Unlocking the black box of geriatric physiotherapy : Quantification of physical activity and walking parameters during inpatient geriatric rehabilitation therapy sessions.

Abstract

Physiotherapy and occupational therapy are currently described using the duration of treatment (days or weeks), the frequency of therapy sessions (on adaily or 3-5days per week basis) and considering the duration of asession (e.g., 30or 45 min). The content is often poorly defined and the intensity is rarely reported. Using digital technology some of these shortcomings can be overcome. The cumulative parameters of walking and activity sessions, the duration of walking, the time spent in an upright or lying/sitting position and the number of steps can now be analyzed. In this study, we examined the parameters during non-treatment periods and therapy time in patients recovering from fragility fractures. The study is asecondary data analysis of atrial that examined the improvement of physical activity (PA) and self-efficacy of fragility fracture patients. Changes in mobility parameters were measured using the ActivPal3 sensor during the 1st and 3rd weeks of rehabilitation and 104 patients were analyzed (mean age 82.5years). Parameters included the time during supervised treatment, the mean number of steps, cumulative time in an upright position and walking duration, the number of walking intervals of > 10 s and sit to stand transfers. Patients received 3-4 therapy sessions adding up to 90-120 min per day. More than 50% of the daily walking activities were achieved in these sessions until discharge. With this amount of therapeutic input most parameters meaningfully improved from baseline to the second measurement. The number of steps increased by 30%, the mean time in an upright position increased by 26% and the mean time spent walking increased by 49%. The sensor-derived measurements describe the amount of walking activity administered during the supervised therapy sessions. This could be used as astarting point for future trials to improve the outcomes or as astandard of process evaluation for clinical services.