Measuring Physical Activity in Hospital Settings: A Scoping Review of Randomized Controlled Trials

Objectives

To identify physical activity and sedentary behavior outcomes, measurement tools and protocols used, and data integrity in randomized controlled trials (RCTs) of hospital-based movement interventions in middle-aged and older adults.

Design

Scoping review of RCTs.

Setting and Participants

Adults with a mean or median age ≥50 years admitted to an acute or subacute hospital.

Methods

Four databases were searched for RCTs published between 2000 and 2023 evaluating interventions and measuring outcomes related to movement behavior (physical activity and/or sedentary behavior) of adults during an acute or subacute inpatient admission. Data extracted included movement behavior outcomes, measurement tools/devices, measurement protocols, and the integrity of movement data. Data were reported and synthesized using frequencies/percentages and via narrative summaries.

Results

After screening (n = 18,018), 34 studies were included. Most studies were conducted in subacute rehabilitation (n = 13) and excluded participants with cognitive impairment (n = 27) and/or mobility impairment (n = 24). A total of 17 different movement behavior outcomes were measured, with step count measured in 22 studies. Most studies (n = 30) measured movement behaviors using a wearable device. There were 43 unique measurement devices/tools used across studies, with significant heterogeneity observed in protocols for their use.

Conclusions and Implications

Given the substantial heterogeneity of movement behavior outcomes, and measurement tools and protocols used, there is an urgent need to develop evidence-based guidelines for measuring movement behaviors in hospital-based trials. Without this, synthesis of clinical trial outcomes and subsequent implementation of effective interventions for improving hospital-based movement behaviors will remain lacking.