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Meta-Analysis
. 2020 Feb:51:151189.
doi: 10.1016/j.apnr.2019.151189. Epub 2019 Sep 3.

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

Sarina Fazio  1 , Jacqueline Stocking  2 , Brooks Kuhn  2 , Amy Doroy  3 , Emma Blackmon  4 , Heather M Young  5 , Jason Y Adams  2
Affiliations
Meta-Analysis

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

Sarina Fazio et al. Appl Nurs Res. 2020 Feb.

Abstract

Aim: To quantify the type and duration of physical activity performed by hospitalized adults.

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: Early mobility; Fitness tracker; Hospitalization; Physical activity; Systematic review.

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Conflict of interest statement

Declaration of Conflicting Interests

Dr. Fazio reports receipt of research equipment donated by Leaf Healthcare Inc. outside of the submitted work. This review was conceived and designed independently of funders who had no role in data collection, analysis or writing of manuscripts.

Figures

Figure 1.
Figure 1.. PRIMSA Flow Diagram
Figure 2.
Figure 2.. Forest plot of minutes spent standing/walking for medical inpatients monitored for at least 24 hours weighted by study sample size
*Denotes studies that reported median and/or interquartile range. The equation Q3-Q1/1.35 was used to estimate the standard error for these studies.
Figure 3.
Figure 3.. Recommendations for Measurement and Reporting of Inpatient Physical Activity Monitoring in Research and Clinical Practice
See this image and copyright information in PMC

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