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Dean C.1,2,3, Scrivener K.1,2, Dean B.1, Gallagher S.1, Henrisson W.1, Thorburn M.1, Jones T.1,2
1Macquarie University, Department of Health Profession, Macquarie Park, Australia, 2Macquaire University, Centre for Physical Health, Macquarie Park, Australia, 3Royal Rehab, Ryde, Australia
Background: Rehabilitation aims to promote independence by improving functional capacity. Effective rehabilitation should include high levels of activity. However, observational studies have repeatedly found individuals in rehabilitation settings spend long periods of time alone and inactive.
Purpose: To quantify the physical, cognitive and social activity levels of clients undergoing inpatient rehabilitation in a new mixed rehabilitation unit which have implemented strategies to promote activity. These strategies include greater utilisation of multidisciplinary teams, use of volunteers, environmental enrichment and increasing the amount of therapy including use of groups. A secondary aim was to determine if there were any differences between activity levels on weekdays compared with weekends.
Methods: An observational study was conducted utilising behaviour mapping to ascertain activity levels, location, people present and position of individuals undergoing inpatient rehabilitation at Royal Rehab Private Hospital in Sydney Australia. At 10 min intervals over 13 hours, participants location, people present, body position and activity type were recorded on two weekdays and one weekend day. Results were calculated as percentage of time spent performing activities (physical, cognitive, social) and time spent alone and inactive.
Results: 15 participants with a mean age 69 years (SD 7) with varying health conditions were recruited over two periods (March 2015, March 2016). On average participants were engaged in activity for 86% (SD 9) of the day, with physical activity accounting for 51% (SD 11), cognitive activity 28% (SD 10) and social activity 42% (SD 16). There was more physical activity (Mean difference 8%, 95% CI 4 to 12) and less social activity (Mean difference -6%, 95% CI -11 to -1) on weekdays compared to weekends. Overall participants were alone and inactive for 12% (SD 9) of the day. There was no difference in time spent alone and inactive on weekdays compared with weekends (Mean difference 2% 95% CI -3 to 7). Participants observed in 2016 displayed similar results to those observed in 2015.
Conclusion(s): Participants observed in this mixed rehabilitation unit displayed high levels of activity which was sustained over a year. There was more physical activity undertaken on weekdays than the weekend and more social activities undertaken on the weekend than on weekdays.
Implications: The activity levels shown in this study are significantly higher than previously reported research. Royal Rehab Private Hospital has successfully increased the physical, social and cognitive activity levels of their clients. They have utilised the evidence based multidisciplinary approach (group therapy and volunteers) as well as an enriched environment and weekend therapy to encourage their clients to perform more activity. These results suggest that it is possible to achieve higher levels of activity in mix rehabilitation units and to reduce the time clients spent alone and inactive to less than 15%.
Disclosure: Professor Cath Dean is a Director of Royal Rehab, this role is voluntary with no remuneration.
Funding acknowledgements: The research was funded in kind by personnel from the Department of Health Professions, Macquarie University, Sydney Australia
Topic: Disability & rehabilitation
Ethics approval: The Northern Sydney Local Health District, and Macquarie University Human Research Ethics Committees approved the study (HREC reference: HREC/14/HAWKE/357).
All authors, affiliations and abstracts have been published as submitted.
