During hospitalization, 'getting out of bed' might be more important than whether one is walking.

📖 Literature Information and Abstract Translation

The Necessity of Focusing on SLEEP in Physical Activity Levels of Hospitalized Patients with Trunk and Lower Extremity Fractures

[Background/Objective] While it is known that bed rest is important for hospitalized elderly patients, current methods of interpreting physical activity (PA) recommend the use of Sleep (SL) and Sedentary Behavior (SB), which includes a broad range of sitting activities with metabolic equivalents (METs) of 0–1.5.

This recommendation seems appropriate for community-dwelling elderly people who rarely lie in bed during the day. However, hospitalized elderly patients often lie in bed, so it was thought that it might be desirable to interpret METs by separating lying down from sitting, rather than using SB which includes lying down..

[Methods] We conducted a cross-sectional study on 25 elderly patients with trunk and lower extremity fractures to investigate the characteristics of PA. PA intensity was interpreted as SL (0–0.9 METs), SB (1–1.5 METs), LIPA (1.6–2.9 METs), and MVPA (>3.0 METs). To clarify the relationship between each intensity level, the following two correlation coefficients were calculated.

[Results] It was revealed that PA time (min/day) was occupied by SB (53.5%), SL (23.2%), LIPA (22.8%), and MVPA (0.5%).

(1) Relationship between each physical activity intensity
Negative correlations were observed between SL and SB (r = -0.837) and between SL and LIPA (r = -0.705), while positive correlations were observed between SB and LIPA (r = 0.346) and between LIPA and MVPA (r = 0.429).

(2) Relationship between each physical activity intensity and physical function
Furthermore, regarding the relationship with physical function, it was found that SL and SB show different trends.

[Conclusion] These results indicate that SL and SB have a trade-off relationship for daytime PA. Therefore, it is recommended that SL and SB in elderly hospitalized patients be interpreted separately.

🌱 So What?: What did I find interesting?

This is my own work.
Perhaps this study is a bit difficult to understand for those unfamiliar with physical activity levels.
The core of the argument is as follows:
"For community-dwelling elderly people, it might not be necessary to distinguish between sleeping and sitting, but it is different for elderly hospitalized patients. It is highly likely that whether they are out of bed (awake) is what matters first."

The history of the study I read this time is personally long.
Soon after I started, the COVID-19 pandemic engulfed the hospital.
Then, the definitions of various movement restrictions (within the ward, within the room, within the hospital) began to change constantly.
In the beginning, these were some of the few subjects I was able to measure while the situation was stable.
The data from this pilot study was suggested by those individuals.
In this study, I plan to perform multivariate analysis on variables such as pain, pain catastrophizing, and apathy to clarify the factors that promote or hinder physical activity levels. It is an analysis that requires a large number of subjects.
I really don't know when I will be able to complete it.
However, I do not intend to be pessimistic.

It is also true that there are channels that were opened up after the COVID-19 pandemic arrived.
・Remote rehabilitation within the hospital during hospitalization began to be considered
・Topics regarding the introduction of wearable devices increased
・Light began to be shed on how to conduct hands-off patient education

Just because the established channel is closed does not mean it is the end.
Strengthen the water flow. Let it gush more.
Force open the channel. Right here, right now.
Whether it is an established channel or a new one, it does not matter.
The path forced open by the current maximum water flow is the next path.
The channel that breaks through the evolutionary pressure will become the next trend.
That is all.
Instead of the reality I desire,
let us trust in ourselves to be able to grow from a completely unexpected reality!

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