Nascimento Paulo, Kirkwood Renata, Griffith Lauren E, Duong Mylinh, Cooper Cody, Hao Yujiao, Zheng Rong, Raza Samir, Beauchamp Marla
School of Rehabilitation Sciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L6, Canada, 1 (905) 525-9140.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
JMIR Aging. 2025 May 12;8:e64372. doi: 10.2196/64372.
Hospitalized, frail older adults have an increased risk of developing hospital-acquired disability associated with hospital practices of restricted physical activity and immobilization. The use of activity tracking wearable devices may allow identification and prevention of mobility decline, reducing hospital-acquired disability.
This study aimed to identify the optimal wearable device and wear location for monitoring mobility in older hospitalized patients. Specific objectives included (1) comparison of the feasibility and acceptability of ActiGraph wGT3X-BT (ActiGraph LLC), MOX1 (Maastricht Instruments), MetaMotionC (mBientLab), and Fitbit Versa (Google) for continuous mobility monitoring and (2) determination of the concurrent validity of the selected device for detecting body posture and step count.
Participants were recruited for this observational study in the acute medical care unit of an academic hospital in Hamilton, Ontario, Canada. Eligible patients were aged 60 years and older, able to undertake the mobility protocol, and had an anticipated length of stay greater than 4 days. The study was divided into 2 experiments. Experiment 1 evaluated the feasibility of 4 wearable devices and validated the derived data for body posture and step count. Experiment 2 involved a mobility assessment session and a 24-hour monitoring and feasibility period with the selected device from experiment 1.
The ActiGraph wGT3X-BT emerged as the most feasible device, demonstrating superior usability, data acquisition, and management. The thigh-worn ActiGraph accurately detected sedentary behavior, while the ankle-worn device provided detailed information on step counts and body postures. Bland-Altman plots and intraclass correlation coefficients indicated that the ankle-worn ActiGraph showed excellent reliability for step counting, with minimal bias and narrow limits of agreement. Patients expressed a high willingness to wear a continuous mobility tracking device at the hospital and at home.
Thigh- and ankle-worn ActiGraph are optimal for assessing and monitoring mobility in older hospitalized patients. Challenges such as discomfort and device removal observed during the 24-hour monitoring period highlight areas for future studies. Overall, our findings support the integration of wearable technology in hospital settings to enhance mobility monitoring and early intervention strategies. Further research is warranted to evaluate the long-term use of wearable data for predicting health outcomes post hospitalization and informing clinical decision-making to promote early mobility.
住院的体弱老年人因医院限制身体活动和固定不动的做法而出现医院获得性残疾的风险增加。使用活动追踪可穿戴设备可能有助于识别和预防行动能力下降，减少医院获得性残疾。
本研究旨在确定用于监测老年住院患者行动能力的最佳可穿戴设备和佩戴位置。具体目标包括：（1）比较ActiGraph wGT3X-BT（ActiGraph LLC）、MOX1（马斯特里赫特仪器公司）、MetaMotionC（mBientLab）和Fitbit Versa（谷歌）进行连续行动能力监测的可行性和可接受性；（2）确定所选设备检测身体姿势和步数的同时效度。
在加拿大安大略省汉密尔顿一家学术医院的急性医疗护理单元招募参与者进行这项观察性研究。符合条件的患者年龄在60岁及以上，能够进行行动能力方案，预期住院时间超过4天。该研究分为2个实验。实验1评估了4种可穿戴设备的可行性，并验证了身体姿势和步数的衍生数据。实验2包括一次行动能力评估环节以及使用实验1中所选设备进行的24小时监测和可行性研究阶段。
ActiGraph wGT3X-BT成为最可行的设备，在可用性、数据采集和管理方面表现出色。佩戴在大腿上的ActiGraph能准确检测久坐行为，而佩戴在脚踝上的设备能提供步数和身体姿势的详细信息。布兰德-奥特曼图和组内相关系数表明，佩戴在脚踝上的ActiGraph在计步方面具有出色的可靠性，偏差极小且一致性界限狭窄。患者表示非常愿意在医院和家中佩戴连续行动能力追踪设备。
佩戴在大腿和脚踝上的ActiGraph最适合评估和监测老年住院患者的行动能力。在24小时监测期间观察到的不适和设备移除等挑战突出了未来研究的方向。总体而言，我们的研究结果支持在医院环境中整合可穿戴技术，以加强行动能力监测和早期干预策略。有必要进一步研究评估可穿戴数据的长期使用情况，以预测出院后的健康结果并为临床决策提供信息，以促进早期行动能力。
