Skip to main content
Erschienen in:

03.11.2022 | Themenschwerpunkt

Unlocking the black box of geriatric physiotherapy

Quantification of physical activity and walking parameters during inpatient geriatric rehabilitation therapy sessions

verfasst von: Marios Stefanakis, Vasiliki Sakellari, Jochen Klenk, Karin Kampe, Matthias Klimek, Klaus Pfeiffer, Prof. Clemens Becker

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 8/2022

Einloggen, um Zugang zu erhalten

Abstract

Background

Physiotherapy and occupational therapy are currently described using the duration of treatment (days or weeks), the frequency of therapy sessions (on a daily or 3–5 days per week basis) and considering the duration of a session (e.g., 30 or 45 min). The content is often poorly defined and the intensity is rarely reported. Using digital technology some of these shortcomings can be overcome. The cumulative parameters of walking and activity sessions, the duration of walking, the time spent in an upright or lying/sitting position and the number of steps can now be analyzed. In this study, we examined the parameters during non-treatment periods and therapy time in patients recovering from fragility fractures.

Methods

The study is a secondary data analysis of a trial that examined the improvement of physical activity (PA) and self-efficacy of fragility fracture patients. Changes in mobility parameters were measured using the ActivPal3 sensor during the 1st and 3rd weeks of rehabilitation and 104 patients were analyzed (mean age 82.5 years). Parameters included the time during supervised treatment, the mean number of steps, cumulative time in an upright position and walking duration, the number of walking intervals of > 10 s and sit to stand transfers.

Results

Patients received 3–4 therapy sessions adding up to 90–120 min per day. More than 50% of the daily walking activities were achieved in these sessions until discharge. With this amount of therapeutic input most parameters meaningfully improved from baseline to the second measurement. The number of steps increased by 30%, the mean time in an upright position increased by 26% and the mean time spent walking increased by 49%.

Conclusion

The sensor-derived measurements describe the amount of walking activity administered during the supervised therapy sessions. This could be used as a starting point for future trials to improve the outcomes or as a standard of process evaluation for clinical services.
Literatur
2.
Zurück zum Zitat Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840 Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840
5.
Zurück zum Zitat Davenport SJ, Arnold M, Hua C, Schenck A, Batten S, Taylor NF (2015) Physical activity levels during acute inpatient admission after hip fracture are very low: physical activity levels after hip fracture. Physiother Res Int 20:174–181. https://doi.org/10.1002/pri.1616CrossRef Davenport SJ, Arnold M, Hua C, Schenck A, Batten S, Taylor NF (2015) Physical activity levels during acute inpatient admission after hip fracture are very low: physical activity levels after hip fracture. Physiother Res Int 20:174–181. https://​doi.​org/​10.​1002/​pri.​1616CrossRef
6.
Zurück zum Zitat Fleig L, McAllister MM, Brasher P, Cook WL, Guy P, Puyat JH, Khan KM, McKay HA, Ashe MC (2016) Sedentary behavior and physical activity patterns in older adults after hip fracture: a call to action. J Aging Phys Act 24:79–84. https://doi.org/10.1123/japa.2015-0013CrossRef Fleig L, McAllister MM, Brasher P, Cook WL, Guy P, Puyat JH, Khan KM, McKay HA, Ashe MC (2016) Sedentary behavior and physical activity patterns in older adults after hip fracture: a call to action. J Aging Phys Act 24:79–84. https://​doi.​org/​10.​1123/​japa.​2015-0013CrossRef
7.
Zurück zum Zitat Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49:M85–M94. https://doi.org/10.1093/geronj/49.2.m85CrossRef Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49:M85–M94. https://​doi.​org/​10.​1093/​geronj/​49.​2.​m85CrossRef
9.
10.
Zurück zum Zitat Kampe K, Pfeiffer K, Lindemann U, Schoene D, Taraldsen K, Rapp K, Becker C, Klenk J (2021) Change of physical activity parameters of hip and pelvic fracture patients during inpatient rehabilitation and after discharge: analysis of global and in-depth parameters. Eur Rev Aging Phys Act 18:9. https://doi.org/10.1186/s11556-021-00261-1CrossRef Kampe K, Pfeiffer K, Lindemann U, Schoene D, Taraldsen K, Rapp K, Becker C, Klenk J (2021) Change of physical activity parameters of hip and pelvic fracture patients during inpatient rehabilitation and after discharge: analysis of global and in-depth parameters. Eur Rev Aging Phys Act 18:9. https://​doi.​org/​10.​1186/​s11556-021-00261-1CrossRef
12.
Zurück zum Zitat Klenk J, Srulijes K, Schatton C, Schwickert L, Maetzler W, Becker C, Synofzik M (2016) Ambulatory activity components deteriorate differently across neurodegenerative diseases: a cross-sectional sensor-based study. Neurodegener Dis 16:317–323. https://doi.org/10.1159/000444802CrossRef Klenk J, Srulijes K, Schatton C, Schwickert L, Maetzler W, Becker C, Synofzik M (2016) Ambulatory activity components deteriorate differently across neurodegenerative diseases: a cross-sectional sensor-based study. Neurodegener Dis 16:317–323. https://​doi.​org/​10.​1159/​000444802CrossRef
14.
Zurück zum Zitat Mazzà C, Alcock L, Aminian K, Becker C, Bertuletti S, Bonci T, Brown P, Brozgol M, Buckley E, Carsin A‑E, Caruso M, Caulfield B, Cereatti A, Chiari L, Chynkiamis N, Ciravegna F, Din SD, Eskofier B, Evers J, Aymerich JG, Gazit E, Hansen C, Hausdorff JM, Helbostad JL, Hiden H, Hume E, Paraschiv-Ionescu A, Ireson N, Keogh A, Kirk C, Kluge F, Koch S, Küderle A, Lanfranchi V, Maetzler W, Micó-Amigo ME, Mueller A, Neatrour I, Niessen M, Palmerini L, Pluimgraaff L, Reggi L, Salis F, Schwickert L, Scott K, Sharrack B, Sillen H, Singleton D, Soltani A, Taraldsen K, Ullrich M, Gelder LV, Vereijken B, Vogiatzis I, Warmerdam E, Yarnall A, Rochester L (2021) Technical validation of real-world monitoring of gait: a multicentric observational study. Bmj Open 11:e50785. https://doi.org/10.1136/bmjopen-2021-050785CrossRef Mazzà C, Alcock L, Aminian K, Becker C, Bertuletti S, Bonci T, Brown P, Brozgol M, Buckley E, Carsin A‑E, Caruso M, Caulfield B, Cereatti A, Chiari L, Chynkiamis N, Ciravegna F, Din SD, Eskofier B, Evers J, Aymerich JG, Gazit E, Hansen C, Hausdorff JM, Helbostad JL, Hiden H, Hume E, Paraschiv-Ionescu A, Ireson N, Keogh A, Kirk C, Kluge F, Koch S, Küderle A, Lanfranchi V, Maetzler W, Micó-Amigo ME, Mueller A, Neatrour I, Niessen M, Palmerini L, Pluimgraaff L, Reggi L, Salis F, Schwickert L, Scott K, Sharrack B, Sillen H, Singleton D, Soltani A, Taraldsen K, Ullrich M, Gelder LV, Vereijken B, Vogiatzis I, Warmerdam E, Yarnall A, Rochester L (2021) Technical validation of real-world monitoring of gait: a multicentric observational study. Bmj Open 11:e50785. https://​doi.​org/​10.​1136/​bmjopen-2021-050785CrossRef
15.
Zurück zum Zitat Pedersen MM, Bodilsen AC, Petersen J, Beyer N, Andersen O, Lawson-Smith L, Kehlet H, Bandholm T (2013) Twenty-four-hour mobility during acute hospitalization in older medical patients. J Gerontol Ser A Biol Sci Med Sci 68:331–337. https://doi.org/10.1093/gerona/gls165CrossRef Pedersen MM, Bodilsen AC, Petersen J, Beyer N, Andersen O, Lawson-Smith L, Kehlet H, Bandholm T (2013) Twenty-four-hour mobility during acute hospitalization in older medical patients. J Gerontol Ser A Biol Sci Med Sci 68:331–337. https://​doi.​org/​10.​1093/​gerona/​gls165CrossRef
16.
Zurück zum Zitat Pfeiffer K, Kampe K, Klenk J, Rapp K, Kohler M, Albrecht D, Büchele G, Hautzinger M, Taraldsen K, Becker C (2020) Effects of an intervention to reduce fear of falling and increase physical activity during hip and pelvic fracture rehabilitation. Age Ageing 49:771–778. https://doi.org/10.1093/ageing/afaa050CrossRef Pfeiffer K, Kampe K, Klenk J, Rapp K, Kohler M, Albrecht D, Büchele G, Hautzinger M, Taraldsen K, Becker C (2020) Effects of an intervention to reduce fear of falling and increase physical activity during hip and pelvic fracture rehabilitation. Age Ageing 49:771–778. https://​doi.​org/​10.​1093/​ageing/​afaa050CrossRef
18.
Zurück zum Zitat Stucki G, Meier D, Stucki S, Michel BA, Tyndall AG, Dick W, Theiler R (1996) Evaluation of a German version of WOMAC (Western Ontario and McMaster Universities) Arthrosis Index. Z Rheumatol 55:40–49 Stucki G, Meier D, Stucki S, Michel BA, Tyndall AG, Dick W, Theiler R (1996) Evaluation of a German version of WOMAC (Western Ontario and McMaster Universities) Arthrosis Index. Z Rheumatol 55:40–49
19.
Zurück zum Zitat Taraldsen K, Askim T, Sletvold O, Einarsen EK, Bjåstad KG, Indredavik B, Helbostad JL (2011) Evaluation of a body-worn sensor system to measure physical activity in older people with impaired function. Phys Ther 91:277–285. https://doi.org/10.2522/ptj.20100159CrossRef Taraldsen K, Askim T, Sletvold O, Einarsen EK, Bjåstad KG, Indredavik B, Helbostad JL (2011) Evaluation of a body-worn sensor system to measure physical activity in older people with impaired function. Phys Ther 91:277–285. https://​doi.​org/​10.​2522/​ptj.​20100159CrossRef
21.
Metadaten
Titel
Unlocking the black box of geriatric physiotherapy
Quantification of physical activity and walking parameters during inpatient geriatric rehabilitation therapy sessions
verfasst von
Marios Stefanakis
Vasiliki Sakellari
Jochen Klenk
Karin Kampe
Matthias Klimek
Klaus Pfeiffer
Prof. Clemens Becker
Publikationsdatum
03.11.2022
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 8/2022
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-022-02126-3

Weitere Artikel der Ausgabe 8/2022

Zeitschrift für Gerontologie und Geriatrie 8/2022 Zur Ausgabe

Mitteilungen der DGGG

Mitteilungen der DGGG

Mitteilungen der DGG

Mitteilungen der DGG

Kompaktes Leitlinien-Wissen Innere Medizin

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Neu im Fachgebiet Innere Medizin

„Vor der Koronarintervention muss nicht gefastet werden!“

Gegen das routinemäßige Fasten vor einer Intervention im Katheterlabor spricht sich eine Studiengruppe aus Australien aus. In ihrer randomisierten Multicenter-Studie hatte der Verzicht auf entsprechende Anweisungen deutliche Vorteile.

Nirsevimab-Prophylaxe bewährt sich in der Praxis

Mit einer passiven RSV-Immunisierung aller Neugeborenen und Säuglinge unter sechs Monate lässt sich die Zahl der Atemwegsinfekt-bedingten Klinikbesuche, Hospitalisierungen und Intensivstationsaufnahmen von Säuglingen in den Wintermonaten um rund 60% senken.

Abnehmspritze bald auch für Kinder ab sechs Jahren?

Der Wirkstoff Liraglutid könnte bald auch für Kinder ab sechs Jahren zugelassen werden. In einer Phase-3-Studie ließ sich der BMI damit um knapp 6% senken, während er unter Placebo weiter zunahm.

Hypoglykämie: Bei der Notfalltherapie kommt es nicht auf Prozente an

In der notfallmäßigen I.v.-Behandlung einer Hypoglykämie mithilfe von Glukosepräparaten spielt die Konzentration der infundierten Lösung offenbar eine untergeordnete Rolle. Niedrigere Konzentrationen könnten sogar vorteilhaft sein.

EKG Essentials: EKG befunden mit System

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.