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In-Hospital Physical Activity Predicts Swallowing Function at Discharge in Patients With Hip Fracture: A Prospective
Kenichiro Maekawa1, Toshiya Nishiwaki1, Takuma Yagi2
1Department of Rehabilitation, Kobe Rehabilitation Hospital, Kobe, Japan.
Objective:
To investigate the impact of physical activity during hospitalization on swallowing function at discharge in patients with hip fractures admitted to convalescent rehabilitation wards.
Design:
Prospective observational study.
Setting:
Convalescent rehabilitation wards in Japan.
Participants:
Of the 197 patients admitted with hip fractures between January 2021 and December 2023, 148 patients aged ≥65 years were analyzed (mean age 83.1±7.9 y; 79.0% women). Patients were excluded if they declined participation (n=13), were transferred because of worsening conditions (n=6), had dementia (n=15), had weight-bearing restrictions (n=5), or had missing data (n=10).
Interventions:
None.
Main Outcome Measures:
Swallowing function was assessed at discharge using the Repetitive Saliva Swallowing Test (RSST). Physical activity was measured via a triaxial accelerometer placed on the anterior superior iliac spine during the first and last 5 days of hospitalization. Activity time was defined as the duration (minutes) spent in movements ≥2.0 metabolic equivalent of tasks. Step count was also recorded. Multiple linear regression analyses were conducted to examine the association between physical activity parameters and RSST scores.
Results:
Median daily activity time was 61.2 (43.5, 94.2) minutes at admission, 99.6 (77.0, 133.5) minutes at discharge, and 813.0 (631.0, 1127.5) minutes in total. Median daily step counts were 134.9 (66.1, 412.1) at admission, 1018.4 (351.0, 2545.0) at discharge, and 6909.0 (2400.0, 15,110.0) in total. The results of multiple linear regression analyses showed that activity time at admission (β=0.178; P=.032), at discharge (β=0.218; P=.010), and total activity time (β=0.299; P=.047) were significantly associated with RSST scores at discharge. Step counts showed no significant associations.
Conclusions:
In patients with hip fractures in convalescent rehabilitation wards, increased physical activity time during hospitalization was positively associated with improved swallowing function at discharge.
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