Physical activity is low before and during hospitalisation: A secondary observational study in older Australian general medical patients

• Published in: Australasian journal on ageing Vol. 42; no. 3; pp. 545 - 553
• Main Authors: D'Souza, Aruska N, Granger, Catherine L, Kay, Jacqueline E, Said, Catherine M
• Format: Journal Article
• Language: English
• Published: Australia 01-09-2023
• Subjects: aged; accelerometry; frail elderly; hospitalization
• ISSN: 1440-6381; 1741-6612
• DOI: 10.1111/ajag.13186

To quantify physical activity in patients prior to and during an acute general medical hospital admission and explore relationships between mobility, pre- and in-hospital physical activity.
This was a prospective, single-site secondary observational study conducted on general medical wards at a tertiary hospital. Prehospital physical activity was measured via the Physical Activity Scale for the Elderly (PASE; scored 0-400); in-hospital physical activity was measured via accelerometry (time at metabolic equivalents [METs] > 1.5), and mobility was measured via the de Morton Mobility Index (DEMMI). Associations were determined via Spearman's correlations.
Forty-six participants were included: median age 81 [76-85] years, 59% female, DEMMI on admission 39 [30-49]. Prehospital physical activity was low (PASE median 27.1 [1.6-61.9]). In-hospital physical activity was also low (0.5 [0.2-1.5] hours per day being physically active and 54 [16-194] steps per day taken). No statistically significant relationships existed between pre- and in-hospital physical activity (Spearman's rho (ρ) 0.24, 95% CI -0.08-0.53, p = 0.07). However, physical activity levels in the pre- and in-hospital settings were positively associated with patients' mobility in-hospital (Spearman's ρ 0.44, 95% CI 0.15-0.67, p = 0.002; Spearman's ρ 0.40, 95% CI 0.08-0.645, p = 0.011 respectively).
Physical activity is low both before and during a general medical admission. Assessment of usual physical activity patterns should be part of the clinical assessment of patients in general medicine; however, the low activity levels observed indicate a need for valid and reliable tools suitable for an older, frail cohort. Findings will inform the development of physical activity guidelines during hospitalisation.