An explorative study of current strategies to reduce sedentary behaviour in hospital wards

Abstract

Prolonged sitting (or sedentary behaviour—SB) has profound detrimental effects on health and is associated with increased risk of chronic disease, hospitalisation and premature death. However, while in hospital, a person will spend the vast majority of the day sitting or lying down. A number of strategies have started to be implemented to counteract this phenomenon and get patients up and moving. This is the first explorative study that used device-based measurements of the postural physical activity of older hospitalised adults taking part in such initiatives. A total of 43 patients, mean age 83.8y (SD 8.3), wore a waterproofed activity monitor (activPAL3) for 4 days (including overnight); physical activity was analysed for waking hours. Interventions designed to get patients up and moving were introduced sequentially. Participants were grouped based on the highest level of intervention they received. There were 4 groups: “control” (n = 12), “education” (advice on SB reduction via infographics on the ward noticeboards, n = 12), “#endpjparalysis” (up and dressed by the nurses before 11: 30 am, n = 9), “personalised activity passports” (agreed by Occupational Therapists and other members of the multidisciplinary team with patients, on SB reduction, n = 10). ANOVA revealed the absence of any differences between the 4 groups for total sitting time (p = 0.989), time spent upright (standing and walking) (p = 0.700), number of sitting events (i.e. sit to stand transitions) (p = 0.418) and longest upright period (p = 0.915). This small explorative study of sequential initiatives within a ward setting to reduce SB found they were not successful. The cross-sectional service-improvement nature of the study limited the ability to assess change in individuals as interventions were introduced. Further work is warranted to untangle the determinants of SB in hospital settings and implement interventions of sustainable SB change in this setting.