Activity patterns in elderly people admitted to an Aged Care ward

Investigators: Mr Paul Smith, Prof Mary Galea, Dr Michael Woodward

There is a lack of hard evidence of the benefits of six or seven day rehabilitation service. This project comprised an observational study aimed at quantifying patterns of physical activity in elderly patients admitted to Austin Health Aged Care Services for rehabilitation, essentially a five-day service. Demonstrating that patients are more active on weekdays than weekends would be a start in exploring the benefits of changing from a five-day service.

The Positional Activity Monitor (PAL1, Fig. 1) measures cumulative uptime by recording values each time the PAL1 changes from an "up" position to a "down" position. This allows examination of the pattern of uptime for each subject for any epoch within the total time recorded. We used this device to measure the frequency and duration of uptime (standing) and downtime (lying or sitting).

Subjects wore the PAL1 continuously over a three-day period including a weekend day. Preliminary results in eleven subjects demonstrate differences in the amount and pattern of physical activity between weekdays and weekends (when physiotherapy was not provided). There was an average of 48 stand ups and total uptime of 88 minutes per day on a weekday compared to 34 stand ups and total uptime of 70 minutes for a weekend day. A Wilcoxon Signed Ranks Test demonstrated a significant difference in the number of stand ups between weekdays and weekends (p=0.004) as well as for Daily Total Uptime (p=0.008).

In this small sample a difference in physical activity on weekends and weekdays was observed. Further information needs to be collected to examine the reasons for this and explore and develop strategies to optimise patients levels of physical activity, including the need for a six or seven day rehabilitation service.

Figure 1.   The PAL1 is attached to the thigh with Tegaderm and worn continuously over a three-day period

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