Physical activity during hospitalization: Activities and preferences of adults versus older adults

Meesters, J.; Conijn, D.; Vermeulen, H.; Vlieland, Thea Vliet

doi:10.1080/09593985.2018.1460429

Cited by 25 publications

(25 citation statements)

References 18 publications

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“…As argued in a recent editorial [9], hospital associated disabilities are still common despite three decades of study and knowledge about modifiable factors during hospitalization-e.g., limited mobility. Several studies have reported low levels of mobility in older patients hospitalized for medical illness (henceforth: older medical patients) [10][11][12][13][14]. Additionally, in a previous study, we found that older medical patients spent a median of 22 h a day lying or sitting and less than one hour a day standing and walking during hospitalization [15].…”

Section: Introductionmentioning

confidence: 49%

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

et al. 2020

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: 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.

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Section: Introductionmentioning

confidence: 49%

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

et al. 2020

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“…This important finding implies that older adults can be more physically active during hospitalization and underlines the need for in-hospital interventions to stimulate physical activity. 50,51 Our findings suggest that, of the of physical frailty factors described by Fried et al, 19 only age, 41 physical performance, and in-hospital step numbers are predictors of postdischarge step numbers. These findings support the theory that acute illness and age-related changes can lead to loss of muscle mass and physical performance, resulting in functional decline and reduced physical activity.…”

mentioning

confidence: 58%

Factors Associated with Step Numbers in Acutely Hospitalized Older Adults: The Hospital-Activities of Daily Living Study

Kolk

Aarden

Vroomen

et al. 2021

Journal of the American Medical Directors Association

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Objectives: To determine the number of steps taken by older patients in hospital and 1 week after discharge; to identify factors associated with step numbers after discharge; and to examine the association between functional decline and step numbers after discharge. Design: Prospective observational cohort study conducted in 2015e2017. Setting and Participants: Older adults (!70 years of age) acutely hospitalized for at least 48 hours at internal, cardiology, or geriatric wards in 6 Dutch hospitals. Methods: Steps were counted using the Fitbit Flex accelerometer during hospitalization and 1 week after discharge. Demographic, somatic, physical, and psychosocial factors were assessed during hospitalization. Functional decline was determined 1 month after discharge using the Katz activities of daily living index. Results: The analytic sample included 188 participants [mean age (standard deviation) 79.1 (6.7)]. One month postdischarge, 33 out of 174 participants (19%) experienced functional decline. The median number of steps was 656 [interquartile range (IQR), 250e1146] at the last day of hospitalization. This increased to 1750 (IQR 675e4114) steps 1 day postdischarge, and to 1997 (IQR 938e4098) steps 7 days postdischarge. Age [b ¼ À57.93; 95% confidence interval (CI) À111.15 to À4.71], physical performance (b ¼ 224.95; 95% CI 117.79e332.11), and steps in hospital (b ¼ 0.76; 95% CI 0.46e1.06) were associated with steps postdischarge. There was a significant association between step numbers after discharge and functional decline 1 month after discharge (b ¼ À1400; 95% CI e2380 to À420; P ¼ .005). Conclusions and Implications: Among acutely hospitalized older adults, step numbers double 1 day postdischarge, indicating that their capacity is underutilized during hospitalization. Physical performance and physical activity during hospitalization are key to increasing the number of steps

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“…This variety of modalities was based on the observation that preferences regarding the promotion of physical activity of patients who are hospitalized may vary considerably. 5 Nevertheless, there was a relatively high dropout rate from the study, and although this occurred in both phases and is thus not likely to be related to the intervention, it cannot be ruled out that the usage and satisfaction outcomes are biased.…”

Section: Discussionmentioning

confidence: 98%

“…In many patients, hospitalization is associated with physical inactivity and more time spent sedentary, in some leading to a longer length of stay and functional decline during and after hospitalization. 1 – 7 In the last 10 years, several randomized controlled trials (RCTs) studied the effect of physical activity interventions during and after hospitalization. A recent systematic review, concluding that the effect of physical activity interventions on physical performance in older patients during hospitalization was uncertain, included 15 trials.…”

Section: Introductionmentioning

confidence: 99%

“… 34 Such a combination of eHealth and therapeutic guidance is called “blended care” or “technology supported care.” 35 A multicomponent intervention may also help to tailor the intervention to patients’ personal needs, as a recent study among 336 hospitalized patients showed that individual preferences regarding the promotion of physical activity may vary considerably. 5 However, to our knowledge, there are no studies investigating the effectiveness of a blended physical therapy intervention during hospitalization. A missed opportunity since hospitalized patients are often more sedentary than strictly necessary.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A multicomponent intervention to decrease sedentary time during hospitalization: a quasi-experimental pilot study

Conijn

Bodegom‐Vos

Volker³

et al. 2020

Clin Rehabil

Self Cite

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Objective: The aim of this study was to evaluate the feasibility and preliminary effects of a multicomponent intervention to decrease sedentary time during and shortly after hospitalization. Design: This is a quasi-experimental pilot study comparing outcomes in patients admitted before and after the implementation of the intervention. Setting: The study was conducted in a university hospital. Subjects: Participants were adult patients undergoing elective organ transplantation or vascular surgery. Interventions: In the control phase, patients received usual care, whereas in the intervention phase, patients also received a multicomponent intervention to decrease sedentary time. The intervention comprised eight elements: paper and digital information, an exercise movie, an activity planner, a pedometer and Fitbit Flex™, a personal activity coach and an individualized digital training program. Measures: Measures of feasiblity were the self-reported use of the intervention components (yes/no) and satisfaction (low–high = 0–10). Main outcome measure was the median % of sedentary time measured by an accelerometer worn during hospitalization and 7–14 days thereafter. Results: A total of 42 controls (mean age = 59 years, 62% male) and 52 intervention patients (58 years, 52%) were included. The exercise movie, paper information and Fitbit Flex were the three most frequently used components, with highest satisfaction scores for the fitbit, paper information, exercise movie and digital training. Median sedentary time decreased from 99.6% to 95.7% and 99.3% to 91.0% between Days 1 and 6 in patients admitted in the control and intervention phases, respectively. The difference at Day 6 reached statistical significance (difference = 41 min/day, P = 0.01). No differences were seen after discharge. Conclusion: Implementing a multicomponent intervention to reduce sedentary time appeared feasible and may be effective during but not directly after hospitalization.

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Physical activity during hospitalization: Activities and preferences of adults versus older adults

Cited by 25 publications

References 18 publications

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

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

Factors Associated with Step Numbers in Acutely Hospitalized Older Adults: The Hospital-Activities of Daily Living Study

A multicomponent intervention to decrease sedentary time during hospitalization: a quasi-experimental pilot study

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