Change of Objectively-Measured Physical Activity during Geriatric Rehabilitation

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.

[1]  M. Granat,et al.  The validation of a novel activity monitor in the measurement of posture and motion during everyday activities , 2006, British Journal of Sports Medicine.

[2]  Cynthia J Brown,et al.  Mobility limitation in the older patient: a clinical review. , 2013, JAMA.

[3]  M. Granat,et al.  The validity and reliability of a novel activity monitor as a measure of walking , 2006, British Journal of Sports Medicine.

[4]  C. Terwee,et al.  Measurement Properties of the Barthel Index in Geriatric Rehabilitation. , 2019, Journal of the American Medical Directors Association.

[5]  C. Becker,et al.  Geriatric rehabilitation after hip fracture , 2014, Zeitschrift für Gerontologie und Geriatrie.

[6]  W. Zijlstra,et al.  Wearable systems for monitoring mobility-related activities in older people: a systematic review , 2008, Clinical rehabilitation.

[7]  K. Janz,et al.  Physical activity in epidemiology: moving from questionnaire to objective measurement , 2006, British Journal of Sports Medicine.

[8]  C. Becker,et al.  Physical activity of moderately impaired elderly stroke patients during rehabilitation , 2012, Physiological measurement.

[9]  H. Kehlet,et al.  Physical Activity in the Acute Ward Following Hip Fracture Surgery is Associated with Less Fear of Falling. , 2016, Journal of aging and physical activity.

[10]  C. Becker,et al.  [Recommendation of an assessment protocol to describe geriatric inpatient rehabilitation of lower limb mobility based on ICF: an interdisciplinary consensus process]. , 2011, Zeitschrift fur Gerontologie und Geriatrie.

[11]  J. Kessler,et al.  DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia , 2004, International journal of geriatric psychiatry.

[12]  M. Granat,et al.  Physical behavior and function early after hip fracture surgery in patients receiving comprehensive geriatric care or orthopedic care--a randomized controlled trial. , 2014, The journals of gerontology. Series A, Biological sciences and medical sciences.

[13]  T. Nikolaus,et al.  Does functional change predict the course of improvement in geriatric inpatient rehabilitation? , 2010, Clinical rehabilitation.

[14]  M. Rathleff,et al.  Very Low Levels of Physical Activity in Older Patients During Hospitalization at an Acute Geriatric Ward: A Prospective Cohort Study. , 2015, Journal of aging and physical activity.

[15]  C. Becker,et al.  Ambulatory Activity Components Deteriorate Differently across Neurodegenerative Diseases: A Cross-Sectional Sensor-Based Study , 2016, Neurodegenerative Diseases.

[16]  恵子 紀国谷 国際生活機能分類(International Classification of Functioning, Disability and Health: ICF)にみた福祉・保健・医療の専門職協働における連携に関する貢献と課題 , 2007 .

[17]  Terry Quinn,et al.  Quantifying sit-to-stand and stand-to-sit transitions in free-living environments using the activPAL thigh-worn activity monitor. , 2019, Gait & posture.

[18]  G M Lyons,et al.  Accelerometers in rehabilitation medicine for older adults. , 2005, Age and ageing.

[19]  N. Peel,et al.  Promoting Activity in Geriatric Rehabilitation: A Randomized Controlled Trial of Accelerometry , 2016, PloS one.

[20]  Wiebren Zijlstra,et al.  Chair Rise Peak Power in Daily Life Measured With a Pendant Sensor Associates With Mobility, Limitation in Activities, and Frailty in Old People , 2017, IEEE Journal of Biomedical and Health Informatics.

[21]  G. Kempen,et al.  Factors influencing home discharge after inpatient rehabilitation of older patients: a systematic review , 2016, BMC Geriatrics.

[22]  A. Jette,et al.  Sensitivity to Change and Responsiveness of Four Balance Measures for Community-Dwelling Older Adults , 2011, Physical Therapy.

[23]  L. Ferrucci,et al.  A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. , 1994, Journal of gerontology.

[24]  F. Mahoney,et al.  Functional evaluation ; the Barthel index. A simple index of the independence useful in scoring improvement in the rehabilitation of the chronically ill. , 1965 .

[25]  Diane Podsiadlo,et al.  The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons , 1991, Journal of the American Geriatrics Society.

[26]  James E. Graham,et al.  Inpatient Walking Activity to Predict Readmission in Older Adults. , 2016, Archives of physical medicine and rehabilitation.

[27]  Kristin Taraldsen,et al.  Evaluation of a Body-Worn Sensor System to Measure Physical Activity in Older People With Impaired Function , 2011, Physical Therapy.

[28]  Gun-Britt Jarnlo Functional balance tests related to falls among community-dwelling elderly , 2003 .