Mrs Jacinta Brenan1, Ms Jacqueline Kay1
1The Royal Melbourne Hospital, Parkville, Australia
Objectives: Describe objectively measured physical activity (PA) and sedentary behaviour in geriatric rehabilitation patients receiving care in the home-based (patient’s home) compared to the hospital-based (ward) setting.
Design: Observational matched cohort.
Method: Patients, were asked to wear ActivPAL4 accelerometers for one week and were assessed by a comprehensive geriatric assessment at admission, discharge, and followed up after three-months. Hospital-based were matched to home-based patients for sex and baseline physical function; Differences in patient characteristics and PA (total, standing and walking durations, number of steps and sit-to stand transitions) and sedentary behaviour (total, sitting and lying durations) were assessed.
Results: 159 patients 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 PA measures were consistently higher in home-based compared to the total group of hospital-based patients. After matching, PA measures remained >2.4 times higher and were significantly different for all measures (total PA, standing and walking durations and steps) except for sit-to-stand transitions. Sedentary behaviours were similar with home-based patients spending significantly less time lying than hospital-based patients.
Conclusion: 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.
Acknowledgements: The authors would like to thank the Royal Melbourne Hospital at Home (RMH@Home) team with special thanks to the nursing staff for help with implementation of accelerometers. Furthermore, the authors thank the multidisciplinary team members of the Royal Melbourne Hospital, Royal Park Campus, involved in the RESORT cohort for their clinical work and the @Age team for their role in the data collection and processing.
Jacinta Brenan is a Senior Clinician Physiotherapist who works at The Royal Melbourne Hospital as the Allied Health Lead of the RMH@Home- subacute program. Jacinta has worked across a number of subacute and community settings over the past 16 years and completed a Masters in Public Health (Health Service Management) in 2013. Jacinta has a special interest in service development, operational leadership and working with older adults and those with complex needs, to help them achieve their goals and improve their quality of life.