Accelerometry shows inpatients with acute medical or surgical conditions spend little time upright and are highly sedentary: systematic review
Open accessAbstract
Background: Physical inactivity and sedentary behaviors have significant and independent effects on health. The use of wearable monitors to measure these constructs in people who are hospitalized with an acute illness is rapidly expanding, but has not been systematically described. Purpose: The purpose of this study was to review the use of accelerometer monitoring with inpatients who are acutely ill, including what activity and sedentary behaviors have been measured and how active or sedentary inpatients are. Data Sources: Databases used were MEDLINE, EMBASE, CINAHL, and Scopus. Study Selection: Quantitative studies of adults with an acute medical or surgical hospital admission, on whom an accelerometer was used to measure a physical activity or sedentary behavior, were selected. Data Extraction and Data Synthesis: Procedures were completed independently by 2 reviewers, with differences resolved and cross-checked by a third reviewer. Forty-two studies were identified that recruited people who had medical diagnoses (n = 10), stroke (n = 5), critical illness (n = 3), acute exacerbations of lung disease (n = 7), cardiac conditions (n = 7), or who were postsurgery (n = 10). Physical activities or sedentary behaviors were reported in terms of time spent in a particular posture (lying/sitting, standing/stepping), active/inactive, or at a particular activity intensity. Physical activity was also reported as step count, number of episodes or postural transitions, and bouts. Inpatients spent 93% to 98.8% (range) of their hospital stay sedentary, and in most studies completed <1,000 steps/day despite up to 50 postural transitions/day. No study reported sedentary bouts. Many studies controlled for preadmission function as part of the recruitment strategy or analysis or both. Limitations: Heterogeneity in monitoring devices (17 models), protocols, and variable definitions limited comparability between studies and clinical groups to descriptive synthesis without meta-analysis. Conclusions: Hospitalized patients were highly inactive, especially those with medical admissions, based on time and step parameters. Accelerometer monitoring of sedentary behavior patterns was less reported and warrants further research.
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Most hospital time for older inpatients, even those able to walk unaided, is sedentary and usually spent in bed.
“Hospitalised older adults, including those who can walk independently, spend most of their hospital time sedentary, usually in bed. 1”
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- Authors
- Baldwin, C., van Kessel, G., Phillips, A., & Johnston, K.
- Affiliations
- University of South Australia (AU)
- G. van Kessel, BAppSci (Physiotherapy), DPH, Sansom Institute of Health Research, School of Health Sciences, Division of Health Sciences, University of South Australia.
- Venue
- Physical Therapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-07-25
- Volume
- 97
- Issue
- 11
- Pages
- 1044-1065
- ISSN
- 0031-9023 (ISSN-L)
- 1538-6724
- OpenAlex
- W2738846298
- Cited by
- 111
- References
- 85
- Citations by year
- 2026: 10 · 2025: 7 · 2024: 25 · 2023: 15 · 2022: 14 · 2021: 11 · 2020: 15 · 2019: 11 · 2018: 3
- FWCI
- 0.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Physical Therapy (publishedVersion)
- PubMed (publishedVersion)
- UniSA Research Outputs Repository (University of South Australia) (acceptedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, other-oa)
- Funders
- University of South Australia
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- sedentary behavior, physical activity, hospitalized patients, accelerometer monitoring, wearable activity trackers, posture, step count, postural transitions, acute conditions, surgical patients, physical inactivity
- MeSH terms
- Adult, Hospitalization, Humans, Posture, Exercise, Sedentary Behavior, Accelerometry
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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