Effect of a Smartphone App with an Accelerometer on the Physical Activity Behavior of Hospitalized Patients: A Randomized Controlled Trial

Hanneke van Dijk-Huisman, Antoine Lenssen, Rachel Senden, Maud Smeets, Rik Marcellis, Fabienne Magdelijns
Purpose:

The purpose of this study was to investigate the effectiveness of using Hospital Fit during usual care physiotherapy in hospitalized patients on increasing patients’ PA behaviour compared to usual care physiotherapy without Hospital Fit. 

Methods:

A randomized controlled trial was performed at Maastricht University Medical Centre between March 2021 and January 2022. Patients receiving physiotherapy while hospitalized at the department of Pulmonology or Internal Medicine were randomized to usual care physiotherapy, or using Hospital Fit additionally. Daily time spent walking, standing, and upright (standing/walking) (minutes) and daily number of postural transitions were measured with a MOX accelerometer between the first and last treatment. Multiple linear regression analysis was performed to determine the association between patients’ PA behavior and Hospital Fit use, corrected for functional independence as scored on the modified Iowa Level of Assistance Scale (mILAS).

Results:

Seventy-eight patients were included, with a median (IQR) age of 63 (56–68) years. Although no significant effects were found, a trend was seen in favor of Hospital Fit use. Effects increased with the number of days Hospital Fit was used. Corrected for functional independence, Hospital Fit use resulted in an average increase of 27.4 minutes (95% CI: –2.4–57.3) standing/walking on day five and 29.2 minutes (95% CI: –6.4–64.7) on day six compared to usual care.

Conclusion(s):

Although patients who used Hospital Fit spent more time standing and walking, and interrupted their sedentary behavior more often compared to patients that received physiotherapy without using Hospital Fit, the effects were not significantly different between groups, even after correcting for functional independence.  

Implications:

This study provides valuable insight that the effect of Hospital Fit increases with the

number of days patients use Hospital Fit. It suggests that a clinically relevant contribution

to the prevention of negative effects associated with inactivity can be seen when Hospital

Fit is used for at least four days. Moreover, the results demonstrate a strong association between

functional independence and PA, with independent patients spending significantly more

time standing and walking per day and performing more transitions per day than patients

that are dependent on others.

Funding acknowledgements:
This research was funded by a Top Consortium Knowledge and Innovation – Top Sector Life Sciences & Health (TKI–LSH) grant (LSHM18071).
Keywords:
Physical activity
Activity monitoring
Wearable sensors
Primary topic:
Health promotion and wellbeing/healthy ageing/physical activity
Second topic:
Disability and rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This study was approved by the Medical Ethics Committee of the University Hospital Maastricht and Maastricht University (METC azM/UM).
Provide the ethics approval number:
METC20-083
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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