Abstract
This prospective study investigated feasibility and sensitivity of sensor-based physical activity (PA) measures to monitor changes in PA during geriatric rehabilitation and its relation to clinical parameters at admission. PA was routinely measured at day 2 and day 15 after admission in 647 patients (70.2% women, mean age = 82.0 (SD = 7.19) years) of a German geriatric hospital using a thigh-worn accelerometer. Clinical records were used to include age, Barthel Index, diagnosis, mobility, orientation and cognition. Mean values and 95% confidence intervals (95%-CI) of walking duration, walking bout duration and number of sit-to-stand transfers were calculated to quantify different domains of PA. All observed PA parameters improved during rehabilitation, regardless of age, diagnosis or physical and cognitive function at admission. Walking duration increased by 12.1 (95%-CI: 10.3; 13.8) min, walking bout duration by 2.39 (95%-CI: 1.77; 3.00) s, and number of sit-to-stand transfers by 7 (95%-CI: 5; 8). Floor and ceiling effects were not observed. Walking duration at day 2 as well as day 15 was continuously associated with Barthel Index and statistically significant improved for all levels of Barthel Index. In summary, this study showed that sensor-based PA monitoring is feasible to assess the individual progress in geriatric rehabilitation patients.
Highlights
Physical activity is a key component for an active and independent life [1]
For this prospective cohort study, physical activity at day 2 and day 15 after admission was routinely measured between July 2012 and February 2014 in 1,251 patients of a geriatric rehabilitation clinic in Southern Germany
Femoral fractures showed the highest prevalence with 22.4% and cognitive impairment was present in about 60% of all patients (Table 1)
Summary
Physical activity is a key component for an active and independent life [1]. It determines three domains: physical capacity, the environment or context and behavioral factors such as motivation and intention. Many patients are not able to perform functional tests at admission due to their disease-specific limitations [5]. This leads to floor effects and missing data. There is a risk of ceiling effects if tests are not challenging enough, especially at the end of a therapy after a patient has improved [5,6]. Both limitations can affect the interpretation of progress during rehabilitation
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