 [0.10-0.92] p=0.034; for definition 2, use of walking aids was associated with a 75% reduction in the likelihood of being active: OR=0.24 [0.06-0.89], p=0.032.Conclusion: Older hospitalized patients are physically active only 10% of daily time and concentrate their PA around eating periods. Whether a Barthel Index below 95 prior to admission may be used to identify patients at risk of inactivity during hospital stay remains to be proven.

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

2015 ◽  
Vol 23 (4) ◽  
pp. 542-549 ◽  
Author(s):  
Morten Villumsen ◽  
Martin Gronbech Jorgensen ◽  
Jane Andreasen ◽  
Michael Skovdal Rathleff ◽  
Carsten Møller Mølgaard
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Older Patients ◽  
Geriatric Patients ◽  
Functional Decline ◽  
Activity Level ◽  
Accelerometer Data ◽  
Geriatric Ward ◽  
Acute Geriatric Ward ◽  
Low Levels

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.

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