title: Twenty-four-hour mobility during acute hospitalization in older medical patients.
abstract: BACKGROUND
  Inactivity during hospitalization in older medical patients may lead to functional decline. This study quantified 24-hour mobility, validated the accelerometers used, and assessed the daily level of basic mobility in acutely admitted older medical patients during their hospitalization.
  
  
  METHODS
  This is a prospective cohort study in older medical patients able to walk independently (ambulatory patients) and those not able to walk independently (nonambulatory patients) on admission. The 24-hour mobility level during hospitalization was assessed by measuring the time in lying, sitting, and standing and/or walking, by two accelerometers. Basic mobility was quantified within 48 hours of admission and repeated daily throughout hospitalization.
  
  
  RESULTS
  Forty-three ambulatory patients and six nonambulatory patients were included. The ambulatory patients tended to be hospitalized for fewer days than the nonambulatory patients (7 vs 16, p = .13). The ambulatory patients were lying median 17 hours, (interquartile range [IQR]: 14.4-19.1), sitting 5.1 hours (IQR: 2.9-7.1), and standing and/or walking 1.1 hours (IQR: 0.6-1.7) per day. On days with independency in basic mobility, the ambulatory patients were lying 4.1 hours less compared with days with dependency in basic mobility (p < .0001), sitting 2.4 hours more (p = .0004), and standing 0.9 hours more (p < .0001). The algorithm identification for lying, sitting, and standing and/or walking of the accelerometers, corresponded by 89%-100% with positions performed by older medical patients.
  
  
  CONCLUSIONS
  Older acutely hospitalized medical patients with walking ability spent 17h/d of their in-hospital time in bed, and the level of in-hospital mobility seemed to depend on the patients' level of basic mobility. The accelerometers were valid in assessing mobility in older medical patients.
authors.affiliation: Clinical Research Centre (136), Copenhagen University Hospital, Hvidovre, DK-2650 Hvidovre, Denmark. mette.merete.pedersen@hvh.regionh.dk
authors.forename: Mette Merete
authors.initials: MM
authors.lastname: Pedersen
authors.forename: Ann Christine
authors.initials: AC
authors.lastname: Bodilsen
authors.forename: Janne
authors.initials: J
authors.lastname: Petersen
authors.forename: Nina
authors.initials: N
authors.lastname: Beyer
authors.forename: Ove
authors.initials: O
authors.lastname: Andersen
authors.forename: Louise
authors.initials: L
authors.lastname: Lawson-Smith
authors.forename: Henrik
authors.initials: H
authors.lastname: Kehlet
authors.forename: Thomas
authors.initials: T
authors.lastname: Bandholm
mesh_terms: D061725:Accelerometry; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001510:Bed Rest / Q000706:statistics & numerical data*; D003718:Denmark; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D051346:Mobility Limitation; D011446:Prospective Studies; D016138:Walking