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Assessment of physical activity of hospitalised older adults: a systematic review

Assessment of physical activity of hospitalised older adults: a systematic review
Assessment of physical activity of hospitalised older adults: a systematic review
Background: The assessment of physical activity levels of hospitalised older people requires accurate and reliable measures. Physical activities that older people in hospital commonly engage in include exercises and walking. Measurement of physical activity levels of older inpatients is essential to evaluate the impact of interventions to improve physical activity levels and to determine associations between physical activity in hospital and other health-related outcome measures.

Objective: To determine which measures are used to measure physical activity of older people in hospital, and to describe their properties and applications.

Method: A systematic review of four databases: Medline, Embase, CINAHL and AMED was conducted for papers published from 1996 to 2016. Inclusion criteria were participants aged ≥ 65 years and studies which included measures of physical activity in the acute medical inpatient setting. Studies which specifically assessed the activity levels of surgical patients or patients with neurological conditions such as stroke or brain injury were excluded. All study designs were included in the review.

Results: 18 studies were included from 127 articles selected for full review. 15 studies used objective measures to measure the physical activity of older inpatients: 11 studies used accelerometers and four used direct systematic observations. Seven accelerometers were identified including the StepWatch Activity Monitor, activPAL, GENEActiv, Kenz Lifecorder EX, Actiwatch-L, Tractivity and AugmenTech Inc. Pittsburgh accelerometer. Three studies used a subjective measure (interviews with nurses and patients) to classify patients into low, intermediate and high mobility groups. The StepWatch Activity Monitor was reported to be most accurate at step-counting in patients with slow gait speed or altered gait. The activPAL was reported to be highly accurate at classifying postures.

Conclusion: Physical activity levels of older inpatients can be measured using accelerometers. The accuracy of the accelerometers varies between devices and population-specific validation studies are needed to determine their suitability in measuring physical activity levels of hospitalised older people. Subjective measures are less accurate but can be a practical way of measuring physical activity in a larger group of patients.
1279-7707
377–386
Lim, Stephen E.R.
dd2bfbd7-7f74-4365-b77e-9989f6408ddc
Ibrahim, K.
54f027ad-0599-4dd4-bdbf-b9307841a294
Aihie Sayer, A.A.
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Roberts, H.C.
5ea688b1-ef7a-4173-9da0-26290e18f253
Lim, Stephen E.R.
dd2bfbd7-7f74-4365-b77e-9989f6408ddc
Ibrahim, K.
54f027ad-0599-4dd4-bdbf-b9307841a294
Aihie Sayer, A.A.
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Roberts, H.C.
5ea688b1-ef7a-4173-9da0-26290e18f253

Lim, Stephen E.R., Ibrahim, K., Aihie Sayer, A.A. and Roberts, H.C. (2018) Assessment of physical activity of hospitalised older adults: a systematic review. The Journal of Nutrition, Health & Aging, 22 (3), 377–386. (doi:10.1007/s12603-017-0931-2).

Record type: Article

Abstract

Background: The assessment of physical activity levels of hospitalised older people requires accurate and reliable measures. Physical activities that older people in hospital commonly engage in include exercises and walking. Measurement of physical activity levels of older inpatients is essential to evaluate the impact of interventions to improve physical activity levels and to determine associations between physical activity in hospital and other health-related outcome measures.

Objective: To determine which measures are used to measure physical activity of older people in hospital, and to describe their properties and applications.

Method: A systematic review of four databases: Medline, Embase, CINAHL and AMED was conducted for papers published from 1996 to 2016. Inclusion criteria were participants aged ≥ 65 years and studies which included measures of physical activity in the acute medical inpatient setting. Studies which specifically assessed the activity levels of surgical patients or patients with neurological conditions such as stroke or brain injury were excluded. All study designs were included in the review.

Results: 18 studies were included from 127 articles selected for full review. 15 studies used objective measures to measure the physical activity of older inpatients: 11 studies used accelerometers and four used direct systematic observations. Seven accelerometers were identified including the StepWatch Activity Monitor, activPAL, GENEActiv, Kenz Lifecorder EX, Actiwatch-L, Tractivity and AugmenTech Inc. Pittsburgh accelerometer. Three studies used a subjective measure (interviews with nurses and patients) to classify patients into low, intermediate and high mobility groups. The StepWatch Activity Monitor was reported to be most accurate at step-counting in patients with slow gait speed or altered gait. The activPAL was reported to be highly accurate at classifying postures.

Conclusion: Physical activity levels of older inpatients can be measured using accelerometers. The accuracy of the accelerometers varies between devices and population-specific validation studies are needed to determine their suitability in measuring physical activity levels of hospitalised older people. Subjective measures are less accurate but can be a practical way of measuring physical activity in a larger group of patients.

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Accepted/In Press date: 2 March 2017
e-pub ahead of print date: 19 May 2017
Published date: March 2018
Organisations: Faculty of Medicine, Human Development & Health

Identifiers

Local EPrints ID: 410376
URI: http://eprints.soton.ac.uk/id/eprint/410376
ISSN: 1279-7707
PURE UUID: 634267ed-c5ac-4e44-8e16-ac16c97dfa95
ORCID for Stephen E.R. Lim: ORCID iD orcid.org/0000-0003-2496-2362
ORCID for K. Ibrahim: ORCID iD orcid.org/0000-0001-5709-3867
ORCID for H.C. Roberts: ORCID iD orcid.org/0000-0002-5291-1880

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Date deposited: 07 Jun 2017 16:31
Last modified: 18 Feb 2021 17:24

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