"Back on your feet in no time": measuring the mobility levels of older adults during acute medical hospital stay
Watson, Gillian Isobel
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Aim The main aim of this study was to describe the mobility levels of older adults during acute medical hospitalisation at Wellington Regional Hospital, New Zealand. The secondary aims were to explore associations between mobility levels during acute hospital stay and patient specific characteristics that had been identified by previous studies. Study Design This was a prospective observational cohort study. Participants Eighty-two community residing older adults admitted to Wellington Hospital for acute medical care were included in the study. Main Outcome Measures Mobility levels were measured using an accelerometer (StepWatch Monitor); participants donned the monitor within 24 hours of admission and wore it until discharge. The monitor recorded steps per day and time spent active. Step gain from first to last complete hospital day was calculated. Low mobility was defined as performing less than 1500 steps per day. Premorbid community mobility was measured by Life space and mobility aid use. Mobility status on admission was assessed using the Elderly Mobility Scale. Length of stay, input from occupational therapy and physiotherapy during admission, and mortality six months following discharge was recorded. Results Participants performed a median (IQR) of 1006 (+/- 938) steps per day. Participants spent 95.6% of each hospital day inactive, that is to say not walking. Two thirds of the sample took more steps on their last day than their first with a median (IQR) gain of 234 (+/- 812) steps. No statistical significant difference was found between premorbid community mobility, mobility status on admission, occupational or physiotherapy input during admission, or mortality six months following discharge. Participants with shorter periods of hospitalisation recorded statistically higher levels of mobility than those who were in hospital for longer (x2=13.98, p=.007). Conclusions Older adults performed physiologically deterimental low levels of mobility during acute medical hospitalisation. Only length of stay was found to influence mobililty levels. The findings of this study concurs with previously published research and demonstrates that low mobility levels during acute hosptialisation is an international issue. This study contributes to previous research suggesting that low mobility levels during acute hospitalisation may be a common pathway leading to adverse health decline associated with acute hospitalisation.