Interventions to Promote Physical Activity and Reduce Functional Decline in Medical Inpatients: An Umbrella Review.

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Hospital Medicine

Background:

• Physical inactivity is prevalent among hospitalized medical patients.
• Inactivity is linked to adverse patient outcomes and increased functional decline.
• Effective interventions are needed to promote physical activity in hospitals.

Purpose of the Study:

• To review the effectiveness of ward or system-level interventions for improving physical activity in general medical inpatients.
• To assess the impact of these interventions on functional decline, length of stay, discharge, falls, and costs.

Main Methods:

• Umbrella review of systematic reviews.
• Searched multiple databases (PubMed, EMBASE, Cochrane, CINAHL, JBI, Web of Science) for English-language reviews (2000-2023).
• Assessed methodological quality using AMSTAR 2; data synthesized narratively.

Main Results:

• 12 systematic reviews (76 primary studies, 72,645 participants) met inclusion criteria; most reviews were low quality.
• Progressive mobilization interventions improved physical activity, reduced functional decline, and increased home discharge.
• Multicomponent interventions also improved functional decline and home discharge, potentially shortening length of stay.

Conclusions:

• Progressive mobilization and multicomponent interventions are effective for enhancing physical activity and mitigating functional decline in hospitalized medical patients.
• Further high-quality research is needed to refine multicomponent intervention strategies.
• Standardizing terminology for inpatient physical activity is recommended.