Use of actigraphy to characterize inactivity and activity in patients in a medical ICU.
Prerna Gupta, Jennifer L Martin, Dale M Needham and 3 others
PMID 32107065WHAT IT FOUND
Medical ICU patients were profoundly inactive: 65% of 30-second recording periods showed no movement, and when they moved activity was low.
Inactivity did not differ significantly by age, continuous sedative infusions, or restraints.
Key findings
01Across 34 patients, 65% of 30-second epochs had zero activity, including 61% during waking hours (06:00 to 21:59).
02Patients in the highest average daily SOFA tertile and those ever mechanically ventilated had significantly higher zero-activity epochs than those in the lowest tertile or never ventilated.
03Mean non-zero activity level was 55±70, compared with 132±141 in a healthy adult reference.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
Only 34 patients contributed actigraphy data, so the study could not reliably detect all subgroup differences. Recording lasted up to 48 hours, so patterns over longer ICU stays are unknown. One patient contributed 34.2 hours rather than 48 hours. The researchers did not observe patients, so they could not separate voluntary movement from tremor or movement caused by care. Patient behaviors and care activities were not collected. Only one actigraph model was used, and the device did not classify positions such as lying, sitting, standing, or walking.
Declared interests
Publication types indicate NIH extramural and non-U.S. government research support. The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that actigraphy proves early mobility improves ICU outcomes. This was a small observational analysis, not a mobility trial, and it could not tell whether movement was voluntary, involuntary, or related to patient care.