1. Lecturer Practitioner Physiotherapist HEYHT
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
Postural transition
Ultimate aim is to is to achieve independence in these movements – functional and quality of life terms

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 March;
68(3):
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):
Retrospective analysis of notes, first 48 hours following transfer to the ward
Research has evolved out of a desire to understand just how much activity patients undertake through the day as they recover and in theory should e increasing their activity levels. What are they doing?

6. The ActigraphTM GT3X Accelerometer
Inclinometer
Body position
Physical activity count
Step count
What must a movement sensor possess in order to capture all functional activity mentioned earlier
Records changes in acceleration – faster acceleration causes a higher physical activity count, giving an idea of the intensity of activity being carried out – smart phone selling point now
Ability to record in real time
Prolonged data capture time

7. Methodology [1]
How well does the ActigraphTM 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
Does it measure what it is supposed to be measuring?

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
These movements will be undertaken both independently and with assistance from 2 physiotherapists

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
Video footage – criterion measure
Each movement repeated 3 times

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
Identification of prolonged sedentary behaviour
Measurement of outcome in trials of new rehabilitation interventions
These functional activities are not solely undertaken Patients recovering from critical illness.
Effective utilisAtion of rehabilitation resources
Feedback for the Clinician
Feedback for the paTient
I - M - P - A - C - T
Even in further research as a unit itself – resetting of intensity cut off levels for specific patient populations – research has been undertaken within MS population in this way looking at oxygen consumption during activities such as walking.

12. Any Questions?