Stephen Lim, University of Southampton, Southampton, Hampshire, United Kingdom,
J Nutr Health Aging. 2018;22(3):377-386. doi: 10.1007/s12603-017-0931-2.
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.
To determine which measures are used to measure physical activity of older people in hospital, and to describe their properties and applications.
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.
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.
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.
评估住院老年人的身体活动水平需要准确可靠的测量方法。住院老年人常见的身体活动包括运动和散步。测量住院老年人的身体活动水平对于评估干预措施对提高身体活动水平的影响以及确定医院身体活动与其他健康相关结果测量之间的关系至关重要。
确定用于测量住院老年人身体活动的测量方法，并描述其特性和应用。
对 Medline、Embase、CINAHL 和 AMED 四个数据库进行了系统综述，检索了 1996 年至 2016 年发表的论文。纳入标准为年龄≥65 岁的参与者和包括急性内科住院环境中身体活动测量的研究。排除专门评估手术患者或患有中风或脑损伤等神经疾病患者活动水平的研究。综述纳入了所有研究设计。
从 127 篇全文文章中选择了 18 项研究进行综述。15 项研究使用客观测量方法来测量住院老年人的身体活动：11 项研究使用加速度计，4 项研究使用直接系统观察。确定了 7 种加速度计，包括 StepWatch 活动监测器、activPAL、GENEActiv、Kenz Lifecorder EX、Actiwatch-L、Tractivity 和 AugmenTech Inc. Pittsburgh 加速度计。三项研究使用主观测量（护士和患者访谈）将患者分为低、中、高活动组。报告称 StepWatch 活动监测器在记录步态缓慢或步态改变的患者的步数时最准确。activPAL 报告称在姿势分类方面非常准确。
可以使用加速度计测量住院老年人的身体活动水平。加速度计的准确性因设备而异，需要进行特定于人群的验证研究来确定其在测量住院老年人身体活动水平方面的适用性。主观测量方法不太准确，但可以更实际地测量更大患者群体的身体活动。
