Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
J Am Med Dir Assoc. 2021 Dec;22(12):2432-2439.e1. doi: 10.1016/j.jamda.2021.04.018. Epub 2021 May 20.
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.
Observational matched cohort study.
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).
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.
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).
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.
本研究旨在描述在家庭环境中接受治疗的老年康复患者与在医院环境中接受治疗的患者的身体活动和久坐行为。
观察性匹配队列研究。
家庭（患者家中）或医院（病房）老年康复是为澳大利亚墨尔本皇家医院的康复成人急性失能（RESORT）观察性、纵向队列中的住院患者提供的。
要求患者佩戴 ActivPAL4 加速度计一周，并在入院时、出院时和 3 个月后进行全面老年评估。将医院患者与家庭患者按性别和基线身体功能（简短身体表现电池 [SPPB]、日常活动的工具性活动以及临床虚弱量表）进行匹配。评估患者特征以及身体活动（总活动量、站立和行走时间、步数和坐立转换次数）和久坐行为（总时间、坐姿和躺姿时间）的差异。
共纳入 159 名患者：18 名家庭患者（平均年龄：81.9 ± 8.6 岁，38.9%为女性，中位数（四分位距 [IQR]）SPPB：7.0（5.0-9.0））和 141 名医院患者（平均年龄：82.9 ± 7.8 岁，57.4%为女性，中位数（IQR）SPPB：1.0（0.0-4.0）），其中 18 名患者进行了匹配（平均年龄：80.1 ± 7.4 岁，38.9%为女性，中位数（IQR）SPPB：6.5（4.8-10.0））。与总住院患者相比，家庭患者的身体活动测量值中位数始终更高。匹配后，除坐立转换次数外，所有测量值（总身体活动、站立和行走时间以及步数）的身体活动测量值仍然高出 2.4 倍且差异显著。与住院患者相比，家庭患者的坐姿时间非显著增加，卧床时间显著减少，但差异无统计学意义。
独立于性别和基线身体功能匹配，家庭住院患者比医院住院患者更活跃，这支持家庭老年康复。
