Changes in physical activity level during hospitalization in patients with stroke and those with fracture: a prospective longitudinal study.
Sota Kobayashi, Satoshi Hasegawa, Shun Yamazaki and 4 others
PMID 38186966WHAT IT FOUND
During rehabilitation, both stroke and fracture patients spent less time sitting and more time moving.
The biggest gain was in light activity during non-therapy hours. However, total activity remained far below WHO guidelines, suggesting the hospital environment itself limits movement regardless of diagnosis.
Key findings
01Sedentary time decreased and light/moderate activity increased from admission to discharge for both groups, with the largest gains occurring during non-therapy time.
02Patients who were already walking independently on admission showed little change in light activity, whereas those who regained independent walking during the stay significantly increased their activity levels.
03Despite improvements, physical activity levels remained below WHO recommendations, and there were no significant differences in characteristics between stroke and fracture patients who increased their activity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
59% of patients had missing physical activity data at discharge because they could not wear the accelerometer for the required three days due to emergency discharge. The study was underpowered to detect small or moderate differences, meaning it might have missed subtle changes in activity. The accelerometer's accuracy for identifying light activity in patients with very slow walking speeds (<0.15 m/s) is unknown. There was a significant difference in sex ratios between the stroke and fracture groups, which could influence activity levels. Dropout occurred during follow-up (17 stroke and 10 fracture patients), which may have introduced bias.
Declared interests
The authors have no conflicts of interest to disclose.
The easy way to misread this
Do not assume that improving a patient's physical function during therapy will automatically lead to higher activity levels throughout the day. The study found that patients who were already walking independently at admission did not significantly increase their light activity, suggesting that function alone does not drive behavior change in the hospital setting.