van Dijk - Huisman H1, Lenssen T1, van Beijsterveld C1, Weemaes A1, Ridder R1, Waelen A1, van der Weijst L1, Marcellis R1
1Maastricht University Medical Center (MUMC+), Physiotherapy, Maastricht, Netherlands
Background: Hospitalized patients spend between 3.7% and 8.1% of their time being physically active (standing and walking). Low amounts of physical activity (PA) during hospitalization are highly associated with functional decline, increased length of stay, institutionalization, and mortality. 22-47% of elderly patients experience functional decline at discharge. One year later, less than half have fully recovered. Low amounts of PA should therefore be prevented, but so far it has not been possible to objectively measure the amount of PA of patients during the physiotherapeutic treatment. However, objective measurement of the amount of PA is necessary in order to provide an adequate therapy for the prevention or treatment of low amounts of PA in hospitalized patients.
Purpose: The aim was to develop an innovative intervention that can be used during the physiotherapeutic treatment of hospitalized patients in order to objectify and improve the amount of PA of patients and the extent of functional recovery.
Methods: The department of Physiotherapy of the MUMC+ and Maastricht Instruments BV combined their knowledge on clinical physical therapy, physical activity monitoring and eHealth for the development of a smartphone-based app that is connected to a tri-axial waterproof MOX accelerometer, worn on the upper leg. The accelerometer is validated to differentiate between sedentary (lying and sitting) and physically active (standing and walking) positions in a hospitalized population.
Results: The Hospital Fit app was introduced in the physiotherapeutic treatment of hospitalized patients in the MUMC+ in September 2018. The app objectively shows patients and therapists the amount of physical activity (number of minutes standing and walking) per day. It also shows the extent to which functional recovery is reached. This is scored by the therapist during each treatment session and is based on the modified Iowa Level of Assistance Scale (mILAS) combined with 3 items of the Barthel Index (BI). Functional recovery is reached when patients are able to independently transfer from a lying to a sitting position and vice versa, from a sitting to a standing position, walk, climb stairs, dress, bathe and use the toilet. The app also contains a patient-specific exercise program, which is supported by exercise videos. After the last session, the therapist has the option to send the data to an online database, which makes the app also suitable for reporting in medical records and for research purposes.
Conclusion(s): The Hospital Fit app is introduced in the physiotherapeutic treatment at the MUMC+. After an implementation period, a study will be performed to test the effectiveness of the app in hospitalized patients following elective orthopaedic surgery and oncological abdominal surgery. Suggestions for future work are to expand the possibilities of the Hospital Fit app to make it suitable to use during physical therapy before and after hospitalization.
Implications: By objectifying the amount of PA and functional recovery, the Hospital Fit app offers essential strategies for the prevention and treatment of low amounts of PA during hospitalization.
Keywords: Activity monitoring, eHealth, hospitalization
Funding acknowledgements: The application development was made possible due to a Small Business Innovation Research (SBIR) funding, subsidized by the Dutch Government.
Purpose: The aim was to develop an innovative intervention that can be used during the physiotherapeutic treatment of hospitalized patients in order to objectify and improve the amount of PA of patients and the extent of functional recovery.
Methods: The department of Physiotherapy of the MUMC+ and Maastricht Instruments BV combined their knowledge on clinical physical therapy, physical activity monitoring and eHealth for the development of a smartphone-based app that is connected to a tri-axial waterproof MOX accelerometer, worn on the upper leg. The accelerometer is validated to differentiate between sedentary (lying and sitting) and physically active (standing and walking) positions in a hospitalized population.
Results: The Hospital Fit app was introduced in the physiotherapeutic treatment of hospitalized patients in the MUMC+ in September 2018. The app objectively shows patients and therapists the amount of physical activity (number of minutes standing and walking) per day. It also shows the extent to which functional recovery is reached. This is scored by the therapist during each treatment session and is based on the modified Iowa Level of Assistance Scale (mILAS) combined with 3 items of the Barthel Index (BI). Functional recovery is reached when patients are able to independently transfer from a lying to a sitting position and vice versa, from a sitting to a standing position, walk, climb stairs, dress, bathe and use the toilet. The app also contains a patient-specific exercise program, which is supported by exercise videos. After the last session, the therapist has the option to send the data to an online database, which makes the app also suitable for reporting in medical records and for research purposes.
Conclusion(s): The Hospital Fit app is introduced in the physiotherapeutic treatment at the MUMC+. After an implementation period, a study will be performed to test the effectiveness of the app in hospitalized patients following elective orthopaedic surgery and oncological abdominal surgery. Suggestions for future work are to expand the possibilities of the Hospital Fit app to make it suitable to use during physical therapy before and after hospitalization.
Implications: By objectifying the amount of PA and functional recovery, the Hospital Fit app offers essential strategies for the prevention and treatment of low amounts of PA during hospitalization.
Keywords: Activity monitoring, eHealth, hospitalization
Funding acknowledgements: The application development was made possible due to a Small Business Innovation Research (SBIR) funding, subsidized by the Dutch Government.
Topic: Outcome measurement; Human movement analysis; Disability & rehabilitation
Ethics approval required: Yes
Institution: Maastricht University Medical Centre
Ethics committee: METC azM/UM
Ethics number: 2017-0175
All authors, affiliations and abstracts have been published as submitted.
