A systematic review of the physical activity levels of acutely ill older adults in hospital at home settings: an under-researched field

Jennifer Scott*, Ukachukwu O. Abaraogu, Graham Ellis, Maria Gine-Garriga, Dawn A. Skelton

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Aim: To identify, evaluate and synthesise the evidence concerning the physical activity levels of acutely-ill older patients undergoing ‘Hospital At Home’ treatment compared to those of patients with similar characteristics in a traditional hospital inpatient setting.

Findings: No studies on the physical activity levels of acutely ill older adults in Hospital At Home Settings were identified. Patients managed in inpatient settings that would be eligible for Hospital At Home services spend 6.6% of their day active and perform only 881.8 daily steps, placing them at increased risk of functional decline.

Message: There is a lack of published research on physical activity in acutely ill older adults in Hospital At Home sttings; further research is needed. Purpose: The purpose of this review was to identify, evaluate and synthesise existing evidence reporting the physical activity levels of acutely ill older patients in a ‘Hospital At Home’ setting and compare this to patients with similar characteristics treated in a traditional hospital inpatient setting. Functional changes and any adverse outcomes due to physical activity (e.g. falls) in both settings where PA was reported or recorded were also evaluated as secondary outcomes.

Methods: A search strategy was devised for the MEDLINE, CINAHL, AMed, PEDRO, OT Seeker and Cochrane databases. Search results were title, abstract and full-text reviewed by two independent researchers. Data were extracted from included articles using a custom form and assessed for quality and risk of bias using the Appraisal Tool for Cross-Sectional Studies.

Results: No studies set in the Hospital at Home environments were identified. 16 hospital inpatient studies met the criteria for inclusion. Older patients managed in inpatient settings that would be eligible for Hospital at Home services spent 6.6% of their day active and undertook only 881.8 daily steps. Functional change was reported in four studies with both improvement and decline during admission reported.

Conclusion: There is a lack of published research on the physical activity levels of acutely-ill older adults in Hospital at Home settings. This review has identified a baseline level of activity for older acutely ill patients that would be suitable for Hospital at Home treatment. This data could be used as a basis of comparison in future hospital at home studies, which should also include functional change outcomes to further explore the relationship between physical inactivity and functional decline.
Original languageEnglish
Pages (from-to)227-238
Number of pages12
JournalEuropean Geriatric Medicine
Volume12
Early online date15 Oct 2020
DOIs
Publication statusPublished - Apr 2021

Keywords

  • aged
  • systematic review
  • physical activity
  • accelerometry
  • hospital at home

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