TY - JOUR
T1 - Geriatric Rehabilitation Inpatients Roam at Home! A Matched Cohort Study of Objectively Measured Physical Activity and Sedentary Behavior in Home-Based and Hospital-Based Settings
AU - Ramsey, Keenan A.
AU - Loveland, Paula
AU - Rojer, Anna G. M.
AU - Denehy, Linda
AU - Goonan, Rose
AU - Marston, Celia
AU - Kay, Jacqueline E.
AU - Brenan, Jacinta
AU - Trappenburg, Marijke C.
AU - Lim, Wen Kwang
AU - Reijnierse, Esmee M.
AU - Meskers, Carel G. M.
AU - Maier, Andrea B.
N1 - Funding Information:
Funding sources: This work was supported by an unrestricted grant of the University of Melbourne (unrestricted grant received by Prof. Andrea B. Maier); the Medical Research Future Fund (MRFF)) provided by the Melbourne Academic Centre for Health (MACH)); and the European Union's Horizon 2020 research and innovation programs under the Marie Sk?odowska-Curie grant agreement 675003 and the PreventIT grant agreement 689238.
Funding Information:
Funding sources: This work was supported by an unrestricted grant of the University of Melbourne (unrestricted grant received by Prof. Andrea B. Maier); the Medical Research Future Fund (MRFF)) provided by the Melbourne Academic Centre for Health (MACH)); and the European Union’s Horizon 2020 research and innovation programs under the Marie Skłodowska-Curie grant agreement 675003 and the PreventIT grant agreement 689238.
Publisher Copyright:
© 2021 The Authors
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/12
Y1 - 2021/12
N2 - Objectives: This study aimed to describe objectively measured physical activity and sedentary behavior in geriatric rehabilitation patients receiving care in the home-based compared to the hospital-based setting. Design: Observational matched cohort study. Setting and Participants: Home-based (patient's home) or hospital-based (ward) geriatric rehabilitation was delivered to inpatients within the REStORing health of acutely unwell adulTs (RESORT) observational, longitudinal cohort of the Royal Melbourne Hospital (Melbourne, Victoria, Australia). Methods: Patients were asked to wear ActivPAL4 accelerometers for 1 week and were assessed by a comprehensive geriatric assessment at admission, discharge, and followed up after 3 months. Hospital-based patients were matched to home-based patients for sex and baseline physical function [Short Physical Performance Battery (SPPB), activities (instrumental) of daily living, and Clinical Frailty Scale]. Differences in patient characteristics and physical activity (total, standing and walking durations, number of steps and sit-to stand transitions) and sedentary behavior (total, sitting and lying durations) were assessed. Results: A total of 159 patients were included: 18 home-based [mean age: 81.9 ± 8.6 years, 38.9% female, median (interquartile range [IQR]) SPPB: 7.0 (5.0-9.0)] and 141 hospital-based [mean age: 82.9 ± 7.8 years, 57.4% female, median (IQR) SPPB: 1.0 (0.0-4.0)] patients, of whom 18 were matched [mean age: 80.1 ± 7.4 years, 38.9% female, median (IQR) SPPB: 6.5 (4.8-10.0)]. Median physical activity measures were consistently higher in home-based patients compared to the total group of hospital-based patients. After matching, physical activity measures remained >2.4 times higher and were significantly different for all measures (total physical activity, standing and walking durations, and steps) except for sit-to-stand transitions. Sedentary behaviors were similar with home-based patients spending non-significantly more time sitting but significantly less time lying than hospital-based patients (matched and total). Conclusions and Implications: Home-based inpatients are more physically active than hospital-based inpatients independent of matching for sex and baseline physical function, which supports home-based geriatric rehabilitation.
AB - Objectives: This study aimed to describe objectively measured physical activity and sedentary behavior in geriatric rehabilitation patients receiving care in the home-based compared to the hospital-based setting. Design: Observational matched cohort study. Setting and Participants: Home-based (patient's home) or hospital-based (ward) geriatric rehabilitation was delivered to inpatients within the REStORing health of acutely unwell adulTs (RESORT) observational, longitudinal cohort of the Royal Melbourne Hospital (Melbourne, Victoria, Australia). Methods: Patients were asked to wear ActivPAL4 accelerometers for 1 week and were assessed by a comprehensive geriatric assessment at admission, discharge, and followed up after 3 months. Hospital-based patients were matched to home-based patients for sex and baseline physical function [Short Physical Performance Battery (SPPB), activities (instrumental) of daily living, and Clinical Frailty Scale]. Differences in patient characteristics and physical activity (total, standing and walking durations, number of steps and sit-to stand transitions) and sedentary behavior (total, sitting and lying durations) were assessed. Results: A total of 159 patients were included: 18 home-based [mean age: 81.9 ± 8.6 years, 38.9% female, median (interquartile range [IQR]) SPPB: 7.0 (5.0-9.0)] and 141 hospital-based [mean age: 82.9 ± 7.8 years, 57.4% female, median (IQR) SPPB: 1.0 (0.0-4.0)] patients, of whom 18 were matched [mean age: 80.1 ± 7.4 years, 38.9% female, median (IQR) SPPB: 6.5 (4.8-10.0)]. Median physical activity measures were consistently higher in home-based patients compared to the total group of hospital-based patients. After matching, physical activity measures remained >2.4 times higher and were significantly different for all measures (total physical activity, standing and walking durations, and steps) except for sit-to-stand transitions. Sedentary behaviors were similar with home-based patients spending non-significantly more time sitting but significantly less time lying than hospital-based patients (matched and total). Conclusions and Implications: Home-based inpatients are more physically active than hospital-based inpatients independent of matching for sex and baseline physical function, which supports home-based geriatric rehabilitation.
KW - accelerometry
KW - aged
KW - home care services
KW - hospitals
KW - physical activity
KW - rehabilitation
KW - sedentary behavior
KW - subacute care
UR - https://www.scopus.com/pages/publications/85107430333
UR - https://www.ncbi.nlm.nih.gov/pubmed/34022152
U2 - 10.1016/j.jamda.2021.04.018
DO - 10.1016/j.jamda.2021.04.018
M3 - Article
C2 - 34022152
SN - 1525-8610
VL - 22
SP - 2432-2439.e1
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 12
ER -
SDG 3 Good Health and Well-being