Association of Posture and Ambulation With Function 30 Days After Hospital Discharge in Older Adults with Heart Failure

Theresa A. Floegel, Jared Dickinson, Cheryl Der Ananian, Marianne McCarthy, Steven P. Hooker, Matthew Buman

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: The aim of this work was to investigate the predictive value of in-hospital posture and ambulatory activity for 30 days following discharge on functional status in older patients with heart failure. Methods and Results: We undertook a prospective observational pilot study of 27 patients (78 ± 9.8 y, 51.8% female) admitted with heart failure. Participants wore 2 inclinometric accelerometers to record posture in-hospital and an ankle accelerometer to record ambulatory activity in-hospital and 30 days after discharge. Function was assessed on the day after discharge (Timed Up and Go [TUG], Short Physical Performance Battery [SPPB], hand grip strength) and 30 days after discharge. Length of stay was 5.1 ± 3.9 days. Participants spent 63.0 ± 19.2% of their hospital time lying down, 30.2 ± 18.7% sitting, 5.3 ± 4.2% standing, and 1.9 ± 8.6% ambulating. Thirty-day mean post-discharge stepping was 4890 ± 2285 steps/day. Each 10% increase in hospital lying time was associated with 0.7 s longer TUG time (95% confidence interval [CI] 0.2–1.9) at 30 days. Each 1000 additional daily steps in the post-discharge period was associated with a 0.8-point higher SPPB score (95% CI 0.1–1.0) at 30 days. Handgrip strength was unchanged. Conclusions: Older patients with heart failure were sedentary during hospitalization, which may contribute to decreased functional performance. Physical activity after discharge may minimize this negative effect.

Original languageEnglish (US)
Pages (from-to)126-130
Number of pages5
JournalJournal of Cardiac Failure
Volume24
Issue number2
DOIs
StatePublished - Feb 1 2018

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Posture
Walking
Heart Failure
Hand Strength
Confidence Intervals
Ankle
Observational Studies
Length of Stay
Hospitalization
Exercise

Keywords

  • accelerometry
  • Hospitalization
  • mobility
  • physical function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{9b3ce49d0d1a49cc916c477557f0573a,
title = "Association of Posture and Ambulation With Function 30 Days After Hospital Discharge in Older Adults with Heart Failure",
abstract = "Purpose: The aim of this work was to investigate the predictive value of in-hospital posture and ambulatory activity for 30 days following discharge on functional status in older patients with heart failure. Methods and Results: We undertook a prospective observational pilot study of 27 patients (78 ± 9.8 y, 51.8{\%} female) admitted with heart failure. Participants wore 2 inclinometric accelerometers to record posture in-hospital and an ankle accelerometer to record ambulatory activity in-hospital and 30 days after discharge. Function was assessed on the day after discharge (Timed Up and Go [TUG], Short Physical Performance Battery [SPPB], hand grip strength) and 30 days after discharge. Length of stay was 5.1 ± 3.9 days. Participants spent 63.0 ± 19.2{\%} of their hospital time lying down, 30.2 ± 18.7{\%} sitting, 5.3 ± 4.2{\%} standing, and 1.9 ± 8.6{\%} ambulating. Thirty-day mean post-discharge stepping was 4890 ± 2285 steps/day. Each 10{\%} increase in hospital lying time was associated with 0.7 s longer TUG time (95{\%} confidence interval [CI] 0.2–1.9) at 30 days. Each 1000 additional daily steps in the post-discharge period was associated with a 0.8-point higher SPPB score (95{\%} CI 0.1–1.0) at 30 days. Handgrip strength was unchanged. Conclusions: Older patients with heart failure were sedentary during hospitalization, which may contribute to decreased functional performance. Physical activity after discharge may minimize this negative effect.",
keywords = "accelerometry, Hospitalization, mobility, physical function",
author = "Floegel, {Theresa A.} and Jared Dickinson and {Der Ananian}, Cheryl and Marianne McCarthy and Hooker, {Steven P.} and Matthew Buman",
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AU - Floegel, Theresa A.

AU - Dickinson, Jared

AU - Der Ananian, Cheryl

AU - McCarthy, Marianne

AU - Hooker, Steven P.

AU - Buman, Matthew

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N2 - Purpose: The aim of this work was to investigate the predictive value of in-hospital posture and ambulatory activity for 30 days following discharge on functional status in older patients with heart failure. Methods and Results: We undertook a prospective observational pilot study of 27 patients (78 ± 9.8 y, 51.8% female) admitted with heart failure. Participants wore 2 inclinometric accelerometers to record posture in-hospital and an ankle accelerometer to record ambulatory activity in-hospital and 30 days after discharge. Function was assessed on the day after discharge (Timed Up and Go [TUG], Short Physical Performance Battery [SPPB], hand grip strength) and 30 days after discharge. Length of stay was 5.1 ± 3.9 days. Participants spent 63.0 ± 19.2% of their hospital time lying down, 30.2 ± 18.7% sitting, 5.3 ± 4.2% standing, and 1.9 ± 8.6% ambulating. Thirty-day mean post-discharge stepping was 4890 ± 2285 steps/day. Each 10% increase in hospital lying time was associated with 0.7 s longer TUG time (95% confidence interval [CI] 0.2–1.9) at 30 days. Each 1000 additional daily steps in the post-discharge period was associated with a 0.8-point higher SPPB score (95% CI 0.1–1.0) at 30 days. Handgrip strength was unchanged. Conclusions: Older patients with heart failure were sedentary during hospitalization, which may contribute to decreased functional performance. Physical activity after discharge may minimize this negative effect.

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