How much do hospitalized adults move? A systematic review and meta-analysis

• Published in: Applied nursing research Vol. 51; p. 151189
• Main Authors: Fazio, Sarina, Stocking, Jacqueline, Kuhn, Brooks, Doroy, Amy, Blackmon, Emma, Young, Heather M., Adams, Jason Y.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2020
• Subjects: Early mobility; Fitness tracker; Hospitalization; Nursing; Physical activity; Systematic review; Early mobility; Systematic review; Hospitalization; Physical activity; Fitness tracker
• ISSN: 0897-1897; 1532-8201
• DOI: 10.1016/j.apnr.2019.151189

To quantify the type and duration of physical activity performed by hospitalized adults.
Inactivity is pervasive among hospitalized patients and is associated with increased mortality, functional decline, and cognitive impairment. Objective measurement of activity is necessary to examine associations with clinical outcomes and quantify optimal inpatient mobility interventions.
We used PRISMA guidelines to search three databases in December 2017 to retrieve original research evaluating activity type and duration among adult acute-care inpatients. We abstracted data on inpatient population, measurement method, monitoring time, activity duration, and study quality.
Thirty-eight articles were included in the review and 7 articles were included in the meta-analysis. Study populations included geriatric (n = 5), surgical (n = 5), medical (n = 12), post-stroke (n = 10), psychiatric (n = 2), and critical care inpatients (n = 4). To measure activity, 29% of studies used human observation and 71% used activity monitors. Among inpatient populations, 87–100% of time was spent sitting or lying in-bed. Among medical inpatients monitored over a continuous 24-hour period (n = 7), 70 min per day was spent standing/walking (95% CI 57–83 min).
This review provides a baseline assessment and benchmark of inpatient activity, which can be used to compare inpatient mobility practices. While there is substantial heterogeneity in how researchers measure and define how much inpatients move, there is consistent evidence that patients are mostly inactive and in-bed during hospitalization. Future research is needed to establish standardized methods to accurately and consistently measure inpatient mobility over time.
•Objective estimates of activity are necessary to optimize inpatient mobility interventions.•Key to addressing these issues is a baseline assessment of inpatient activity.•We reviewed studies measuring type and duration of activity performed by hospitalized adults.•There is consistent evidence that hospitalized adults are mostly inactive and in-bed.•There is substantial heterogeneity in how researchers measure and define how much inpatients move.