Objective Measurement of Physical Activity Over Time in Older Adults with Heart Failure
Taylor, Catherine Lee
Older adults with heart failure are at a greater risk for mortality, hospitalizations, and poorer health when their physical function and movement is limited. However, little objective data is available identifying functional decline or functional trajectory over time in this population. This limits the ability to develop (e.g. identify critical time periods for intervention) or evaluate nursing interventions (e.g. identify norms with which to compare) aimed at improving or maintaining function. Daily step activity, measured by accelerometry, has been used to quantify physical activity (PA) and has been shown to be associated with physical function level. We explored the use of objective accelerometry to measure PA over time in a sample of community-dwelling older adults with heart failure who had a recent hospitalization for their condition. We used a longitudinal design to measure bi-weekly steps for 4 months. Steps were measured using the Fitbit Alta affixed to the ankle with a nylon band. Participants wore the device at all times, with the exception of bathing. Preliminary data includes results from six participants with New York Heart Association (NYHA) class III heart failure. They were 76.1 4.1 years, BMI range 21.5 to 38.8 kg/m2, and mean ejection fraction of 38.3% 8.2%. The sample was 16.7% female (n=1) and 33.3% African American (n=2). Participants had 82.1% recorded step data across the study. Reasons for missing data were device not worn for a period of time or user initialization issue. During the first week, participants had an average recorded step count of 1586 868 steps per day. At week 16, participants took an average of 1831 1712 steps a day. Five out of six participants had at least one week of less than 2000 average daily recorded steps. The highest recorded “stepper” averaged 6159 daily steps during week 8, while the lowest averaged only 280 recorded steps a day during week 8. These preliminary findings provide support for long term use of accelerometry to capture PA in older adults with heart failure. Findings from the larger trial will explore the association of stepping activity and physical function. The use of accelerometry has the potential to quantify daily function without the need of physical assessment or use of invasive measures. These findings will support development of nursing interventions to improve or maintain physical function after hospital discharge.
Taylor, Catherine Lee. (May 2019). Objective Measurement of Physical Activity Over Time in Older Adults with Heart Failure (Honors Thesis, East Carolina University). Retrieved from the Scholarship. (http://hdl.handle.net/10342/7292.)
Taylor, Catherine Lee. Objective Measurement of Physical Activity Over Time in Older Adults with Heart Failure. Honors Thesis. East Carolina University, May 2019. The Scholarship. http://hdl.handle.net/10342/7292. September 26, 2020.
Taylor, Catherine Lee, “Objective Measurement of Physical Activity Over Time in Older Adults with Heart Failure” (Honors Thesis., East Carolina University, May 2019).
Taylor, Catherine Lee. Objective Measurement of Physical Activity Over Time in Older Adults with Heart Failure [Honors Thesis]. Greenville, NC: East Carolina University; May 2019.
East Carolina University