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Impact of physical activity level and sedentary behavior on postural control and functionality of elderly hospitalized in a geriatric unit

Grant number: 18/19618-8
Support type:Regular Research Grants
Duration: September 01, 2019 - August 31, 2021
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:José Eduardo Pompeu
Grantee:José Eduardo Pompeu
Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Assoc. researchers: Caroline Gil Pigini ; Keith David Hill ; Naomi Kondo Nakagawa


Introduction: Low levels of physical activity and sedentary behavior have been identified in hospitalized elderly people, related to poor health, increased risk of developing pathologies, and increased risk of mortality. Studies associating the low level of physical activity and sedentary behavior with a decrease in functional capacity used questionnaires and interviews to characterize such behavior, which makes less specific results. Using a precise method to identify such behaviors, and correlating the data obtained to understand possible changes in postural control and functionality, are fundamental to identify a possible decline in health and functional status and to determine whether there is a need to plan new prevention practices to sedentary behavior and low physical activity in the hospital environment, minimizing the deleterious effects of the hospitalization of the elderly patients. Objectives: General: To evaluate the impact of physical activity level and sedentary behavior on the postural control and functionality of the elderly hospitalized in a geriatric unit. Specific: Identify the main barriers to ambulation in the patients hospitalized at the ICHC-FMUSP Geriatrics Service Hospitalization Unit. Methods: This is a longitudinal study. Data collection will be performed at the ICHC-FMUSP Geriatrics Service Infirmary. Inclusion criteria: Patients aged 60 years or older who have minimal level of consciousness to respond to commands and are able to wander even with the use of ancillary device. Exclusion criteria: hospitalized for more than 48 hours; have restriction prescription in the bed; in contact or respiratory isolation; are in delirium or in clinical instability; are not able to answer the questionnaires and do not have an accompanying person / person who can answer for them; presence of skin lesions that prevent accelerometer fixation; that do not complete the evaluations by refusal, intercurrences or by not understanding the tests; discontinue use of the accelerometer; that exceed the total of 20 days of hospitalization; that re-enter the unit during the study period. Personal and clinical data will be collected from the electronic medical record to characterize the sample. The following questionnaires will be applied to evaluate mobility, functionality, physical activity level, fear of falling and identify depressive symptoms: Life space Assessment; Barthel Index; International Physical Activity Questionnaire - Short Form; Fall Eficacy Scale; Geriatric Depression Scale. Patients will also undergo four clinical tests: Mental State mini-exam to assess cognition; Timed up and Go with G-Walk Sensor to assess mobility accurately; Palmar grip strength to measure muscle strength; Brief-Balance Evaluation Systems Test to test the balance; evaluation of the static posture in the force platform for the evaluation of postural control; and the use of the accelerometer during hospitalization time to measure the level of physical activity. Patients will be reassessed at the time of hospital discharge, three months and six months after hospital discharge through scheduled outpatient returns. Data Analysis: Sample characterization data will be analyzed through descriptive analysis and presented as frequency, mean and standard deviation. The Covariance Analysis will be performed to analyze the effect of the influence of an uncontrolled variable on a response variable. All analyzes will be processed in the SPSS software, adopting the significance level of 5% (p <0.05). (AU)