Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021;44(1):45-50.
doi: 10.1519/JPT.0000000000000259.

Activity Level and Intensity of Older Adults in Skilled Nursing Rehabilitation Measured via Actigraphy

Marghuretta D Bland  1   2   3 , Peggy Barco  3 , Catherine E Lang  1   2   3 , Emily Lenard  4 , Selmi Kallmi  4 , Sarah Pennock  4 , Eric J Lenze  4
Affiliations
Observational Study

Activity Level and Intensity of Older Adults in Skilled Nursing Rehabilitation Measured via Actigraphy

Marghuretta D Bland et al. J Geriatr Phys Ther. 2021.

Abstract

Background and purpose: Increasing activity has been shown to improve outcomes in patients receiving post-acute rehabilitation, but little is known about the activity duration and intensity that are actually occurring throughout the rehabilitative stay for older adults in skilled nursing facilities. The purpose of this study was to quantify duration and intensity of movement in older adults receiving rehabilitation in a skilled nursing facility, using 4-limb actigraphy.

Methods: Observational study of 92 older adults admitted for rehabilitation services at 2 skilled nursing facilities. All participants wore actigraph accelerometers (wGT3X+) on bilateral wrists and ankles for 24 hours, inclusive of 1 session each of physical and occupational therapy. Using actigraphy data, we calculated (a) movement duration (time the dominant or noninvolved upper or lower limb was active) and (b) movement intensity (sum of activity counts per minute for the dominant or noninvolved upper or lower limb).

Results: Over the 24-hour period, the lower limb moved a total median [interquartile range] of 01:10 (hours:minutes) [01:01] and the upper limb moved a total average (SD) of 04:45 (02:00). When participants did move, it was at low intensities with 61 [87] and 610 [623] activity counts per minute for lower limb out-of-therapy time and during physical therapy, respectively. For the upper limb, activity counts per minute were 689 (388) for out-of-therapy movement and 1359 (695) during physical therapy. However, neither the lower or upper limb reached a moderate-intensity level (2690-6166 counts per minute).

Discussion: Older adults receiving rehabilitation in 2 skilled nursing facilities had low movement duration and movement intensity both in and out of therapy.

Conclusion: Rehabilitation interventions for older adults should target and increase movement duration and intensity, during and after skilled nursing facility care.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Similar articles

See all similar articles

Cited by

References

    1. McWilliams JM, Gilstrap LG, Stevenson DG, Chernew ME, Huskamp HA, Grabowski DC. Changes in postacute care in the Medicare shared savings program. JAMA Intern Med. 2017;177(4):518–526.
    1. Talkowski JB, Lenze EJ, Munin MC, Harrison C, Brach JS. Patient participation and physical activity during rehabilitation and future functional outcomes in patients after hip fracture. Arch Phys Med Rehabil. 2009;90(4):618–622.
    1. Host HH, Lang CE, Hildebrand MW, et al. Patient active time during therapy sessions in postacute rehabilitation: development and validation of a new measure. Phys Occup Ther Geriatr. 2014;32(2):169–178.
    1. Jette DU, Warren RL, Wirtalla C. The relation between therapy intensity and outcomes of rehabilitation in skilled nursing facilities. Arch Phys Med Rehabil. 2005;86(3):373–379.
    1. Hornby TG, Holleran CL, Hennessy PW, et al. Variable Intensive Early Walking Poststroke (VIEWS): a randomized controlled trial. Neurorehabil Neural Repair. 2016;30(5):440–450.

Publication types

LinkOut - more resources