1. CAN A MOVEMENT SENSOR CAPTURE FUNCTIONAL ACTIVITY TYPICALLY UNDERTAKEN IN HOSPITAL BY PATIENTS RECOVERING FROM CRITICAL ILLNESS? Jayne Anderson Lecturer Practitioner Physiotherapist HEYHT PhD Student York St John University

2. Aims Rationale for the research Methodology Proposed analysis of results Anticipated value of the research

3. ‘Functional activity’ in the hospital setting Sitting over the edge of the bed Getting out of bed Transferring from a bed to a chair Moving from sitting to standing Walking variable distances Climbing stairs

4. How active are patients in hospital? ‘Older acutely hospitalised medical patients with walking ability spent 17 hours a day of their ‘in hospital’ time in bed’ 1 ‘Total time upright (not necessarily walking) in the first four days following upper abdominal surgery: 3 minutes on day 1, 8.2 minutes on day 2, 7.6 minutes on day 3 and 34.4 minutes on day 4’ 2 1 Pedersen M.M, Bodilson A.C, Petersen J et al., Twenty-four-hour mobility during acute hospitalization in older medical patients. J Gerontology A Biol Sci Med Sci. 2013 March; 68(3): 331-337. 2 Browning L, Denehy L, Scholes R.L. The quantity of early upright mobilisation performed following upper abdominal surgery is low: an observational study. Australian Journal of Physiotherapy 2007; 53: 47-52

5. What about those recovering from critical illness? ‘Of 61 participants who walked 100ft on their last day of an intensive care unit stay, 14 did not walk at all on the first full day back on the ward, 22 walked less than 100ft and 25 ambulated 100ft or more’ Hopkins, R.O, Miller III R.R, Rodriguez L et al. Physical therapy on the wards after early physical mobility in the intensive care unit. Physical Therapy 2012; 92 (12): 1518-1523

6. The Actigraph TM GT3X Accelerometer Inclinometer –Body position Physical activity count Step count

7. Methodology [1] How well does the Actigraph TM GT3X accelerometer detect physical activity, body position and postural transition? Validation study Healthy population n = 30 Ethics - YSJU, REC and NHS R and D approval Location – Ward 7, Castle Hill Hospital, Cottingham, East Yorkshire

8. Methodology [2] Informed consent process Accelerometers worn around the waist and ankle Healthy participants will undertake a movement protocol –Lying to sitting over the edge of a bed –Sitting to standing –Walking a ten metre distance All movements will undergo video recording time synchronised with the accelerometers

9. Proposed analysis of the results [1] Data captured from the accelerometers will be compared against the time synchronised video footage. Inclinometer setting: –0 - not wearing –1 - standing –2 - lying –3 - sitting

10. Proposed analysis of the results [2] Agreement between accelerometer data and that observed from video analysis –Categorical data - inclinometer (Kappa statistic) –Continuous data - step count (Bland Altman) Repeatability of measurements –Value of the area under the curve

11. Anticipated value of the research I dentification of prolonged sedentary behaviour M easurement of outcome in trials of new rehabilitation interventions These functional activities are not solely undertaken P atients recovering from critical illness. Effective utilis A tion of rehabilitation resources Feedback for the C linician Feedback for the pa T ient I - M - P - A - C - T

12. Any Questions?