Physiotherapist advice to older inpatients about the importance of staying physically active during hospitalisation reduces sedentary time, increases daily steps and preserves mobility: a randomised trial

Moreno, Nayara Alexia; Aquino, Bruno Garcia de; Garcia, Isabel Fialho Fontenele; Tavares, Lucas Spadoni; Costa, Larissa Francielly; Giacomassi, Ivens Willians Silva; Lunardi, Adriana Cláudia

doi:10.1016/j.jphys.2019.08.006

Cited by 32 publications

(55 citation statements)

References 26 publications

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“…As a consequence, actigraphy was chosen as an objective method to assess the construct validity of the FSS-ICU. Previous studies have shown the feasibility and safety of using actigraphy for measuring movement in critically ill patients [20,21,36,37], while others have reported the correlation between actigraphy with the gross motor activity:…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, a longer inactivity time during a hospital stay is associated with worse mobility [32,37].…”

Section: Discussionmentioning

confidence: 99%

“…The variables activity and inactivity time are reported in minutes and minutes per hour. Freedson et al [36,37] definition was used, where 0-99 counts per minute (CPM) are considered inactivity time, while 99 CPM or higher are considered activity time. The actigraphy variables reported on ICU awakening correspond to a cumulative measure of counts or minutes from ICU admission to awakening, while those reported at ICU discharge correspond to a cumulative measure of counts or minutes from admission to ICU discharge.…”

Section: Fss-icu Mobility Was Measured With the Fss-icu Chilean-spanmentioning

confidence: 99%

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Construct validity of the Functional Status Score for the Intensive Care Unit: a prospective observational study using actigraphy in mechanically-ventilated patients

Camus-Molina

González-Seguel

Castro³

et al. 2020

Preprint

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Background The Functional Status Score for the Intensive Care Unit (FSS-ICU) is a widely used instrument, designed to measure the mobility of critically ill patients that is available in English, Portuguese, Turkish and Spanish. The lack of a gold standard for measuring mobility limits the validation of outcome measures. However, actigraphy, from which measures movement intensity can be derived, is a potential alternative in the intensive care unit (ICU). Thus, this study aimed to assess the construct validity (hypotheses testing) of the FSS-ICU using continuous actigraphy from ICU admission to ICU discharge. Methods This prospective observational study included mechanically-ventilated patients selected from a 12-bed academic medical-surgical ICU. The Chilean-Spanish version of the FSS-ICU was used to evaluate its correlation with activity counts, activity time (>99 counts per minute) and inactivity time (0-99 counts per minute) measured by actigraphy ( GT9X Link ActiGraph). The FSS-ICU was assessed on awakening and at ICU discharge, while actigraphy variables were recorded from ICU admission to ICU discharge. Results Of 92 patients screened, 30 were analysed. The median FSS-ICU was 19 (IQR 10–26) points on awakening and 28.5 (IQR 22–32) at ICU discharge. There was no floor/ceiling effect of the FSS-ICU at awakening (0%/0%) and only a ceiling effect at ICU discharge that was acceptable (0%/10%). Less activity time was associated with better mobility on the FSS-ICU at both awakening (rho = -0.62, P<0.001) and ICU discharge (rho = -0.79, P<0.001). Activity counts and activity time were not correlated as expected with the FSS-ICU. Conclusions The FSS-ICU had a strong correlation with inactivity time during the ICU stay. These findings enhance the available clinimetric properties of the FSS-ICU.

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Section: Discussionmentioning

confidence: 99%

“…Additionally, a longer inactivity time during a hospital stay is associated with worse mobility [32,37].…”

Section: Discussionmentioning

confidence: 99%

Section: Fss-icu Mobility Was Measured With the Fss-icu Chilean-spanmentioning

confidence: 99%

See 1 more Smart Citation

Construct validity of the Functional Status Score for the Intensive Care Unit: a prospective observational study using actigraphy in mechanically-ventilated patients

Camus-Molina

González-Seguel

Castro³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Accelerometry. Evaluated the level of physical activity using Actigraph GT3X (Actigraph Corp., USA), installed on the dominant side of the patient's wrist according to the patient's report [19]. The device was calibrated during 24 hours between the examiner's test and retest.…”

Section: Evaluationsmentioning

confidence: 99%

“…The time percentage variables in different intensities of activity were used to characterize the sample [20]. The number of steps was recorded [19].…”

Section: Evaluationsmentioning

confidence: 99%

Reliability, validity, interpretability and responsiveness of the DEMMI mobility index for Brazilian older hospitalized patients

et al. 2020

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To translate and adapt cross-culturally the De Morton Mobility Index from English to Brazilian Portuguese. Furthermore, to test the content validity, reliability, construct validity, interpretability and responsiveness for older hospitalized patients. Methods After we carried out the translation and the cross-cultural adaptation of the De Morton Mobility Index and its administration instructions according to international guidelines, the content validity of De Morton Mobility Index was tested by experienced physiotherapists. In the sequence, the reliability, construct validity, interpretability and responsiveness were tested in a test-retest design with 93 older patients hospitalized in ward for clinical reasons. The reliability was tested by Cronbach's alpha coefficient (internal consistency), standard error measurement (agreement), and interclass correlation coefficients (intra and inter-examiner reliability). The construct validity was tested by Pearson's correlation between the De Morton Mobility Index score and the number of steps. Interpretability was analyzed by determining the minimum detectable change and the floor and ceiling effects (frequency of maximum and minimum scoring). Responsiveness was analyzed by effect size. Results The Brazilian version of the De Morton Mobility Index was made and adapted. The internal consistency (α = 0.89), reliability intra-(ICC = 0.94) and inter-examiners (ICC = 0.82), agreement were all adequate. The De Morton Mobility Index is validity when correlated with number of steps (r = 0.46). Floor or ceiling effects (<15%) were not observed and the responsiveness was high (ES = 3.65).

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Screening, Diagnosis and Management of Sarcopenia and Frailty in Hospitalized Older Adults: Recommendations from the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Expert Working Group

Daly

Iuliano

Fyfe

et al. 2022

The Journal of nutrition, health and aging

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Sarcopenia and frailty are highly prevalent conditions in older hospitalized patients, which are associated with a myriad of adverse clinical outcomes. This paper, prepared by a multidisciplinary expert working group from the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR), provides an up-to-date overview of current evidence and recommendations based on a narrative review of the literature for the screening, diagnosis, and management of sarcopenia and frailty in older patients within the hospital setting. It also includes suggestions on potential pathways to implement change to encourage widespread adoption of these evidence-informed recommendations within hospital settings. The expert working group concluded there was insufficient evidence to support any specific screening tool for sarcopenia and recommends an assessment of probable sarcopenia/sarcopenia using established criteria for all older (≥65 years) hospitalized patients or in younger patients with conditions (e.g., comorbidities) that may increase their risk of sarcopenia. Diagnosis of probable sarcopenia should be based on an assessment of low muscle strength (grip strength or five times sit-to-stand) with sarcopenia diagnosis including low muscle mass quantified from dual energy X-ray absorptiometry, bioelectrical impedance analysis or in the absence of diagnostic devices, calf circumference as a proxy measure. Severe sarcopenia is represented by the addition of impaired physical performance (slow gait speed). All patients with probable sarcopenia or sarcopenia should be investigated for causes (e.g., chronic/acute disease or malnutrition), and treated accordingly. For frailty, it is recommended that all hospitalized patients aged 70 years and older be screened using a validated tool [Clinical Frailty Scale (CFS), Hospital Frailty Risk Score, the FRAIL scale or the Frailty Index]. Patients screened as positive for frailty should undergo further clinical assessment using the Frailty Phenotype, Frailty Index or information collected from a Comprehensive Geriatric Assessment (CGA). All patients identified as frail should receive follow up by a health practitioner(s) for an individualized care plan. To treat older hospitalized patients with probable sarcopenia, sarcopenia, or frailty, it is recommended that a structured and supervised multi-component exercise program incorporating elements of resistance (muscle strengthening), challenging balance, and functional mobility training be prescribed as early as possible combined with nutritional support to optimize energy and protein intake and correct any deficiencies. There is insufficient evidence to recommend pharmacological agents for the treatment of sarcopenia or frailty. Finally, to facilitate integration of these recommendations into hospital settings organization-wide approaches are needed, with the Spread and Sustain framework recommended to facilitate organizational culture change, with the help of ‘champions’ to drive these changes. A multidisciplinary team approach incorporating awareness and education initiatives for healthcare professionals is recommended to ensure that screening, diagnosis and management approaches for sarcopenia and frailty are embedded and sustained within hospital settings. Finally, patients and caregivers’ education should be integrated into the care pathway to facilitate adherence to prescribed management approaches for sarcopenia and frailty.

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Physiotherapist advice to older inpatients about the importance of staying physically active during hospitalisation reduces sedentary time, increases daily steps and preserves mobility: a randomised trial

Cited by 32 publications

References 26 publications

Construct validity of the Functional Status Score for the Intensive Care Unit: a prospective observational study using actigraphy in mechanically-ventilated patients

Construct validity of the Functional Status Score for the Intensive Care Unit: a prospective observational study using actigraphy in mechanically-ventilated patients

Reliability, validity, interpretability and responsiveness of the DEMMI mobility index for Brazilian older hospitalized patients

Screening, Diagnosis and Management of Sarcopenia and Frailty in Hospitalized Older Adults: Recommendations from the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Expert Working Group

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