1. N Frowd7, J Darby1, G Arnold 1, JRF Gladman1
Are accelerometers a useful way to measure activity in care home residents?
GM Walker1, PA Logan1*, A L Gordon2, S Conroy3, S Armstrong4, K Robertson5, M Ward6,
N Frowd7, J Darby1, G Arnold 1, JRF Gladman1
1Division of Rehabilitation and Ageing, University of Nottingham, 2Nottingham University Hospitals NHS Trust, Nottingham, 3fUniversity of Leicester School of Medicine, University Hospitals of Leicester , 4 NIHR Research Design Service for the East Midlands, Faculty of Medicine & Health Sciences, 5Research and Innovation, Nottinghamshire Healthcare NHS Trust, 6Nottingham CityCare Partnership, Nottingham, 7Arthritis Research UK Pain Centre, The University of Nottingham
Introduction
To achieve health benefits 8000 steps/day, and 20 minutes per day at an exercise intensity >3 METs is recommended (Shephard et al, 2010)
Accurate measurement of activity in care home residents is important for monitoring and evaluating interventions for activity promotion (Myers, 1999) .
Accelerometers provide a potential method.
However, their usefulness in this population has not been well documented.
Aim
To evaluate the accuracy of the activity data
To evaluate the feasibility and tolerability of study procedures and device wear in an elderly care home population with a history of falls.
Results
10/16 residents aged between years agreed to wear accelerometers.
7 residents wore them for 7 days and the remainder for 4, 5 and 6 days respectively.
No falls were recorded.
Data indicated 1 resident continuously standing which was verified not to be the case by observation.
Non-waterproof attachment (PAL stickie & Micropore) method was not used.
Accelerometers and attachment materials total cost: £
Problems were:
Data disturbance through removal/fidgeting
Hydrofilm dressing flaccidity
Premature detachment
Care staff non-compliance to waterproof continuous wear,
Resident skin check non-compliance
Prior leg ache attributed to accelerometers (with no worsening)
Pink skin
Activity restriction by care staff.
Method
Inclusion criteria:
Long stay nursing/residential/old age/dementia registered care homes
> 10 beds
Over age 65 years
Fell in the past year
Provided consent
Exclusion criteria:
Bed bound (defined as only movable by hoist)
Wheelchair bound
Near death/terminal
Injury/skin abrasion on both thighs
Procedure:
Residents asked to wear (ActivPAL3TM) on the lower thigh for 7 days.
Tissue viability nurse consulted to advise safety and local acceptability of dressing methods.
Care staff were trained in device application, wear methods, data recording and provided with spare application materials and staff contact details.
Users’ skin and problems with use were checked daily.
Activity data sought were: step count, time sedentary, time standing and Metabolic Equivalent of Task (METs).
Care records were checked for falls.
Table 2. Activity per day
 n=9
Steps
Sedentary (mins)
Standing (mins)
METs
Minutes >3 METs
Mean (SD)
832 (914.63)
(79.68)
77.67 (53.16)
4.95 (5.64)
Median (IQR)
1.26 ( )
Range
Conclusion
In this feasibility study of care home residents tri-axial accelerometers were so problematic to be of negligible use for the older aged care home population and we will not be using them in our definitive trial.
We found: they were not accurate, not acceptable to all, are often not tolerated for long, and there were indications that they affected behaviour and became an intervention in it’s own right.
For these reasons they are not a suitable outcome measure for old age residents dwelling in care homes.
Activity levels, where accurately recorded were in keeping with published literature showing care residents to be highly sedentary (Barber, Forster, & Birch, 2014).
The research presented here does not preclude accelerometer use in some individuals, given these limitations to provide an objective measure of activity.
Method of wear:
Waterproof continuous wear (24 hours): nitrile sleeve covering accelerometer from the connecter end, wrapped in a hydrofilm sheet, attached to the central lower thigh using a sheet of 10 x 15cm hydrofilm dressing. Can bath/shower with device attached. Non-waterproof method was optional (PAL stickie & Micropore).
*Professor Pip Logan: Corresponding author. Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Queens Medical Centre, Derby road, NG7 2UH, UK. Telephone:
This poster presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Funding Scheme (PB-PG ). The views expressed in this poster are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.