Monitoring Physical Activity in Acutely Hospitalized Elderly of 70 Years and Older
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Physical Activity
- Sponsor
- Maastricht University Medical Center
- Enrollment
- 165
- Locations
- 1
- Primary Endpoint
- Mean number of minutes spent physically active (standing and walking) per day
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
This study aims to create reference values regarding the amount of physical activity of acutely hospitalized elderly ≥70 years during hospitalization and aims to create a prediction model in order predict the probability of low amounts of physical activity of acutely hospitalized elderly ≥70 years during hospitalization.
Detailed Description
Rationale: Despite numerous studies supporting adverse outcomes associated with low physical activity (PA), there is insufficient insight in the amount of PA of acutely hospitalized Dutch elderly ≥ 70 years. PA can be objectively measured by accelerometers, but it is time consuming and expensive to provide every patient with an accelerometer. We need to be able to predict which elderly patients are likely to spend low amounts of physical activity during hospitalization. Because of the association between PA and functional decline it is expected that functional assessment tests like the Short Physical Performance Battery (SPPB) or Activity Measure for Post-Acute Care (AM-PAC) could be used as a screening tool to determine which patients will be at risk of low amounts of PA. Objective: The primary objectives of this study are: 1) To assess the amount of PA of acutely hospitalized elderly ≥70 years during hospitalization and to create reference values regarding the amount of time patients are standing and walking per day and the number of breaks in sedentary time (BST) per day. 2) To be able to predict the probability of low amounts of physical activity during hospitalization for acutely hospitalized elderly ≥70 years. Study design: This is a single center, observational, prospective cohort study. Study population: 165 patients aged ≥70 years that are acutely hospitalized at the department of internal and geriatric medicine in the Maastricht University Medical Center (MUMC+). Method: PA will be monitored with an accelerometer from inclusion (t0) until the day of intended discharge (t1). A functional assessment (SPPB and AM-PAC) will be performed at t0. Medical and demographic data will be obtained from the medical record and by patient report. Main study parameters/endpoints: Mean number of minutes spent physically active (standing and walking) per day, dichotomized into a low and high amount of time spent physically active per day during hospitalization for the prediction model. Mean number of BST per day, dichotomized into a low and high number of BST per day during hospitalization for the prediction model.
Investigators
Eligibility Criteria
Inclusion Criteria
- •70 years or older
- •Acutely hospitalized in MUMC+ at the department of Internal and Geriatric Medicine
- •Sufficient understanding of the Dutch language
- •Living at home before hospitalization
- •Able to walk independently 2 weeks before admission, as scored on the Functional Ambulation Categories (FAC \>3)
Exclusion Criteria
- •A life expectancy of less than three months as assessed by the attending physician
- •Incapacitated subjects
- •The inability to follow instructions due to cognitive problems or severe agitation
- •A contraindication to wearing an accelerometer, fixated by a hypoallergenic plaster, on the upper leg (such as active bilateral upper leg infection, severe edema or bilateral transfemoral amputation)
- •(Re)admittance to the intensive care unit
- •Presence of contraindications to walking as assessed by the attending physician
- •Previous participation to this study
Outcomes
Primary Outcomes
Mean number of minutes spent physically active (standing and walking) per day
Time Frame: Measured continuously from the day of inclusion (Day 0) until the day the subject is medically ready to be discharged from the hospital.
Defined as the total number of minutes standing and walking divided by the total number of valid measurement days in the period between inclusion and (intended) discharge. In order to create a prediction model, this will be dichotomized into a low and high amount of time spent physically active per day during hospitalization. As the estimated event rate of a high amount of time spent physically active per day during hospitalization is 50%, the cut-off value between a low and high amount of time spent physically active will be defined by dividing the cohort at the median.
Mean number of breaks in sedentary time (BST) per day
Time Frame: Measured continuously from the day of inclusion (Day 0) until the day the subject is medically ready to be discharged from the hospital.
Defined as the total number of BST divided by the total number of valid measurement days in the period between inclusion and (intended) discharge. A BST is defined as any transition from being sedentary (lying or sitting) to being physically active (standing or walking). In order to create a prediction model, this will be dichotomized into a low and high number of breaks in sedentary time per day during hospitalization. As the estimated event rate of a high number of breaks in sedentary time per day during hospitalization is 50%, the cut-off value between a low and high number of breaks in sedentary time will be defined by dividing the cohort at the median.
Secondary Outcomes
- Activity Measure for Post-Acute Care (AM-PAC) Inpatient Basic Mobility short form score(Measured on the day of inclusion (Day 0))
- Disability in activities of daily living (ADLs) two weeks prior to admission(Scored once the day of inclusion (Day 0).)
- Physiotherapy consulted during hospitalization(On day of intended discharge from hospital, estimated up to 1 month. (Intended discharge is defined as the day the patient is medically ready for discharge and is either discharged or staying for non-medical reasons.))
- The use of ambulation assistive devices prior to admission(Scored on the day of inclusion (Day 0).)
- Clinical diagnosis(On day of intended discharge from hospital, estimated up to 1 month. (Intended discharge is defined as the day the patient is medically ready for discharge and is either discharged or staying for non-medical reasons.))
- Short Physical Performance Battery scores (summary and component scores)(Measured on the day of inclusion (Day 0))
- Age(Scored once on the day of inclusion (Day 0))
- Sex(Scored once on the day of inclusion (Day 0).)