Geriatric Rehabilitation Inpatients Roam at Home! A Matched Cohort Study of Objectively Measured Physical Activity and Sedentary Behavior in Home-Based and Hospital-Based Settings

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    Author
    Ramsey, KA; Loveland, P; Rojer, AGM; Denehy, L; MOTPrac, RG; Marston, C; Kay, JE; Brenan, J; Trappenburg, MC; Lim, WK; ...
    Date
    2021-12-01
    Source Title
    Journal of the American Medical Directors Association (JAMDA): long-term care: management, applied research and clinical issues
    Publisher
    ELSEVIER SCIENCE INC
    University of Melbourne Author/s
    Denehy, Linda; Maier, Andrea; Reijnierse, Esmee
    Affiliation
    Melbourne School of Health Sciences
    Medicine (RMH)
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Ramsey, K. A., Loveland, P., Rojer, A. G. M., Denehy, L., MOTPrac, R. G., Marston, C., Kay, J. E., Brenan, J., Trappenburg, M. C., Lim, W. K., Reijnierse, E. M., Meskers, C. G. M. & Maier, A. B. (2021). Geriatric Rehabilitation Inpatients Roam at Home! A Matched Cohort Study of Objectively Measured Physical Activity and Sedentary Behavior in Home-Based and Hospital-Based Settings. JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 22 (12), pp.2432-+. https://doi.org/10.1016/j.jamda.2021.04.018.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/274894
    DOI
    10.1016/j.jamda.2021.04.018
    Abstract
    OBJECTIVES: 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. DESIGN: Observational matched cohort study. SETTING AND PARTICIPANTS: 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). METHODS: 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. RESULTS: 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). CONCLUSIONS AND IMPLICATIONS: 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.

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