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The purpose of this review was to examine the utility and accuracy of commercially available motion sensors to measure step-count and time spent upright in frail older hospitalized patients. A database search (CINAHL and PubMed, 2004-2014) and a further hand search of papers' references yielded 24 validation studies meeting the inclusion criteria. Fifteen motion sensors (eight pedometers, six accelerometers, and one sensor systems) have been tested in older adults. Only three have been tested in hospital patients, two of which detected postures and postural changes accurately, but none estimated step-count accurately. Only one motion sensor remained accurate at speeds typical of frail older hospitalized patients, but it has yet to be tested in this cohort. Time spent upright can be accurately measured in the hospital, but further validation studies are required to determine which, if any, motion sensor can accurately measure step-count.

Background An acute hospital admission often means that patient's mobility can decline if not maintained and encouraged throughout their inpatient stay. The "Buddy Walking Programme" is a joint initiative between the physiotherapy department, nursing department and hospital volunteers. The aim of this research was to implement a hospital "Buddy Walking Programme" within a teaching hospital in Cork to allow the provision of accompanied walking sessions by members of the hospital's volunteer team. Methods Ward based physiotherapy staff and nursing staff identify suitable patients and add their bed number and mobility status to a list each morning. Patients are identified who are independently mobile or can safely mobilise with the supervision of one person, with or without a mobility aid and who are cognitively capable of simple commands. Physiotherapists and nursing staff are made aware of the programme at induction. Volunteers partake in an educational session and manual handling training prior to offering supervised walking sessions. Results A standard operating procedure has been developed for the "Buddy Walking Programme". Training has been rolled out hospital wide amongst nursing staff, physiotherapy staff and hospital volunteers. Conclusion This programme will help encourage a culture of physical activity within the hospital in-patient setting and improve mobility levels. Further research is warranted to explore the beliefs and perceptions of hospital staff and volunteers regarding the initiative and to examine barriers and facilitators to the programme. [ABSTRACT FROM AUTHOR]

Objective To measure the step-count accuracy of an ankle-worn accelerometer, a thigh-worn accelerometer, and a pedometer in older and frail inpatients. Design Cross-sectional design study. Setting Research room within a hospital. Participants Convenience sample of inpatients (N=32; age, ≥65 years) who were able to walk 20m independently with or without a walking aid. Interventions Patients completed a 40-minute program of predetermined tasks while wearing the 3 motion sensors simultaneously. Video recording of the procedure provided the criterion measurement of step count. Main Outcome Measures Mean percentage errors were calculated for all tasks, for slow versus fast walkers, for independent walkers versus walking-aid users, and over shorter versus longer distances. The intraclass correlation was calculated, and accuracy was graphically displayed by Bland-Altman plots. Results Thirty-two patients (mean age, 78.1±7.8y) completed the study. Fifteen (47%) were women, and 17 (51%) used walking aids. Their median speed was .46m/s (interquartile range [IQR], .36–.66m/s). The ankle-worn accelerometer overestimated steps (median error, 1% [IQR, −3% to 13%]). The other motion sensors underestimated steps (median error, 40% [IQR, −51% to −35%] and 38% [IQR −93% to −27%], respectively). The ankle-worn accelerometer proved to be more accurate over longer distances (median error, 3% [IQR, 0%–9%]) than over shorter distances (median error, 10% [IQR, −23% to 9%]). Conclusions The ankle-worn accelerometer gave the most accurate step-count measurement and was most accurate over longer distances. Neither of the other motion sensors had acceptable margins of error. [ABSTRACT FROM AUTHOR]

Background: Older adults experience functional decline in hospital leading to increased healthcare burden and morbidity. The benefits of augmented exercise in hospital remain uncertain. The aim of this trial is to measure the short and longer-term effects of augmented exercise for older medical in-patients on their physical performance, quality of life and health care utilisation.Design& Methods: Two hundred and twenty older medical patients will be blindly randomly allocated to the intervention or sham groups. Both groups will receive usual care (including routine physiotherapy care) augmented by two daily exercise sessions. The sham group will receive stretching and relaxation exercises while the intervention group will receive tailored strengthening and balance exercises. Differences between groups will be measured at baseline, discharge, and three months. The primary outcome measure will be length of stay. The secondary outcome measures will be healthcare utilisation, activity (accelerometry), physical performance (Short Physical Performance Battery), falls history in hospital and quality of life (EQ-5D-5 L).Discussion: This simple intervention has the potential to transform the outcomes of the older patient in the acute setting.Trial Registration: ClinicalTrials.gov Identifier: NCT02463864 , registered 26.05.2015. [ABSTRACT FROM AUTHOR]