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",
year = "2018",
month = "2",
day = "1",
doi = "10.1016/j.cardfail.2018.01.001",
language = "English (US)",
volume = "24",
pages = "126--130",
journal = "Journal of Cardiac Failure",
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TY - JOUR

T1 - Association of Posture and Ambulation With Function 30 Days After Hospital Discharge in Older Adults with Heart Failure

AU - Floegel, Theresa A.

AU - Dickinson, Jared

AU - Der Ananian, Cheryl

AU - McCarthy, Marianne

AU - Hooker, Steven P.

AU - Buman, Matthew

PY - 2018/2/1

Y1 - 2018/2/1

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.

AB - 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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U2 - 10.1016/j.cardfail.2018.01.001

DO - 10.1016/j.cardfail.2018.01.001

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