Patterns of Objectively Measured Sedentary Behavior and Physical Activity and Their Association with Changes in Physical and Functional Performance in Geriatric Rehabilitation Inpatients

Journal article

Rojer, Anna Galina Maria, Ramsey, Keenan A., Trappenburg, Marijke C., Meskers, Carel G.M., Twisk, Jos W., Goonan, Rose, Marston, Celia, Kay, Jacqueline E., Lim, Wen, Turbic, Alisa, Island, Louis, Denehy, Linda, Parry, Selina M., Reijnierse, Esmee M., Pijnappels, Mirjam and Maier, Andrea B.. (2023). Patterns of Objectively Measured Sedentary Behavior and Physical Activity and Their Association with Changes in Physical and Functional Performance in Geriatric Rehabilitation Inpatients. Journal of the American Medical Directors Association (JAMDA): long-term care: management, applied research and clinical issues. 24(5), pp. 629-637. https://doi.org/10.1016/j.jamda.2023.01.011
AuthorsRojer, Anna Galina Maria, Ramsey, Keenan A., Trappenburg, Marijke C., Meskers, Carel G.M., Twisk, Jos W., Goonan, Rose, Marston, Celia, Kay, Jacqueline E., Lim, Wen, Turbic, Alisa, Island, Louis, Denehy, Linda, Parry, Selina M., Reijnierse, Esmee M., Pijnappels, Mirjam and Maier, Andrea B.
Abstract

Objectives: To examine whether The Ending PyJama (PJ) Paralysis campaign, focused on increasing in-hospital physical activity, affects objectively measured sedentary behavior and physical activity patterns and if these are associated with changes in physical and functional performance in geriatric rehabilitation inpatients.

Design: Quasi-experimental study.

Setting and Participants: Within the REStORing health of acutely unwell adulTs (RESORT) observational, longitudinal cohort of geriatric rehabilitation inpatients, the Ending PJ Paralysis campaign was implemented on 2 out of 4 wards.

Methods: Objectively measured sedentary behavior and physical activity were measured by an inertial sensor (ActivPAL4) for 1 week, comparing control (non-PJ) and intervention (PJ) groups using linear mixed models. Mean sedentary behavior and physical activity measures and their association with physical and functional performance changes were investigated by linear regression analyses, stratified by low vs high performance at admission using the median as a cut-off.

Results: A total of 145 (n = 68 non-PJ and n = 77 PJ) inpatients with a mean age of 83.0 (7.7) years (55.9% female inpatients) were included. The median nonupright time was 23.1 [22.1-23.6] and 23.0 [21.8-23.6] hours/day for non-PJ and PJ groups, respectively. Objectively measured sedentary behavior and physical activity measures did not significantly change over measurement days and were independent of the Ending PJ Paralysis campaign. For inpatients with low performance at admission, lower sedentary behavior [B(SE) −0.013 (0.005) to −0.157 (0.045), P < .01] and higher physical activity [B(SE) 0.033 (0.007) to 0.814 (0.200), P < .01] measures were associated with improved physical performance. In addition, lower sedentary behaviour [B(SE) = -0.058 (0.024), P < .05 and higher physical activity [B (SE) 0.060 (0.024) to 0.683 (0.182), P < .05] were associated with improved instrumental functional performance.

Conclusions and Implications: In geriatric rehabilitation inpatients, the Ending PJ Paralysis campaign did not affect objectively measured sedentary behavior and physical activity patterns. Lower mean sedentary behaviour and higher physical activity measures were associated with improved physical and functional performance in inpatients with low performance.

KeywordsSubacute care; rehabilitation; hospitals; sedentary behavior; motor activity; aged; accelerometry; physical functional performance; activities of daily living; bed rest
Year01 Jan 2023
JournalJournal of the American Medical Directors Association (JAMDA): long-term care: management, applied research and clinical issues
Journal citation24 (5), pp. 629-637
PublisherElsevier Ltd
ISSN1525-8610
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jamda.2023.01.011
Web address (URL)https://www.sciencedirect.com/science/article/pii/S1525861023000506
Open accessPublished as ‘gold’ (paid) open access
Research or scholarlyResearch
Page range629-637
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Print27 Apr 2023
Publication process dates
AcceptedFeb 2023
Deposited04 Feb 2025
Additional information

2023 The Authors. Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Place of publicationUnited States
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