Technology-assisted physical activity among hospitalized medical patients: a cluster randomized trial

AIMS: Hospitalization is associated with physical inactivity, resulting in loss of functional capacity and elevated risk of complications for medical patients. The aim of the study is to assess the effect of an accelerometer-based physical activity monitoring system with visual feedback and encouragement to increase walking activity on time spent out of bed during hospitalization. METHODS AND RESULTS: This study is a cluster randomized trial performed in a tertiary hospital in Denmark. A total of 354 adults with independent ambulatory function were admitted to one of four medical wards (two cardiology, one respiratory, and one geriatric). Intervention group was encouraged to walk via the accelerometer-based physical activity recording system with visual feedback on a tablet placed on the bedside table for 1-7 days. Control group had the same physical activity recording but without feedback or encouragement. Primary outcome was the average time spent out of bed in minutes per day. Secondary outcomes included number of steps, length of stay, readmission, and mortality. Mean age of the participants was 72.9 years, and 53% were females. On average, the intervention and control groups spent 143.5 (SD 96.6) and 120.8 (SD 75.2) min/day out of bed, respectively. Intervention group spent 23.6 min more out of bed per day (95% CI 13.7-33.5) and took 440 steps/day more than the control group. No significant differences were observed between groups for length of stay, readmissions, falls, or mortality. CONCLUSION: Among hospitalized patients, technology-assisted physical activity monitoring with visual feedback significantly increases daily time out of bed, approaching clinically meaningful thresholds for improving functional outcomes and reducing adverse events. REGISTRATION: ClinicalTrial.gov.: NCT04555330.