This study aimed to assess whether substituting time spent in the lying position with time spent in upright activities (standing/walking) during rehabilitation in the acute phase could improve functional recovery in patients with HF.
This retrospective longitudinal observational study collected data from the medical records of an acute care hospital. Post-surgical patients with HF aged 60 and above were included in the analysis. Patients with non-weight-bearing instructions, those requiring reoperation, or those with missing data were excluded. The time spent lying, sitting, and standing/walking, as well as the total daily rehabilitation time during the first week of post-operative rehabilitation, were documented in five-minute increments. The motor component of the Functional Independence Measure (mFIM) was used as the functional outcome, and the absolute mFIM gain (the score at discharge minus the baseline score) was calculated. Using an isotemporal substitution model, multiple regression analysis was conducted to evaluate the effects of substituting one minute of lying with an equivalent duration of standing/walking or sitting per day on absolute mFIM gain. Potential confounding variables such as age, sex, body mass index, fracture type, surgical procedure, fracture to surgery days, dementia, pre-fracture new mobility score, baseline mFIM, postoperative complications, length of hospital stay, and the number of days undergoing rehabilitation were incorporated into the analysis. The statistical significance level was set at 5%.
The analysis included 181 patients (mean age 85.6 years, 82.3% female), with an average daily rehabilitation time of 34.4 minutes during the first week, consisting of 8.6 minutes lying, 12.5 minutes standing/walking, and 13.3 minutes sitting. Replacing one minute of lying time with standing/walking per day significantly increased mFIM gain (B = 1.03, 95% confidence interval: 0.54 – 1.52, p 0.001). No significant association was observed when lying time was substituted with sitting time (B = 0.29, −0.22 – 0.79, p = 0.26).
Substituting time spent in the lying position with standing and walking activities during rehabilitation in the acute phase could significantly enhance functional recovery in older patients with HF.
The results suggest that promoting physical activity, such as standing and walking, may be more beneficial than therapeutic interventions in the lying position during acute rehabilitation for patients with HF, where the time available for rehabilitation is limited.
rehabilitation
physical activity
