Critical Illness, Motor Activity, Sedentary Lifestyle
Conditions
Keywords
accelerometry
Brief summary
This study aims to describe the pattern of active and sedentary time in survivors of a critical illness, at three time points during their hospital admission (awakening in the ICU after ≥ 5 days of mechanical ventilation, discharge to ward and discharge from hospital). The specific research objectives are to 1. Determine the duration of active and sedentary parameters including time and bouts in 24 hour periods 2. Examine changes in the active and sedentary parameters including time and bouts between time points of awakening and both ICU and hospital discharge. 3. Conduct a preliminary examination of relationships between activity and sedentary behaviour metrics with measures of muscle strength, physical function and hospital length of stay.
Detailed description
This is a prospective observational study that consecutively samples eligible patients with a critical illness, requiring intensive care. This study will use two activity monitors (accelerometers) to measure physical activity and sedentary variables from patients recovering from a critical illness in a single tertiary hospital on three occasions during their acute hospital admission. Accelerometer derived measures will be obtained from continuous 24 hour monitoring periods once patients are sufficiently awake and attentive within the ICU, at ICU discharge and again at acute hospital discharge. Measurements of patients muscle strength and physical function will also be made at the time of accelerometry.
Interventions
None listed
Sponsors
Australian Physiotherapy Research Foundation
University of Leicester
University of South Australia
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patient ≥ 18 years of age * Patient is/was intubated (endotracheal, nasotracheal or tracheostomy) and required ≥ 5 days of mechanical ventilation (irrespective of reason for ventilatory support)
Exclusion criteria
* Unable to ambulate independently (either with or without gait aids) at least 10 meters within the last 3 months * Ordinarily unable to understand written and spoken English sufficient to provide consent (e.g. due to non-English speaking background or pre-existing cognitive impairment) * Assessed by medical staff as approaching imminent death or withdrawal of medical management
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sedentary time | Change between events (each event assessed over 24 hours): From closest to the date of awakening in ICU (after at least 5 days of mechanical ventilation, assessed up to 4 months) to closest to the date of ICU discharge (assessed up to 6 months) | Total time in minutes over 24 hours periods spent: at a sedentary activity threshold, and in body positions of sitting/lying. Minute data derived from 2 accelerometers worn concurrently on each measurement occasion (wrist worn geneactiv for activity thresholds and thigh worn activpal for body postures) |
| Physical activity bouts | Change between events (each event assessed over 24 hours): From closest to the date of awakening in ICU (after at least 5 days of mechanical ventilation, assessed up to 4 months) to closest to the date of ICU discharge (assessed up to 6 months) | Total number of bouts of physical activity over 24 hours periods spent: in light, moderate and vigorous activity thresholds, in body positions of standing, walking and upright. Data on number of bouts derived from 2 accelerometers worn concurrently on each measurement occasion (wrist worn geneactiv for activity thresholds and thigh worn activpal for body postures) |
| Sedentary bouts | Change between events (each event assessed over 24 hours): From closest to the date of awakening in ICU (after at least 5 days of mechanical ventilation, assessed up to 4 months) to closest to the date of ICU discharge (assessed up to 6 months) | Total number of bouts of sedentary time over 24 hours periods spent: at a sedentary activity threshold, and in body positions of sitting/lying. Data on number of bouts derived from 2 accelerometers worn concurrently on each measurement occasion (wrist worn geneactiv for activity thresholds and thigh worn activpal for body postures) |
| Physical activity time | Change between events (each event assessed over 24 hours): From closest to the date of awakening in ICU (after at least 5 days of mechanical ventilation, assessed up to 4 months) to closest to the date of ICU discharge (assessed up to 6 months) | Total time in minutes over 24 hours periods spent: at light, moderate and vigorous activity thresholds, in body positions of standing, walking and upright. Minute data derived from 2 accelerometers worn concurrently on each measurement occasion (wrist worn geneactiv for activity thresholds and thigh worn activpal for body postures) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Low level physical function/mobility | Change between events (each event assessed within 24 hours): From closest to the date of awakening in ICU (after at least 5 days of mechanical ventilation, assessed up to 4 months) to closest to the date of ICU discharge (assessed up to 6 months) | Assessed with the PFIT (physical function in ICU test), reported as an interval score /10 |
| Peripheral muscle strength | Change between events (each event assessed within 24 hours): From closest to the date of awakening in ICU (after at least 5 days of mechanical ventilation, assessed up to 4 months) to closest to the date of ICU discharge (assessed up to 6 months) | Assessed with the medical research council (MRC) sum score, reported as a raw score /60 and categorically (yes/no) to indicate the presence of ICU acquired weakness (scores \< 48/60 indicative of clinically significant weakness) |
| Hand grip strength | Change between events (each event assessed within 24 hours): From closest to the date of awakening in ICU (after at least 5 days of mechanical ventilation, assessed up to 4 months) to closest to the date of ICU discharge (assessed up to 6 months) | Assessed with hand grip dynamometry in kilograms |
| High level physical function/mobility | Change between events (each event assessed within 24 hours): From closest to the date of awakening in ICU (after at least 5 days of mechanical ventilation, assessed up to 4 months) to closest to the date of ICU discharge (assessed up to 6 months) | Assessed with the DEMMI (deMorton mobility index), reported as an interval score /100 |
Other
| Measure | Time frame | Description |
|---|---|---|
| Intensive Care unit (ICU) length of stay | Time to event: from the date of hospital admission to the date of ICU discharge (up to 6 months) | Based on hospital record data, reported in number of days. Associations with primary outcomes to be reported. |
| Discharge destination | Event: date of hospital discharge (up to 12 months) | Based on hospital record data, categorised as home, inpatient rehabilitation, another acute/community hospital, nursing home, other. Associations with primary outcomes to be reported. |
| Acute hospital length of stay | Time to event: from the date of hospital admission to the date of hospital discharge (up to 12 months) | Based on hospital record data, reported in number of days. Associations with primary outcomes to be reported. |
Outcome results
None listed