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Evaluation of a technology assisted physical activity intervention among hospitalised patients: A randomised study

  • Christian Have Dall
    Correspondence
    Corresponding author at: The Department of Physical and Occupational Therapy, Bispebjerg Bakke 23, building 10, 2400 Copenhagen NV, Denmark.
    Affiliations
    Department of Physical and Occupational Therapy, Bispebjerg Frederiksberg University Hospital, Copenhagen and University of Copenhagen, Denmark

    Department of Cardiology, Bispebjerg Frederiksberg University Hospital, Copenhagen and University of Copenhagen, Denmark

    The Parker Institute, Bispebjerg Frederiksberg University Hospital, Copenhagen and University of Copenhagen, Denmark
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  • Helle Andersen
    Affiliations
    Department of Physical and Occupational Therapy, Bispebjerg Frederiksberg University Hospital, Copenhagen and University of Copenhagen, Denmark
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  • Tina Myung Povlsen
    Affiliations
    VihTek, Rigshospitalet, Valdemar Hansens Vej 2, 2600 Glostrup, Denmark
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  • Marius Henriksen
    Affiliations
    Department of Physical and Occupational Therapy, Bispebjerg Frederiksberg University Hospital, Copenhagen and University of Copenhagen, Denmark

    The Parker Institute, Bispebjerg Frederiksberg University Hospital, Copenhagen and University of Copenhagen, Denmark
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Published:September 04, 2019DOI:https://doi.org/10.1016/j.ejim.2019.08.019

      Highlights

      • Assess effect of a physical activity measuring system with feedback during hospitalisation
      • Across all patients the visual feedback provided no reduction in time spent out of bed.
      • Feedback group spent 81 minutes and control spent 64 minutes per day out of bed.
      • Group difference was 18 minutes per day potentially in favour of the visual feedback.
      • In a subgroup with independent mobility, feedback resulted in 51 minutes more out of bed.

      Abstract

      Background

      Physical inactivity is common during hospitalisation and poses a threat to functional capacity and independency in the elderly.

      Aim

      We aimed to assess the effect of physical activity measurements with visual feedback about time spent in various activities on the average daily time spent out of bed during hospitalisation.

      Methods

      We recorded physical activity during hospitalisation by accelerometers and compared the effect of the visual feedback (intervention) with no feedback (control) on time spent out of bed. Patients admitted to the pulmonary ward were invited and assigned to intervention with feedback or control with no feedback in 6 alternating waves of approximately 18 patients each. The order of feedback/no feedback was randomised at the outset of the study. The visual feedback intervention group was provided with visual feedback of the daily time spent in bed, sitting, standing, and walking. The control group did not receive feedback.

      Results

      93 patients completed the study with a median length of stay of 5 days. Across all patients there were no statistically significant group differences in daily time out of bed; however, patients with independent mobility spent 51 minutes (95% CI 0 to 102; P = .049) more out of bed when provided with visual feedback compared to no feedback.

      Conclusions

      A simple technology assisted physical activity intervention with visual feedback to encourage mobility was not effective at increasing time spent out of bed among hospitalised patients. With feedback, a subgroup of patients with independent walking abilities increased time out of bed and may benefit from this type of intervention.
      Trial registration: clinicaltrials.gov Identifier: NCT01945749.

      Keywords

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      References

        • Brown CJ
        • Redden DT
        • Flood KL
        • Allman RM
        The underrecognized epidemic of low mobility during hospitalization of older adults.
        J Am Geriatr Soc. 2009; 57: 1660-1665
        • Pedersen MM
        • Bodilsen AC
        • Petersen J
        • Beyer N
        • Andersen O
        • Lawson-Smith L
        • et al.
        Twenty-four-hour mobility during acute hospitalization in older medical patients.
        J Gerontol A Biol Sci Med Sci. 2013; 68: 331-337
        • Suetta C
        • Hvid LG
        • Justesen L
        • Christensen U
        • Neergaard K
        • Simonsen L
        • et al.
        Effects of aging on human skeletal muscle after immobilization and retraining.
        J Appl Physiol (1985). 2009; 107: 1172-1180
        • Ostir GV
        • Berges IM
        • Kuo YF
        • Goodwin JS
        • Fisher SR
        • Guralnik JM
        Mobility activity and its value as a prognostic indicator of survival in hospitalized older adults.
        J Am Geriatr Soc. 2013; 61: 551-557
        • Jones SW
        • Hill RJ
        • Krasney PA
        • O’Conner B
        • Peirce N
        • Greenhaff PL
        Disuse atrophy and exercise rehabilitation in humans profoundly affects the expression of genes associated with the regulation of skeletal muscle mass.
        FASEB J. 2004; 18: 1025-1027
        • de Boer MD
        • Selby A
        • Atherton P
        • Smith K
        • Seynnes OR
        • Maganaris CN
        • et al.
        The temporal responses of protein synthesis, gene expression and cell signalling in human quadriceps muscle and patellar tendon to disuse.
        J Physiol. 2007; 585: 241-251
        • Dean E
        Effect of body position on pulmonary function.
        Phys Ther. 1985; 65: 613-618
        • Marklew A
        Body positioning and its effect on oxygenation--a literature review.
        Nurs Crit Care. 2006; 11: 16-22
        • Nielsen KG
        • Holte K
        • Kehlet H
        Effects of posture on postoperative pulmonary function.
        Acta Anaesthesiol Scand. 2003; 47: 1270-1275
        • Villumsen M
        • Jorgensen MG
        • Andreasen J
        • Rathleff MS
        • Molgaard CM
        Very low levels of physical activity in older patients during hospitalization at an acute geriatric Ward: a prospective cohort study.
        J Aging Phys Act. 2015; 23: 542-549
        • Karlsen A
        • Loeb MR
        • Andersen KB
        • Joergensen KJ
        • Scheel FU
        • Turtumoeygard IF
        • et al.
        Improved functional performance in geriatric patients during hospital stay.
        Am J Phys Med Rehabil/Assoc Acad Physiatrists. 2017; 96: e78-e84
        • Foss NB
        • Kristensen MT
        • Kehlet H
        Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score.
        Clin Rehabil. 2006; 20: 701-708
        • Kortebein P
        • Ferrando A
        • Lombeida J
        • Wolfe R
        • Evans WJ
        Effect of 10 days of bed rest on skeletal muscle in healthy older adults.
        Jama. 2007; 297: 1772-1774
        • Volpato S
        • Onder G
        • Cavalieri M
        • Guerra G
        • Sioulis F
        • Maraldi C
        • et al.
        Characteristics of nondisabled older patients developing new disability associated with medical illnesses and hospitalization.
        J Gen Intern Med. 2007; 22: 668-674
        • Suetta C
        • Andersen JL
        • Dalgas U
        • Berget J
        • Koskinen S
        • Aagaard P
        • et al.
        Resistance training induces qualitative changes in muscle morphology, muscle architecture, and muscle function in elderly postoperative patients.
        J Appl Physiol (Bethesda, Md: 1985). 2008; 105: 180-186
        • Brown CJ
        • Foley KT
        • Lowman Jr, JD
        • MacLennan PA
        • Razjouyan J
        • Najafi B
        • et al.
        Comparison of Posthospitalization function and community mobility in hospital mobility program and usual care patients: a randomized clinical trial.
        JAMA Intern Med. 2016; 176: 921-927
        • Gruther W
        • Pieber K
        • Steiner I
        • Hein C
        • Hiesmayr JM
        • Paternostro-Sluga T
        Can early rehabilitation on the general Ward after an intensive care unit stay reduce hospital length of stay in survivors of critical illness?: a randomized controlled trial.
        Am J Phys Med Rehabil/Assoc Acad Physiatrists. 2017; 96: 607-615