Howie-Esquivel Jill, Zaharias Evanthia
Department of Physiological Nursing, University of California, San Francisco, San Francisco, USA.
Department of Case Management, UCSF Medical Center, San Francisco, CA, USA.
Cardiol Res. 2013 Feb;4(1):15-25. doi: 10.4021/cr244w. Epub 2013 Mar 8.
Patients with heart failure (HF) experience frequent rehospitalizations and poor functional capacity. Early hospital mobility may prevent functional decline, but mobility patterns among hospitalized HF patients are not yet known. Accelerometers may provide a method to monitor and measure patient mobility objectively. Therefore, the purpose of this study was to describe mobility and function using accelerometers among hospitalized HF patients.
Wireless accelerometers were attached to the thigh and ankle of previously ambulatory hospitalized HF patients (n = 32) continuously for up to 5 days, beginning on the second day of hospitalization. The mean proportion of time spent lying, sitting, and standing or walking daily was measured. Ability to perform activities of daily living (ADLs) and physical function was measured using the Katz Index and Short Physical Performance Battery (SPPB).
Patients' mean age was 58.2 ± 13.6 and 78% (n = 25) were male. Mean New York Heart Association Class upon enrollment and at the end of the study period was 2.9 ± 0.8 and 2.2 ± 0.8 respectively. A mean Katz Index of 5.6 ± 1.1 upon enrollment demonstrated minimal dependence on assistance for completion of ADLs (possible scores 0 - 6). However, mobility testing revealed low physical function, with mean SPPB scores of 6.4 ± 3.1 (possible scores 0 - 12). During hospitalization, 70% of the measured hospital stay (16.8 hours/day) was spent lying in bed. The average time spent standing or walking was 4.1%, or 59 minutes per day and the range was 0-10% (0 - 150 minutes).
Immobility was pervasive as HF patients spent almost all of their time sitting or lying in bed despite their baseline ambulatory status and improved NYHA class.
心力衰竭（HF）患者经常再次住院且功能能力较差。早期的医院内活动能力可能会预防功能衰退，但目前尚不清楚住院HF患者的活动模式。加速度计可能提供一种客观监测和测量患者活动能力的方法。因此，本研究的目的是使用加速度计描述住院HF患者的活动能力和功能。
从住院第二天开始，将无线加速度计连续5天附着在先前可走动的住院HF患者（n = 32）的大腿和脚踝上。测量每天躺着、坐着以及站立或行走所花费时间的平均比例。使用Katz指数和简短体能表现量表（SPPB）测量日常生活活动（ADL）能力和身体功能。
患者的平均年龄为58.2±13.6岁，78%（n = 25）为男性。入组时和研究期末的平均纽约心脏协会分级分别为2.9±0.8和2.2±0.8。入组时Katz指数平均为5.6±1.1，表明完成ADL对他人帮助的依赖程度最低（可能得分0 - 6）。然而，活动能力测试显示身体功能较差，SPPB平均得分为6.4±3.1（可能得分0 - 12）。住院期间，所测量的住院时间中有70%（16.8小时/天）是躺在床上度过的。站立或行走的平均时间为4.1%，即每天59分钟，范围为0 - 10%（0 - 150分钟）。
尽管HF患者基线时可走动且纽约心脏协会分级有所改善，但他们几乎所有时间都坐着或躺在床上，活动受限情况普遍存在。
