Observations of Activity Levels in a Purpose-Built, Inpatient, Rehabilitation Facility

Scrivener, Katharine; Pocovi, Natasha; Jones, Taryn; Dean, B.; Gallagher, Shaun; Henrisson, Wesley; Thorburn, Michael; Dean, Catherine M.

doi:10.1177/1937586718823519

Cited by 9 publications

(11 citation statements)

References 19 publications

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“…55 Provision of communal dining and activity areas have also been noted as helping to increase patient activity. 56 Importantly, the mere existence of a communal area is likely not sufficient to guarantee its use. 37 Future research could examine the optimal design of communal areas including: whether their use should be flexible or structured, their optimal size and their optimal placement in relation to the patient bedrooms and other key spaces.…”

Section: Discussionmentioning

confidence: 99%

Built environments for inpatient stroke rehabilitation services and care: a systematic literature review

et al. 2021

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ObjectivesTo identify, appraise and synthesise existing design evidence for inpatient stroke rehabilitation facilities; to identify impacts of these built environments on the outcomes and experiences of people recovering from stroke, their family/caregivers and staff.DesignA convergent segregated review design was used to conduct a systematic review.Data sourcesOvid MEDLINE, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature were searched for articles published between January 2000 and November 2020.Eligibility criteria for selecting studiesQualitative, quantitative and mixed-methods studies investigating the impact of the built environment of inpatient rehabilitation facilities on stroke survivors, their family/caregivers and/or staff.Data extraction and synthesisTwo authors separately completed the title, abstract, full-text screening, data extraction and quality assessment. Extracted data were categorised according to the aspect of the built environment explored and the outcomes reported. These categories were used to structure a narrative synthesis of the results from all included studies.ResultsTwenty-four articles were included, most qualitative and exploratory. Half of the included articles investigated a particular aspect of the built environment, including environmental enrichment and communal areas (n=8), bedroom design (n=3) and therapy spaces (n=1), while the other half considered the environment in general. Findings related to one or more of the following outcome categories: (1) clinical outcomes, (2) patient activity, (3) patient well-being, (4) patient and/or staff safety and (5) clinical practice. Heterogeneous designs and variables of interest meant results could not be compared, but some repeated findings suggest that attractive and accessible communal areas are important for patient activity and well-being.ConclusionsStroke rehabilitation is a unique healthcare context where patient activity, practice and motivation are paramount. We found many evidence gaps that with more targeted research could better inform the design of rehabilitation spaces to optimise care.PROSPERO registration numberCRD42020158006.

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Section: Discussionmentioning

confidence: 99%

Built environments for inpatient stroke rehabilitation services and care: a systematic literature review

et al. 2021

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“…High levels of activity are already observed in this particular rehabilitation setting in contrast with most other similar settings. 27 Also, due to existing procedures and time restraints, there was suboptimal uptake of the Pt Pal™ app by the physiotherapists on site. This in turn, had an effect on when and how soon exercises were upgraded for participants, also potentially affecting participant usage and reducing motivation to use the app.…”

Section: Discussionmentioning

confidence: 99%

“…First, high levels of activity are already observed in this particular rehabilitation setting in contrast to most other similar settings. 13 This potentially limits the amount of activity that could be completed by the intervention group with the supplemental app-based exercise programme. Second, due to existing procedures and time restraints, there was suboptimal uptake of the app by the physiotherapists on site.…”

Section: Discussionmentioning

confidence: 99%

“…In rehabilitation settings, it is recommended to quantify exercise dose as the number of repetitions completed as this measure includes only the actual activity performed and does not take into account additional events (such as rest periods) which would be included in measures of time. 13 In this trial, total supplementary exercise dosage was measured as time with the app open and repetitions of exercise completed within the app. Use of the app was completed outside of therapy time.…”

Section: Methodsmentioning

confidence: 99%

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App-based supplemental exercise in rehabilitation, adherence, and effect on outcomes: a randomized controlled trial

Bui

Phan

et al. 2020

Clin Rehabil

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Question: To determine the uptake of an app-based supplemental exercise programme in a rehabilitation setting and the effect of such a programme on length of stay and function compared to usual care physiotherapy. Design: Randomized controlled trial with random allocation and assessor blinding. Participants: A total of 144 individuals with mixed diagnoses (orthopaedic, neurological, reconditioning) admitted for inpatient sub-acute rehabilitation. Interventions: Participants were randomly allocated to usual care physiotherapy (control group) or usual care physiotherapy with the addition of an app-based supplemental exercise programme (intervention group). Outcome measures: The primary measure of interest was total supplementary exercise dosage completed by the intervention group. The primary between-group outcome measure was length of stay with secondary measures including walking endurance (Six-Minute Walk Test), walking speed (10-Metre Walk Test), functional mobility (Timed Up and Go Test) and level of disability (Functional Independence Measure). Results: Participants in the intervention group performed 7 minutes (SD: 9) or 49 repetitions (SD: 48) of supplementary exercise using the app each day. There were no differences between the groups for length of stay (mean difference (MD): −0.5 days, 95% confidence interval (CI): −3.2 to 2.2) or change in any secondary functional outcome measures, including walking speed (MD: −0.1 m/s, 95% CI: −0.2 to 0.0) and disability (MD: −0.9, 95% CI: −3.6 to 1.8). Conclusion: A small supplementary exercise dose was achieved by participants in the intervention group. However, such a programme did not affect length of stay or functional outcomes when compared to usual care.

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“…Behavioural mapping is a method which involves observing the patient, categorising the observed activity, and recording the patient's location at different time points. Studies using behaviour mapping have been completed within inpatient rehabilitation in the UK, 6,8 USA, 9 Europe 10,11 and Australia 2,3,12,13 …”

Section: Introductionmentioning

confidence: 99%

Activity levels of inpatients admitted to two rehabilitation units in regional hospitals: An observational study

Garner

Smith

2021

Australian J Rural Health

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Objective The objective of this study is to measure the activity levels of patients admitted to adult general inpatient rehabilitation units in regional areas. These included physical, social, cognitive and self‐care activities. A secondary aim was to explore differences in activity levels across different diagnostic groups. Design An observational study using behavioural mapping. Patient activity was mapped every 15 minutes, over a 12‐hour period (07:00‐19:00), on two, non‐consecutive days. Setting 2 inpatient rehabilitation units, inner regional NSW. Participants All patients were admitted for rehabilitation in an adult general rehabilitation unit. Patients presented with diverse diagnoses (eg neurological, musculoskeletal, orthopaedic, pulmonary and cardiovascular diseases). The sample had a mean age of 74.4 years with a range of 33‐96 years. Main outcome measures The percentage of the day spent in physical, cognitive or social activities was recorded. In addition, the patients’ location and interacting personnel were recorded. Results Fifty‐six participants across 8 diagnosis groups were observed. A total of 2285 observations were made. Patients were observed being active physically for 10% of their day, socially active for 23%, and cognitively for 6%. Patients engaged in other activities such as watching TV or eating 21% of their time, and completing self‐care activities 7% of their time. Patients were inactive for 27% of their day. There was no statistically significant difference between the diagnostic groups and activity categories. Conclusion Patients spent a large proportion of their time inactive and alone in rehabilitation. In order to maximise outcome, rehabilitation units can look at new opportunities to maximise activity and promote engagement.

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Observations of Activity Levels in a Purpose-Built, Inpatient, Rehabilitation Facility

Cited by 9 publications

References 19 publications

Built environments for inpatient stroke rehabilitation services and care: a systematic literature review

Built environments for inpatient stroke rehabilitation services and care: a systematic literature review

App-based supplemental exercise in rehabilitation, adherence, and effect on outcomes: a randomized controlled trial

Activity levels of inpatients admitted to two rehabilitation units in regional hospitals: An observational study

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