Clinical Research Centre (136), Copenhagen University Hospital, Hvidovre, DK-2650 Hvidovre, Denmark.
J Gerontol A Biol Sci Med Sci. 2013 Mar;68(3):331-7. doi: 10.1093/gerona/gls165. Epub 2012 Sep 12.
Inactivity during hospitalization in older medical patients may lead to functional decline. This study quantified 24-hour mobility, validated the accelerometers used, and assessed the daily level of basic mobility in acutely admitted older medical patients during their hospitalization.
This is a prospective cohort study in older medical patients able to walk independently (ambulatory patients) and those not able to walk independently (nonambulatory patients) on admission. The 24-hour mobility level during hospitalization was assessed by measuring the time in lying, sitting, and standing and/or walking, by two accelerometers. Basic mobility was quantified within 48 hours of admission and repeated daily throughout hospitalization.
Forty-three ambulatory patients and six nonambulatory patients were included. The ambulatory patients tended to be hospitalized for fewer days than the nonambulatory patients (7 vs 16, p = .13). The ambulatory patients were lying median 17 hours, (interquartile range [IQR]: 14.4-19.1), sitting 5.1 hours (IQR: 2.9-7.1), and standing and/or walking 1.1 hours (IQR: 0.6-1.7) per day. On days with independency in basic mobility, the ambulatory patients were lying 4.1 hours less compared with days with dependency in basic mobility (p < .0001), sitting 2.4 hours more (p = .0004), and standing 0.9 hours more (p < .0001). The algorithm identification for lying, sitting, and standing and/or walking of the accelerometers, corresponded by 89%-100% with positions performed by older medical patients.
Older acutely hospitalized medical patients with walking ability spent 17h/d of their in-hospital time in bed, and the level of in-hospital mobility seemed to depend on the patients' level of basic mobility. The accelerometers were valid in assessing mobility in older medical patients.
住院老年患者活动量减少可能导致功能下降。本研究量化了 24 小时活动量，验证了所使用的加速度计，并评估了急性住院老年患者在住院期间的日常基本活动能力水平。
这是一项前瞻性队列研究，纳入了能够独立行走（活动组）和不能独立行走（非活动组）的住院老年患者。通过两个加速度计测量患者在住院期间卧床、坐、站立和/或行走的时间来评估 24 小时活动量。在入院后 48 小时内量化基本活动能力，并在整个住院期间每天重复测量。
共纳入 43 名活动组患者和 6 名非活动组患者。活动组患者的住院天数较非活动组患者少（7 天比 16 天，p =.13）。活动组患者平均每天卧床 17 小时（四分位间距[IQR]：14.4-19.1），坐 5.1 小时（IQR：2.9-7.1），站立和/或行走 1.1 小时（IQR：0.6-1.7）。在具备基本活动能力的日子里，活动组患者卧床时间比不具备基本活动能力的日子少 4.1 小时（p <.0001），坐的时间多 2.4 小时（p =.0004），站立的时间多 0.9 小时（p <.0001）。加速度计识别卧床、坐和站立/行走的算法与老年患者的实际动作具有 89%-100%的一致性。
有行走能力的急性住院老年患者，在住院期间有 17 小时/天的时间在床上度过，住院期间的活动量水平似乎取决于患者的基本活动能力水平。加速度计可有效评估老年患者的活动能力。
