Abstract
Measuring in-hospital mobility of older adults with accelerometers is becoming more
common practice. However, neither the unique challenges surrounding accelerometer
use within acute hospital settings nor the potential solutions to these challenges
have been well documented. The aim of this article is to present and discuss what
occurs “behind the scenes” when using accelerometers to quantify in-hospital mobility
among older adults in acute hospital wards. The article identifies the challenges
related to accelerometer use that emerged over the course of daily data collection
for 2 large-scale studies, including matters of recruitment, daily use, technical
and methodological issues, loss of devices, missing data, and troubleshooting. The
article details the tasks and the strategies we developed for overcoming these challenges
and how we implemented them within the acute wards. Finally, the article provides
recommendations for researchers and clinicians on how to improve future use of accelerometers
or other devices aimed to enhance in- hospital mobility of older adults.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Association between 900 steps a day and functional decline in older hospitalized patients.JAMA Intern Med. 2017; 177: 272-274
- Hospitalization-associated disability: “She was probably able to ambulate, but I'm not sure.JAMA. 2011; 306: 1782-1793
- Low mobility during hospitalization and functional decline in older adults.J Am Geriatr Soc. 2011; 59: 266-273
- Trajectories of community mobility recovery after hospitalization in older adults.J Am Geriatr Soc. 2018; 66: 1399-1403
- The underrecognized epidemic of low mobility during hospitalization of older adults.J Am Geriatr Soc. 2009; 57: 1660-1665
- Hospitalization-associated change in gait speed and risk of functional limitations for older adults.J Gerontol A Biol Sci Med Sci. 2019; 74: 1657-1663
- Early ambulation and length of stay in older adults hospitalized for acute illness.Arch Intern Med. 2010; 170: 1942-1943
- Accelerometer-measured hospital physical activity and hospital-acquired disability in older adults.J Am Geriatr Soc. 2020; 68: 261-265
- What affects the subjective sleep quality of hospitalized elderly patients?.Geriatr Gerontol Int. 2017; 17: 471-479
- Optimizing function and physical activity in hospitalized older adults to prevent functional decline and falls.Clin Geriatr Med. 2019; 35: 237-251
- Older adults’ personal routine at time of hospitalization.Geriatr Nurs. 2017; 38: 27-32
- A systems approach is needed for in-hospital mobility: a qualitative metasynthesis of patient and clinician perspectives.Arch Phys Med Rehabil. 2021; 102: 984-998
- The relationships between step count and hospitalisation-associated outcomes in acutely hospitalised older adults-a systematic review.J Clin Nurs. 2021 Nov 5; ([Epub ahead of print])
- Mobility after hospital discharge as a marker for 30-day readmission.J Gerontol A Biol Sci Med Sci. 2013; 68: 805-810
- Review of accelerometry for determining daily activity among elderly patients.Arch Phys Med Rehabil. 2011; 92: 998-1014
- Assessment of physical activity of hospitalised older adults: a systematic review.J Nutr Health Aging. 2018; 22: 377-386
- Assessing daily physical activity in older adults: unraveling the complexity of monitors, measures, and methods.J Gerontol A Biol Sci Med Sci. 2016; 71: 1039-1048
- Validity of different activity monitors to count steps in an inpatient rehabilitation setting.Phys Ther. 2017; 97: 581-588
- Validity of three accelerometers to investigate lying, sitting, standing and walking.PloS One. 2019; 14e0217545
- Walking for better outcomes and recovery: the effect of walk-for in preventing hospital-associated functional decline among older adults.J Gerontol A Biol Sci Med Sci. 2019; 74: 1664-1670
- Mobility activity and its value as a prognostic indicator of survival in hospitalized older adults.J Am Geriatr Soc. 2013; 61: 551-557
- Development and psychometric testing of a measure of older adult patients’ attitudes towards mobility during hospitalization (ATM-H).Geriatr Nurs. 2017; 38: 119-123
- Gender-related differences in maximum gait speed and daily physical activity in elderly hospitalized cardiac inpatients.Medicine (Baltimore). 2015; 94: e623
- Validity of the Actical activity monitor for assessing steps and energy expenditure during walking.J Sports Sci. 2015; 33: 769-776
- A scoping review of interventions using accelerometers to measure physical activity or sedentary behaviour during hospitalization.Clin Rehabil. 2020; 34: 1157-1172
- Accelerometry data in health research: challenges and opportunities.Stat Biosci. 2019; 11: 210-237
- Challenges and opportunities related to the objective assessment of physical activity within US health surveys.Ann Epidemiol. 2020; 43: 1-10
- How active are people with stroke? Use of accelerometers to assess physical activity.Stroke. 2009; 40: 163-168
- Optimizing obstetric venous thromboembolism protocol adherence: the experience of a hospital system.Seminars in perinatology. Elsevier, New York2019: 234-237
- Association of posture and ambulation with function 30 days after hospital discharge in older adults with heart failure.J Card Fail. 2018; 24: 126-130
- How do nurses spend their time? A time and motion analysis of nursing activities in an internal medicine unit.J Adv Nurs. 2021; 77: 4459-4470
- Disparity between functional recovery and daily use of the upper and lower extremities during subacute stroke rehabilitation.Neurorehabil Neural Repair. 2012; 26: 76-84
- Very low levels of physical activity in older patients during hospitalization at an acute geriatric ward: a prospective cohort study.J Aging Phys Act. 2015; 23: 542-549
Article info
Publication history
Published online: January 24, 2022
Accepted:
January 17,
2022
Received in revised form:
October 29,
2021
Received:
April 22,
2021
Footnotes
Disclosures: none
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
